Enter & View Visit to Ronald Gibson House Intermediate Care Unit
Posted on 03/08/2018
Intermediate Care (IC) is intended to be a range of integrated services that promote faster recovery from illness; prevent unnecessary acute hospital admissions and premature admissions to long-term care; support timely discharge from hospital; and maximise independent living. IC services in Wandsworth are not yet fully integrated but include both home-based and nursing home care. IC largely serves the needs of older people experiencing difficulty regaining their independence after illness, falls or other injuries.
In line with our current interest in the care of older people and following our visits to senior health wards at St George’s Hospital in September 2017, we were invited by Wandsworth and Merton Clinical Commissioning Group to visit the IC facilities at Ronald Gibson House, a 16-bed unit in a care home on the Springfield Hospital site in Tooting. When we visited there were thirteen patients in the unit. We interviewed eight patients, three relatives and one paid home carer. We also spoke to the GP responsible for medical oversight of the unit, and three other members of staff.
The role identified for intermediate care is clearly an important one. The balance of the feedback we received from patients and their relatives about the standards of care at RGH was largely positive, although some of it led us to wonder about the optimum levels of rehabilitative therapy and also nursing staff levels.
For more details from our visit, a look at the recommendations we made to the unit and their response to those recommendations, please see the attached report.
Wandsworth BME (Black, Minority and Ethnic) Mental Health Forum - 17 May
Posted on 30/05/2018
A full agenda with focussed discussion on feedback from the well-attended BME Young People's Mental Health Conference held in April. A successful conference with value placed upon the importance of creative approaches such as drama and movement in overcoming barriers to conversation about mental health with young people.
Highlighted also was the need for more to be done in collaboration with the services to promote and support recruitment of local young people to jobs in mental health.
Talk Wandsworth's internship programme which is giving work experience to young people from local communities acknowledged that more effort needed to be made to increase the diversity of the clinical staff team in this area.
Healthwatch will continue to support the work of the Forum and contribute to its deliberations.
Please refer to the summary report outlining all points of discussion.
Co-production is now a key element of Talk Wandsworth's contract and a new governance framework has been developed involving the formal recognition of community co-facilitators. Workshops are seen as a great way of reaching some of the 13 "inequality" groups prioritised in the service contract ,and of those groups, four (BME, older people, refugees and victims of domestic violence) have been selected for initial focus.
The service's Step 1 team is being built up and a number of unpaid interns have been recruited with more being sort, particularly from the local community.
Healthwatch recognise the amount of work done and progress achieved with widespread enthusiasm and a range of ideas for more to follow.
Liaison Meeting with St George's Mental Health Trust
Posted on 02/05/2018
This was the third in a new series of liaison meetings under the Trust's Service Line organisation. A new national system, OPEL (Operational Pressure Escalation Levels) has been put in place to alleviate bed pressures. This will help organisations to identify where the pressure is and respond accordingly.
Healthwatch will ask to be involved in the review of the crisis cafes and the Lotus suite to assist service users and carers in having a voice. Along side an invitation to meetings being held in June on working across the community in Wandsworth and on a pilot scheme to embed police officers in to Community Mental Health Teams (CMHT’s) in Kingston and Richmond. We intend to keep the public informed on these issues.
Please refer to our full report for all the issues discussed.
Primary Care Plus (PCP) is a new mental health service being piloted in the Wandle locality. It involves stationing qualified support workers in GP practices to help them in supporting people with serious mental illnes.
The service has been running in the Wandle locality for a year and is now being evaluated before being rolled out on a more permanent basis throughout Wandsworth. This event was designed to feed service users, carers and GP practices views into the evaluation and redesign process.
Wandsworth Clinical Commissioning Group Board Meeting
Posted on 30/04/2018
Wandsworth are contributing £286K this year to the Health London Partnership which is still active in co-ordinating health strategy in London.
2018/19 Budget & Planning & Commissioning - is being submitted to NHS England for approval with confidence that it is realistic and achievable, despite there being no agreement (or mechanism) to move money/resources around South West London.
SW London Healthwatch liaison meeting with SWL St George’s Mental Health Trust
Posted on 30/04/2018
Healthwatch reported on their mental health activities and it was noted that there is high pressure on inpatient beds with redevelopment of Springfield starting in July. However, there will be a reduction on the present number of beds.
The recent Care Quality Commission inspection of the Trust went well and an improvement was noted in Community Services.
The Trust agreed to notify Healthwatch in the rare event of a suicide on an inpatient ward.
This was the last official meeting of the Wandsworth SAPB, following on from the recent establishment of a single safeguarding team for Richmond & Wandsworth. It has been decided that day to day business will be managed by a Transition Board. Healthwatch Wandsworth intend to be present in a February meeting to agree new arrangements.
A presentation on Wandsworth’s Joint Strategic Needs Assessment noted the vulnerability of residents aged 65+ in relation to falls and fraud. Concern was expressed about the health of 1800 prisoners locally and Care Homes in Wandsworth are being jointly monitored.
SWL & St George's Mental Health NHS Trust Monthly Board meeting Part A
Posted on 23/04/2018
A routine meeting with no major reports. However, of interest relating to a service user story, was the problem of transition from children’s CAMHS (Child and Adolescent Mental Health Services) to adult services. This gap in provision would be brought to the attention of the commissioners.
The Trust's finances were reported as in good shape although extra funding would be needed if required bed numbers were to be maintained.
Heathwatch queried the wider publication of a new set of principles for care planning to be launched by the Community service line.
Clinical Quality Review Group at St George’s Hospital
Posted on 23/04/2018
An update on progress with the Elective Care Recovery programme reported Phase 1 of the validation exercise complete, having reviewing the records of 15,000 people on outpatient waiting lists. Various problems were were noted as hampering the Outpatients Transformation initiative.
A review of deaths in patients in 2016 with fractured femur admissions identified some problems but the lead consultant believed that the population dealt with at St. Georges were generally older and frailer. An audit of gall bladder related admissions established a lack of theatre capacity.
South West London St George's Mental Health Trust - Triangle of Care and Involvement Update
Posted on 18/04/2018
Helen Miles, the Mental Health Trust's Head of Therapies, kindly gave our Healthwatch Wandsworth representative an hour and a half of her time to update us on progress of the Triangle of Care and on the development of the Trust's Involvement Plan for service users and carers.
It is a set of standards drawn up by the independent Carers Trust and based on clear principles for effective working with the carers and families of people using mental health services.
There is a membership scheme for Trusts involving the award of stars for compliance following a rigorous system of self-assessment involving carers themselves. St George's was one of the first to receive the first star, covering inpatient and crisis teams.
We will follow these developments of purposeful change through our ongoing liaison with the Trust. Please refer to our full report with Helen Miles.
Clinical Quality Review Group meeting at St George’s Hospital
Posted on 18/04/2018
The meeting began with the Clinical Quality Review Group (CQRG) responding to concerns at St George's Hospital in both cardiac surgery and a breach in the twelve hour trolley wait time.
The Trust report concludes that the mortality figures related to cardiac surgery ‘probably relates to historic practice’. However, the Trust has taken steps to improve poor team working and the monitoring of clinical risk.
In light of this Healthwatch will continue to use these meetings to monitor reports on the Trust’s performance against national targets as well as the more detailed reports presented to the CQRG.
Attached is a summary report of all items discussed on the agenda, including how best to resource the maternity service.
South West London Patient & Public Engagement Steering Group
Posted on 18/04/2018
Our Healthwatch Wandsworth representative attended a meeting with the Public Engagement Team from South West London Clinical Commissioning Group (CCG) to report on key issues including:
- an imminent campaign to inform the public of a South West London project to improve digital information sharing. Mixed opinions presented with the South West London NHS believing the public need to op-out rather than opt-in.
Please see the attached report for further discussions involving significant changes in NHS practice in the move from the current Sustainability and Transformation Plan (STP) to an Integrated Care System.
South West London Committee for Collaborative Decision Making
Posted on 11/04/2018
Two papers were agreed at the South West London Committee for Collaborative Decision Making….
“Funding to Deliver Extended Access and Primary Care at Scale”- South West London has received £8 million from NHS England to improve access to primary care and to encourage GP practices to share resources.
“Developing South West London Individual Funding Requests Triage Process & Panel” - a new motion to streamline how funding is issued is in it's development stages.
Please see our attached summary for further details.
Wandsworth Black and Minority Ethnic Mental Health Forum
Posted on 11/04/2018
A wide range of topics discussed with updates and ideas for future work at the Black Minority Ethnic Mental Health Forum.
There was a lot of concern about the recent NHS data on emergency response to knife crime - the rise in the figures indicated the anger and fear many young people were feeling.
Some time was devoted to a preview of the forthcoming Wandsworth BME Young people and Mental Health Conference to be held at South Thames College on 12 April. The focus would be on the 14 to 25 age group.
The conference would start with presentations from different youth groups identifying the problems young people are experiencing at home, in school and in the community. There would then be a range of workshop sessions led by some of the young people who would then report back for a panel discussion.
Healthwatch will continue to support the important work of the BME Forum. Please refer to attached report for full details.
A Patient Partnership and Engagement Event at St George’s Hospital
Posted on 11/04/2018
The purpose of the meeting was to consult on the Trust’s draft publication: Outstanding Care Every Time: Our Engagement, Experience and Patient Partnership Strategy.
It was suggested that the strategy should prioritise some specific areas for improving patient’s experience (such as outpatients), with targets, milestones and suitable outcome measures. Following this the Trust would need to improve its networking activities to ensure that the Strategy would be as inclusive as possible, engaging with all age groups and ethnicities.
HealthWatch Wandsworth is clearly well-placed to provide feedback from service users via its various outreach activities, and to help the Trust widen its engagement with local community and patient groups.
Our Healthwatch invitation to the Trust to speak at the forthcoming HealthWatch Wandsworth Assembly will be a great opportunity for them to start reaching out more to the general public.
The attached summary report highlights the above issues in more detail.
The Strategic Commissioning Group is broad in its representation with Leads from Child services, NHS England, and the CCG -Clinical Commissionig Group, to name a few. Healthwatch raised the lack of engagement and communication with service users in carrying out the review. As a result it is to be added as an action point.
A key focus was on new NICE recommendation for Universal screening to include routine HIV testing for all patients attending St George’s A&E unless they opt out. Kingston hospital are currently on board with a pilot run.
A new website of the Sexual Health services has gone live to raise the much needed awareness.
For a full report please refer to the attached summary.
SWLSt George's Mental Health Trust Monthly Board Meeting - Part A
Posted on 06/04/2018
St George's Mental Health Trust engaged with both service users and local citizens to discuss matters affecting in-patient care on Crocus Ward and CAMHS along with improvement measures. We heard a brave account by one female patient of her experience on the mixed Crocus Ward - unfortunately the aggression she had experienced from some male patients along with insensitivity from staff overshadowed any positves.
Healthwatch has since carried out an Enter and View inspection of Crocus Ward which has been positive, although evident that patients need clearer pathways in raising concerns to staff.
For full details of more topics discussed, including an update on Talk Wandsworth, see out attached report.
Wandsworth Social Services Market Engagement event: Recommissioning Care and Support Services in Extra Care Housing Schemes
Posted on 14/03/2018
The meeting was for Commissioners to meet with and consult potential providers of extra-care housing for vulnerable people. There are three extra-care housing schemes for older people in Wandsworth and two more are in the pipeline.
The Commissioners presented their current position and then facilitated discussion which covered: service models; maximising independence; the workforce; procurement and contracting; mobilisation (taking over provision) and pricing.
Healthwatch reps asked whether they could see the contract specification, as they had input to the previous specification in 2016. The potential aim is to be fully involved in the procurement process.
For full details in to this please read our attached summary.
St George’s NHS Trust: Clinical Quality Review Meeting
Posted on 14/03/2018
Six key agenda items were discussed, of these was the South West London Pathology report. This service was formed by a merger of pathology services. The hub is at St George’s Hospital with spokes at Kingston, Croydon and a partnership with the Royal National Orthopaedic Hospital. The report shows significant improvement in performance since 2016, as measured by the figures for serious incidents and complaints from SouthWest London.
Healthwatch, however, will now continue to monitor three issues highlighted, that of dual prescribing at the Trust; bed shortages and other factors associated with an arguably unacceptable rate of same-day cancellations of surgery at St George’s Hospital; and performance against targets of the Trust’s cancer treatment services.
Quality and Safety Committee at St George’s Hospital
Posted on 14/03/2018
A meeting of broad topics discussed ranging from End of Life care (EOL) to the merging of Adult and Children's Safeguarding practise, and the impletation of the Prevent Programme which deals with the issue of modern day slavery.
Significant progress has been made in promoting good practice in a number of areas especially End of Life care (EOL) which seems to be energising the leadership. Stability and morale at this level continues to rise.
Also the number of prescribing pharmacists is increasing following education and training. Plans for working with physician assistants are now in place and also a new apprenticeship scheme for school leavers.