Cheadle & Bramhall Consultation Event

Closed 23 Mar 2012

Opened 22 Mar 2012

Feedback updated 10 Jul 2012

We asked

How can we get more people involved in local NHS events?

You said

Vary times of events to allow people who work / have other committments to attend at different times.

We did

We will now make sure we offer a variety of time slots for events as well as different methods of engaging, such as online survey, so that as many different people as possible can have their say on local NHS decisions.

Results updated 28 May 2012

25 local residents attended the event on the 22nd March.

Dr Ranjit Gill gave a presentation on plans for Stockport's Clinical Commissioning Group.

A number of comments were made about the CCG’s vision of reducing health inequalities:

Health inequality (Brinnington) is a key issue not just for health, but for all sectors - raising educational attainment levels, housing etc. Liaison with the council and hospital is needed. Working together hasn’t been what it should and there is scope for improvement.

Dr Gill responded that these are two important issues. In Brinnington, the average man is 70 when he dies - two years ago this was just 68. In Bramhall, men are living until 82. Lifestyle and education are a key factor in this difference. The CCG will work very closely with the Council and the Hospital, as well as other local organisations, to try and improve the situation. We also have a seat on the Health and Wellbeing Board, an overview committee based at the Council which sets Stockport’s health and wellbeing strategy. The changes in the NHS are a good opportunity to re-set relationships between organisations. Public money will be targeted effectively to make sure that what we do in healthcare compliments the work done by the local authority.

Health inequalities are primarily due to wealth. People in less affluent areas don’t eat five a day or go to gyms. Most people know they shouldn’t drink or smoke. Even the Queen has six units a day.

Speaking as a GP, Dr Gill agreed with the meeting about the impact of education on improving health opportunities. Improving understanding and education improves people more than wealth ever could. Restricting alcohol intake, eating healthily, not smoking, taking walks, and getting enough sunlight significantly improve health. These are the conversations we need to have with local people about taking responsibility for their own health.

The meeting then discussed general wellbeing among older people:

The older age group are lonely and depressed (loss of friends, unable to get out) and it takes simple things to improve their lives - sometimes just need a cup of tea and a chat.
We recognise this is a common problem. For this reason, one of the biggest changes we are proposing is in how we deal with long-term conditions and older patients with complex care needs. One of the things we will look at for this group is increasing access to psychological therapies in primary care to help improve mental wellbeing, which can then have a big impact on health.

The meeting discussed how the CCG intends to make changes and keep within budget.

Dr Gill informed the group that from April 2012, we will have approximately £380m to spend on healthcare for all of Stockport. We are currently spending slightly more than this, so patients, the public and the CCG need to make a joint decision on what we are going to carry on and what we won’t be able to do.

Can we make savings through preventing delayed discharge?

We spend more than allocated because Stockport has the most emergency admissions and second highest number of hospitalised people in the country. This is less than ideal for patients, who don’t want to go into hospital if they don’t need to and it’s a high-cost way of treating people. If less people were admitted we could invest in other areas, such as mental health.

Is there any good practice from another part of the UK we could follow?

Torbay is an area that has addressed this issue. They have made significant changes and their hospital rate is much lower than Stockport now.

Why do we have the second highest rate of hospitalised patients in the country?

We’ve looked at all of the statistics and narrowed it down to the way we treat certain conditions. There are a set of conditions called Ambulatory Care Sensitive conditions (ACS), such as pneumonia, chest conditions, deep vein thrombosis (DVT), where patients in Stockport seem to end up coming back to A&E and being admitted to hospital. We need to transform the way we treat patients with these conditions and improve their care pathways so that they can be treated at home or in the community without needing emergency treatment.

A lot of stroke people go to SHH, is it anything to do with that?

No, more chest pain.  Stockport has a significant number of people who suffer because of alcohol. Three years ago, 12% of Stockport’s adult population was in the adult cardiology system. This is because the system hasn’t reformed.  Cardiology costs around £160 to see a cardiologist for the first time and £100 for follow ups.  Many systems are completely different.

To what extent are people going to A&E who should be going to their GP?

We believe between 10 and 25% of people who go to A&E could have waited and seen their GP instead.

Will getting to see your doctor be easier with the CCG?

Things are never black and white: Stockport’s population is the healthiest in Greater Manchester; mortality rate is improving much faster in Stockport than anywhere else in Greater Manchester.

50 of Stockport’s 52 GP Practices offer extended hours – so they open early mornings, late in the evenings and at weekends. They run back to back appointments. In addition, when GP Practices are closed, the phone goes through to our ‘Out of Hours’ GP service, which will treat patients between 6.30pm and 8am while the GP Practice is closed. Stockport’s population accesses this Out of Hours GP service 20% more than people in other parts of the country.

We have the healthiest population in Greater Manchester, we are offering more GP appointments, a high level of access to out-of-hours GP services, and yet A&E attendances are also rising.

We need to have a frank conversation with the public about how they use the NHS and how local taxes are spent so that we can provide the best option for everyone within a fixed pot of money.

There is a pressure on money and people have to wait longer.  Would like to see an improvement in the pathway with early diagnosis and early action?

We need to eliminate duplications, remove inefficiency in the system and make sure everyone has access to early diagnostics.

Can you screen for aortic aneurism?

Yes, Stockport was one of the first in the country to do this.

Could all children be vaccinated against flu?

The latest research and guidance from the Chief Medical Officer said that there is not enough strong evidence yet for this to happen.

My wife went for a flu vaccine and was told by the practice that she was not on the carers’ list – she insisted and got it.

Carers are absolutely included in the list of ‘at-risk’ groups who should receive flu vaccines for free through their local Practice.

Caring for carers – what do you mean? 

We understand the huge impact that unpaid carers make in Stockport. Without carers a huge number of vulnerable people would require much more support from the state – both the healthcare sector and social care. We want to ensure that carers stay healthy and can continue to care for people, which is why they are on the list of ‘at risk’ groups who receive the flu vaccine. Flu vaccine – most people who are carers don’t know they need support and access treatment, access to welfare. We also want to make sure that carers are taking enough care of themselves and attending screening.

The meeting then discussed access to counselling:

£5m has been put into a programme called Increasing Access to Psychological Therapies (IAPT). We have invested in the numbers of counsellors and reduced waiting times.

There is now self-referral via phone number, which has a waiting time of around 4 – 5 weeks.

We have also introduced free Web-based counselling information www.livinglifetothefull.comand there are four office suites in Stockport where you can access this instantly.

More complex issues can be accessed through your GP.

A discussion took place on how to get more people involved in the NHS.

Does every practice have a Patient Reference Group and why don’t they inform patients?

We are encouraging all practices to develop their patient groups and inform patients. Most have had adverts on their websites and posters in surgeries. If you want to join your practice group, just ask at reception next time you’re in the Practice on check their website.

Part of getting to people is communication. There is a barrier in getting information out to people. 

Not everyone is interested in healthcare until they need to use services themselves. We use a wide variety of methods to try and communicate with different groups, including a new engagement website to try and get more involvement with younger people.

What is the link with schools in Stockport? Awareness can be raised and children can be told about alcohol, chlamydia, smoking.

We work with the Local Authority to communicate with younger people in schools. We also run the school nurse service in Stockport. 

It would appear that meeting is not represented from people around Stockport.  How did you select people to get involved?

We want as many people as possible to give their views on our plans. We have set up one public event in each area of Stockport and put up posters around the borough in GP Practices, shops, libraries, community halls, pharmacies and opticians. We also took out an advert in the local papers.

In addition to these meetings, we have run focus groups with a range of local voluntary organisations –Local Involvement Network, Carers Forum, U3A, Council Overview & Scrutiny Committee, College, Social Care group, SCAA and the Offerton ladies group.

For those who cannot attend a meeting, or do not wish to, we have also set up an online survey, which was emailed out to over 350 local community groups.

We are always learning and would welcome any other recommendations for widening the scope of our engagement.

Timings are wrong

We know that we will never be able to find a time that suits everyone, but have varied the events as much as possible, We are also taking feedback at every event to see what works and what doesn’t work – including the times of events.

The meeting then discussed how the CCG will be governed:

The PCT had regular Board Meetings held in public – will the CCG meetings be the same?

Yes, the CCG’s Governing Body will meet monthly and the public are welcome to attend. Papers are available via our website around a week before meetings. The CCG and its Governing Body have adopted the Nolan principles of public service – this gives good corporate governance. 

Would you be prepared to move around the area to different venues?

Yes, we agreed in our Constitution that we will have at least one meeting a year in each of the four localities so that the Governing Body is accessible to as many people as possible.

Will these be a public question time?

No – this is a decision-making meeting, so as with current PCT Board, only members can contribute to substantive discussions, but members of the public can ask questions regarding agenda items at the start.

However, the Governing Body will meet four times a year with its Patient Panel, to take questions and challenges from the public. Members will also be heavily involved in local engagement like this meeting.

In addition, we have taken the decision to start each governing body meeting with a patient story.

Bullet points from a health point of view could be put into the LA newsletter

The PCT already advertises in the Civic Review – at a cost. A monthly write-up of decisions will be added into a newsletter for Patient Panel members and any interested parties. We also give regular articles, including decision taken, to the LINks newsletter.

Files:

Overview

Public Consultation Event in Cheadle & Bramhall

Thursday 22nd March 2012

The Village Hotel

5-7pm

Event Poster

Areas

  • Bramhall North
  • Bramhall South
  • Cheadle & Gatley
  • Cheadle Hulme North
  • Cheadle Hulme South

Audiences

  • GP
  • Nurse
  • Dentist
  • Optician
  • Pharmacist
  • Practice Manager
  • Admin
  • Commissioner
  • Manager
  • Consultant
  • Men
  • Women
  • Older people
  • Younger people
  • Young adults
  • Patients
  • Carers
  • Ethnic Minorities
  • Families
  • People with disabilities
  • Charity
  • Disability group
  • Youth group
  • Religious Groups
  • LGBT group
  • Carers
  • Patient Reference Group
  • Ethnic Minority Community group

Interests

  • Cancer
  • Dementia
  • Diabetes
  • Mental Health
  • COPD
  • Vaccination
  • Stroke
  • Sexual Health
  • Heart Disease
  • Weight
  • General Practice
  • Hospital Care
  • Pharmacy
  • Screening
  • Dentistry
  • Community Clinics
  • Intermediate Care
  • End of Life Care
  • Prescription Medication
  • Optometry
  • Unscheduled care
  • Surgery
  • Interpreters
  • Annual Health check
  • Out of Hours Care
  • Health information leaflets
  • Website
  • Events
  • Patient Reference Group
  • Input into decision making
  • Dignity & Respect
  • Equality & Diversity
  • Access
  • Waiting Times
  • Patient Satisfaction
  • Satisfaction
  • Environment
  • Information
  • Management
  • Training
  • Role