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.
Enter & View Visit to Ashley House Supported Living Scheme
Posted on 03/03/2017
A current strategic priority of the use of our Enter and View powers is to visit extra care and supported living housing schemes. We feel that tenants in such schemes get less chance to express their views compared with people using other health or social care services.
One such scheme is Ashley House, a Supported Living scheme that provides care and support for older people, based in the Battersea area. The scheme has been running for just over five years and whilst it was clear that the staff at Ashley House are committed to providing quality care and support as and when needed, it was evident from our interviews with the tenants that they have a wide range of needs and personal issues which could make providing care challenging.
We're pleased to report that the findings from our visit to Ashley House were, on the whole, very positive.
If you would like to read our report on Ashley House, please click the icon below.
Right Care, Right Place Wandsworth Delivery Group - 7th November
Posted on 01/03/2017
Our representative Mike Grahn attended the Right Care Right Place meeting along with Representatives of the SouthWest London Commissioning, Sustainability Transformation Plan Group (STP), Care Commissioning Groups (CCGs), Social Services and acute hospitals in Wandsworth.
This was the second meeting of this group whose job is to implement the RCRP workstream arising from the South West London Sustainability and Transformation Plan for the Wandsworth and Merton sub-region. They meet monthly and have been facilitating the effective functioning of healthcare processes, including sensitive areas like patient discharge into the community.
Assessments are in their early stages and the complexity and individuality of care is key to the ongoing success and developement of the various programmes.
Healthwatch will be ready to respond to consultations on changes to the way patients are discharged from hospital and the delivery of services.
Please read the attached report for a fuller explanation of these serives.
Feedback from South West London's St George's Mental Health Trust Board Meeting - 6th October
Posted on 01/03/2017
The October monthly meeting was attended by both Executive and Non-Executive Directors and was chaired by the Trust Chair, Peter Molyneux.
The board reviewed issues including:
The Trust's current dependence on agency staffing as a result of difficulties in recruitment and retention of permanent staff, particularly in mental health
The effects of agency usage on quality of care
Agency expenditure and the need for an increase in NHS bank staff
The positive outcome in the opening of the Ellis Ward at Queen Mary's Hospital
The other main area of challenge was the ability of management to keep control of all the complex details of care so as to avoid findings of regulatory non-compliance by the Care Quality Commission (CQC).
The public were invited to ask questions and Healthwatch took the opportunity to raise the issue of the impact of increased demand for the assessment of young people with ADHD via Wandsworth Child and Adolescent Mental Health Services (CAMHS) Neurodevelopmental service.
Please refer to the attached report for more information on this topic and the above raised issues.
In the meantime Healthwatch will continue to follow the important work of this Board.
Feedback from South West London St George's Mental Health Trust - Mental Health Month 10th & 19th October
Posted on 27/02/2017
Mental Health Month at South West London's Mental Health Trust seeks to inform the public of the NHS Trust's more committed holistic approach to mental health issues in society. Using practical approaches such as film and Art, conditions such as schizophrenia are highlighted and reported on at Springfield hospital in Tooting.
The recovery college is based in a beautiful setting and their work gives us an amazing insight in to the work of the Trust.
Healthwatch encourages everyone to keep talking about mental health because it matters to all of us!
For more information please refer the attached feedback report.
SWLSTG Mental Health Trust Board Meeting - 1 February
Posted on 06/02/2017
There is a lot happening at our local Mental Health Trust, including the restructure of their service line management which comes into effect in April 2017.
Something that remains at the forefront of the Trust's focus is the improvement of community services. It was noted that there is a wide variety of standards of care in community teams, and the Trust's aim is to achieve greater consistency over the next year or so. They also plan to increase engagement and co-production of services with local service users and carers.
More from this meeting, including the papers and minutes of the meeting, can be found on the Trust's website or on the attached summary.
Feedback from Wandsworth CCG's Board Meeting - 1 February
Posted on 03/02/2017
On Wednesday 1st February our representative Jamie attended the Wandsworth CCG Board meeting, which was also attended by Public Health and is open to members of the public.
There were some concerns around cuts to the Phlebotomy Service, but these fears were allayed when it was made clear that the service is simply being moved to 42 local GP surgeries to make it more accessible to the public.
There are also some changes to urgent care services in Wandsworth, with three levels of care being introduced - Primary, Urgent and Emergency. NHS 111 will be on hand to indicate which service members of the public should use in each situation.
For more information you can read the brief report from this meeting attached below, or visit the CCG's website.
Multispecialty Community Provider Procurement Panel - 5 October
Posted on 25/01/2017
On the 5th of October 2016, Jamie (one of our Representatives) sat on the Wandsworth CCG procurement panel for Multispecialty Community Provider Services.
Multispecialty Community Providers have been designed to bring together GP practices, nurses, community health services, social workers and other health and social care professionals. The idea is that working collaboratively will help to:
Better meet the needs of patients
Ensure that community health care services are well coordinated
Increase the options to receive care at home and in the community
The panel was made up of five CCG Board members, officers from Wandsworth and Richmond council Social Services department, a Quality Adviser & Jamie, from Healthwatch Wandsworth.
The Wandsworth GP Federation has since been awarded the MCP contract as lead provider and as such will be responsible for organising this new model of care.
Read our Rep's take on the procurement process and Healthwatch Wandsworth's role on the day (see attached).