We Asked, You Said, We Did

Below are some of the issues we have recently consulted on and their outcomes.

We asked

To redesign the 516 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

Stockport Clinical Commissioning Group held an FASD Awareness workshop on 5th February 2020 with the aims to raise awareness of FASD and to identify how parents and health and social care professionals would like the offer for the prevention, pregnancy, assessment, diagnosis and for FASD in Stockport.

You said

 

Stockport midwives trained to administer LARC should be promoted and we should train our midwives to have the “are you drinking alcohol “conversations?".

Lots of different patient groups are enabling the patient voice to be heard.

Miss-diagnosis  is very common and a recent freedom of information request stated that Stockport had no children with a diagnosis of FASD. Early diagnosis is vital to get the correct support in place.

Future issues for children with FASD include; Drug and alcohol misuse, Youth Offending/Penal

Current issues are;Accessing services in the right area, Lack of knowledge by professionals, Incorrect assessments, Community in do not understand, Various secondary illnesses.

Conditional Issues;

Confabulation = Tendency to fabricate the truth; mixing films/stories with their actual life and links with impulsivity

82% anxious about the future there will also be the parents who will be anxious and access mental health services

89% of parents who have a child with FASD have reported they are very stressed

Education and transition to adulthood as reduced mental health age, 18years olds are functioning as a 9 year old

A priority for parents was professionals who know about FASD

Most children are diagnosed with attachment disorder prior to a FASD diagnosis.

Adoptive parents need training in FASD.

Children with FASD are not affected any differently to trauma than other children.

Educational Phycologists are very important and should be involved inEducation Health and Care Plans (EHCPs) and their support.

Dr Barrett informed that there is a possibility of a FASD pathway and that work is ongoing to drive down waiting times for ASD and ADHD pathways.

It was thought that FASD was not mentioned in the NHS Long Term plan however, there will be an FASD NICE guidance out later this year.

We did

FASD NICE guidelines are currently being written and until these have been agreed pathway work cannot start.

We asked

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment ­ December 2019

We did

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

We asked

To improve access to the assessment and diagnosis pathway for ASD for 5 16 year olds and improve timeliness of assessment and to redesign the 516 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment December 2019

We did

The CCG has developed a performance framework in relation to the SEND commissioning programmes it is leading on. Baselines and trajectories in relation to the ASD assessment and diagnosis pathway have been clarified.

The plan has now been approved and is being mobilised.

Re designed the ASDAT patient information Leaflet

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment ­ December 2019

We did

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

We asked

The CCG asked for views from local people, health and care professionals, VCSE and other local interested parties on proposals to review our current policy on commissioning In Vitro Fertilisation (IVF) services.

You said

Over 400 people responded to the consultation. 

People wanted more information on how changes may impact on other health and care services. 

It was also highlighted that some parts of the consultation process required a review.

We did

The CCG reviewed and reflected on the feedback and reports from local partners and it is clear that we need to stop and thoroughly review the consultation process we have undertaken.

We would like to thank everyone across Stockport who has given their views and assure them that we will work with Healthwatch to agree the information and consultation process going forward, learning the lessons.

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

 

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment

Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment ­ December 2019

We did

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

 

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment ­ December 2019

We did

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

We asked

To agree and develop a joint approach to commissioning of therapy services for children and young people aged 0 ­ 25 and to develop a joint commissioning plan to improve access to therapy services, address the deficits in children's therapy services and improve post 16 pathways.

You said

  • Improve access to children’s therapy services – achievement of NHS 18 week referral to treatment standard
  • Improve access to therapy services for young people post 16
  • Improved information for families whilst their children are waiting for assessment and treatment

We did

  • The CCG has approved a short term commissioning plan for improving access and waiting times for Speech and Language Therapy. The likely start date is March or April 2020.
  • The CCG has now approved a short term plan to recruit 3 SALT therapists for a 6 month period to meet the needs of those on the waiting list and establish a sustainable position
  • The CCG has progressed a rapid review of the OT service and made recommendations which have been shared with the senior leadership team in the FTs children's service.
  • The CCG has employed a consultant to support work on children's commissioning. They have done a rapid review of the service and have made recommendations.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment
  • Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

To improve access to the assessment and diagnosis pathway for ASD for 5 ­ 16 year olds and improve timeliness of assessment and to redesign the 5­16 years ASD assessment and diagnostic pathway in line with the Pennine Care 7 stage model

You said

  • Improve access to assessment and diagnosis pathway for ASD and improve the timeliness of the process
  • Improved information for families whilst their children are waiting for assessment and treatment ­ December 2019

We did

  • The CCG has developed a performance framework in relation to the SEND commissioning programmes it is leading on. Baselines and trajectories in relation to the ASD assessment and diagnosis pathway have been clarified.
  • The plan has now been approved and is being mobilised.
  • Re designed the ASDAT patient information Leaflet

We asked

We asked for interested service users/carers to become involved in this multi agency bi-monthly mental health advisory group.

You said

Two volunteers came forward and after further discussion regarding the nature of the group have joined and attended.

We did

In the three meetings held since joining their contribution has been extremely valuable.  In particular in respect to suicide prevention and crisis pathway development.

We asked

To redesign the 5­16 year’s assessment and treatment service for ADHD and ensure it is able to meet need / prevalence and to develop a plan to ensure that those currently waiting for assessment and treatment receive a timely service.

You said

  • Reduce the current waiting list for assessment and treatment for ADHD receive a timely service
  • Streamline the process for ADHD diagnosis and treatment

Improve information on ADHD services for children, young people and families

We did

  • Recruited a temporary consultant Paediatrician to provide short term support (6 month post) who will provide extra ADHD clinics.
  • Stockport FT has been providing some additional clinics and waiting times have improved.
  • A new ADHD patient information leaflet has been drafted. This has been shared with parents groups who have commented on it. We aim to finalise the leaflet in January 2020.

We asked

As Neighbourhood Clinical Commissioner, Steve Bradshaw has indicated an interest and wish to be involved in the development of social prescribing networks. 

You said

TPA Community Connectors arrange periodic 'Team around the Place' meetings.  These offer the opportunity for local groups/residents to meet and share their values along with what their group can offer as a means of promoting greater local knowledge.

We did

An example of a positive outcome was that at the Marple meeting it was noticed that there was a clash of meeting times between two groups both of whom would have benefited the same group of attendees.  Therefore one group agreed to change their meeting times.

The overall outcome of all meetings is a better local  knowledge between groups of what is already available and potential gaps.  This will hopefully also then lead to ongoing cooperation and signposting between groups.

We asked

Overall aim of the engagement

The aim of the engagement was to learn from experiences of family carers what works well, what needs improvement, what is missing and what suggestions people might have to improve our local palliative care offer.

What we were asking

  • What support did you use and how useful was it for you & person you cared for?
          Prompt: support can be professionals, services, information such as leaflets etc.
  • What did you find challenging / gave you extra stress?
    Prompt: can be transport, I.T, lack of information, communication ect
  • What did you miss / what didn’t work well / what can we do better?
  • Were your needs assessed / what are your needs at the moment and what support do you receive / need?

 

You said

What participants said

Strengths:

  • End of life team at home
  • End of Life assessment
  • Enhanced care team highly valued but only in last 2 weeks of life
  • Advanced care planning works especially well for dementia patients but not necessarily for other conditions

Weaknesses

  • Not a person-centred care plan, no choice provided
  • Not possible to book respite care
  • Variable support from GPs: some very supportive GPs and some carers reported not having received much support from their GP
  • Lack of conversations to discuss and plan end of life care
  • No bereavement support offered
  • Lack of training for staff; staff don’t know when / how to start conversations and what services are available
  • Treatment for pain was lacking

Challenges

  • Adapting home gave stress and had an impact financially; home environment felt less homely
  • Need to start conversations earlier
  • Skills of family carers not appreciated by care home staff when cared for moves into care home
  • Support for deaf people in end phase of life was lacking

Barriers

  • Disjointed services
  • Lack of training for family carers

We did

What we did or will do as a result (ie how this will influence decision-making)

The feedback from the participants confirmed that the new model needs to have:

  • A single contact point for patients and family
  • More opportunities for respite for the carer
  • Right balance between peer support for carers based on condition and more generic; to create more opportunities to meet others in a similar situation for carers looking after someone with a less common condition
  • Clearer signposting on bereavement support offer
  • Continuity in contact with carers by services in days after person passed away to avoid abrupt ending of support on day person passed away

Based on the feedback we have now

  • Made a split between the palliative care and bereavement pathway to acknowledge the different needs
  • reviewed respite opportunities and are looking in creating more options for respite
  • looked at continuity in support for carers in first days after death
  • improved joint working between elements of the pathway
  • extended enhanced support team involvement
  • looked at training opportunities to upskills staff e.g. home care staff

We asked

We asked Special Education Needs and Disability (SEND) parents and carers to look at the SEND review undertaken by Ofsted and CQC and give us their feedback

You said

To see a full report of all the feedback and themes please go to the Local Offer page - https://stockport.fsd.org.uk/kb5/stockport/fsd/localoffer.page

We did

There are a number of actions raised by parents for the Local Authority and CCG to work on.  This includes a number of workstreams which all have parent representatives on them  The full details of activity, plans and outcomes to date can be found on the 'Local Offer' page via this link - https://stockport.fsd.org.uk/kb5/stockport/fsd/localoffer.page 

We asked

Colleagues were asked about challenges they faced day to day when dealing with clients.

You said

TPA colleagues asked for training on a list of commonly encountered difficulties relating to clients mental health

We did

To help improve competencies of non health staff in managing distressed patients within a social prescribing setting, a series of training sessions covering the list was developed and delivered in a small group interactive setting.

 

 

 

We asked

The scheme is simply asking patients to participate once invited in order to improve their wellbeing by improving contact with GP surgery staff and

You said

Feedback after the event from patients was excellent and it was enjoyed by all.

We did

We are arranging a further event in this Neighbourhood and then approach the charity (Contact the Elderly) to gain permission/obtain funding for further Neighbourhoods.

We asked

Citizens Representation Panel

You said

A number of issues were discussed as can be seen in the attached paper

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP

We asked

Whilst attending a Public Health led discussion with colleagues from Stockport Homes,  ABL, CGL, and START  it became clear that they frequently work with distressed or challenging residents.

The Clinical Commissioner for Neighbourhoods, Steve Bradshaw, offered to deliver bespoke training sessions to these colleagues to help with these challenges.

 

 

 

You said

Each of the four organisations took up the offer.  Training for START and ABL was completed during 20017/18.  Stockport Homes and CGL training was completed during 2018/19.

Feedback during follow up question and answer sessions reflected better confidence and knowledge subsequent to the training.

We did

Colleagues now have a better understanding of communicating with mentally distressed clients and social prescribing to compliment their area of expertise.

 

 

 

 

We asked

We asked Special Education Needs and Disability (SEND) parents and carers to look at the SEND review undertaken by Ofsted and CQC and give us their feedback

You said

To see a full report of all the feedback and themes please go to the Local Offer page - https://stockport.fsd.org.uk/kb5/stockport/fsd/localoffer.page

We did

There are a number of actions raised by parents for the Local Authority and CCG to work on.  This includes a number of workstreams which all have parent representatives on them.  The full details of activity, plans and outcomes to date can be found on the 'Local Offer' page via this link - https://stockport.fsd.org.uk/kb5/stockport/fsd/localoffer.page 

We asked

  • What is being done well?
  • Where are the gaps?
  • What could be done better?
  • What are our aspirations?

You said

During the disucssion a number of themes emerged for example:

  • How Stockport Mind is involved in GM wide developments
  • Challenges of being a small single borough provider
  • The activities led through SPARC
  • Challenges for Carers

We did

All the information from the workshops were considered and discussed.  The Local Authority is using this to redraught contracts and nuance aspiration.

These contracts are out for competitive tender at the time of writing this.

We asked

This survey formed part of the 100 day Rapid Testing programme where new ways of working were trialled.  Patients were asked if they would be happy to be contact again to take part in possible further research.

You said

The majority of patients confirmed they would be happy to be contacted to take part in further research. 

We did

Feedback from the survey helped to structure the newly formatted public workshops.

We asked

Patients attending an education session on Osteoarthritis of the Knee.

You said

We asked patients to feedback on a pre/post questionnaire regarding the osteoarthritis of the knee workshop. 

We did

Comments from the survey aided professionals to make any improvements needed to the format of the workshop.

We asked

The Citizen's Representation Panel (CRP)

You said

Please see notes below from the meeting.

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP

We asked

We would like The Stockport Red Bag Pathway to be known as one of the most successful in GM and have great partnership working across CCG, NHS Trust, NWAS, ASC and our care providers. We would like the Residents and families from the Residential and Nursing homes to give continual feedback that it has supported their transition into hospital and the safe discharge back home again.

You said

A number of positives have been received about the scheme:
Staff at the hospital are engaging with the scheme and service users are coming home quicker.
Families are happy (not losing glasses etc)
Reduced phone calls to the care home
Protects providers – evidence that information has been sent to the hospital- check list
Positive feedback and support from NWAS and ED
 
However there are still some area that require improvement:
 
Notes not always returned -Paperwork needs to stay in the bag.
More promotion in the hospital so all staff are aware, due to high turnover of care and nursing staff.
Person Centred info poor quality or not always read
DNACPR not always returned even with EOLC patients operationally

We did

A Pathway Development Plan has been developed with actions for each of the providers such as Nursing, Residential, Extra Care Homes, NWAS and  Hospitals to ensure Champions have been identified and the necessary staff are well trained and fully aware of the scheme.
 
 

We asked

The Citizens Representation Panel

You said

Please see notes of the meeting below

We did

The attached paper provides an outline of activity for the CCG and Partners to complete on behalf of the CRP.

We asked

Citizens Representation Panel

You said

A range of details were discussed as can be seen by the attached document.

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP.

We asked

Citizens Representation Panel

You said

A range of details were discussed as can be seen by the attached document.

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP.

We asked

Citizens Representation Panel

You said

A range of details were discussed as can be seen by the attached document.

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP.

We asked

Walthew House Deaf Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Walthew House - Visually Impaired group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Bredbury Practice - Patient Participation Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Healthwatch Stockport

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Alvanley Group Practice Patient Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Mental Health Carers Group Stockport (MHCGS)

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Disability Stockport

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

NHS Watch

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Walthew House, for those with sensory impairment

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Poets Corner Action Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Stockport Breath Easy Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Cheadle Patient Participation Group

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together

We asked

Citizens Representation Panel

You said

A range of issues were discussed as can be seen in the attached document.

We did

The attached paper provides an outline of the activity for the CCG and partners to complete on behalf of the CRP.

We asked

Marple Patient Participation Group

You said

A range of issues were discussed as can be seen in the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together

We asked

Citizens Representation Panel

You said

A range of issues were discussed which can be seen in the attached document.

We did

The attached document provides an outline of activity for the CCG and partners to complete on behalf of the CRP.

We asked

Citizen's Representation Panel

You said

A range of issues were discussed that can be seen in the attached document.

We did

The attached paper provides an outline of activity for the CCG and partners to complete on behalf of the CRP.

We asked

Mental Health Carer's Group Stockport (MHCGS)

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

Healthwatch Stockport

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of details were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of details were discussed as can be seen by the attached document

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of issues were discussed as can be seen by the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together

We asked

Cheadle Women's Institute

You said

A range of issues were discussed as can be seen by the attached document.

We did

The impact of public involvement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of issues were discussed as can be seen in the attached document.

We did

The impact of public involvement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

An open public meeting.

You said

A range of issues were discussed as can be seen in the attached document.

We did

The impact of public involvement enabled the CCg to reflect and review the proposals for Stockport Together.

We asked

An open public meeting

You said

A range of issues were discussed as can be seen in the attached document.

We did

The impact of public engagement enabled the CCG to reflect and review the proposals for Stockport Together.

We asked

How the group would like to be updated on transformation plans and to get involved in any of the CCG surveys, groups, campaigns.

You said

Comments on wide range of topics. Group keen to understand the changes to the NHS and how they will impact on care.

We did

Plans are being developed on how patient reference groups are going to be engaged or consulted on neighbourhood plans in Stockport Together.

We asked

For views and feedback on each of the four Stockport Together workstream plans.

You said

Information should be produced about service changes in patient friendly format

Mental health to be considered in the neighbourhoods

In order to make changes conversations in partnership with people should be around ‘what matters to them’ as prime motivators along with relevant information.

Preventative education needs to start early with young people

Encouraging health & social care staff to work together and not in separate silos.

Panel members will align to the workstreams

We did

Some of the panel members have been aligned to the workstreams and are working with them.

Public friendly overviews have been produced for each of the smaller business cases.

Mental health consultant for the neighbourhoods is coming to talk to the group in January.

We asked

We asked you to review the draft findings of the 2015-16 JSNA before we completed the review and the Health and Wellbeing Board adopted the findings.

You said

We received more than 80 responses to this consulation, you rated each of our 14 topic briefings and summary report positively, as providng a good summary of the current state of health and wellbeing in Stockport and adding to the eivdence base. You also provided specific feedback including corrections and suggestions for additional evidence.

We did

We made amendments to each of the briefings and used these to inform our overall prioritisation. We have now completed the 2015/16 JSNA and have published the final briefings and priorities at www.stockportjsna.org.uk

We asked

The Citizens Representation Panel were asked to comment on the new model of care draft plans for Stockport Together.

You said

People without web based access or skills will need help accessing online care or records.

Mental health will need to be strengthened in the neighourhood plans.

Some people face more barriers than others when faced with the need to change lifestyles or behaviour.

More work should be done to train others to cascade health advice.

Concern that reducing hospital referrals will reduce specialist advice or care.

We did

Extend 'health chat' training to more front line staff.

Appoint mental health consultant to work with the neighbourhood teams.

New 'consultant connect' service is introduced to provide quick advice from hospital consultants before a referral is made.

We asked

You to come along and hear about the progress on developing models of care and to test them against seven 'personas'.

You said

You raised the following questions:

•Where does the ambulance service fit into the model?
•What is the out of hours model?
•Strengthen the ambition on prevention and lifestyle offering
•How can we pick up people (not previously known to the system) before they exacerbate?
•Model should look beyond health and social care to other public / private sector partners eg housing, fire, police to ensure it’s fully holistic (and sustainable) model
•How do we recognise that people are an asset as well as users of resource ie community asset building? The model is currently very practitioner and service focussed.
•Want assurance that the IT systems will be able to talk to each other at the right level.
•Virtual Access for planned care appointments / accessing consultants for advice and guidance – will require cultural shift – this will take time which needs to be reflected in implementation timescales.
•End of life care needs a wide remit to include people who may die within 5 years – need to include advance directives which underpin care planning so people have their wishes respected rather than working on a clinically safe model.
 
 

We did

•The programme teams have reflected on all the comments raised and will continue to address the issues and gaps as the models are designed in more detail throughout December and January.
•It was agreed that it would be useful to test the model of care on other personas, with more specific needs. As a result, the programme will develop additional personas around Dementia, Mental Health, End of Life, Care Home residents; additionally the persona for ‘Chronic condition, stable but with serious disability’ will be added to the cohort to be used going forward.

We asked

At a number of workshops over summer 2015 we asked members of the public, staff, voluntary sector and other stakeholders to come together to give us their views on what needs to change about health and social care.

You said

Examples include:

- We feel lost in a complex system

- The lack of shared IT systems are causing delays and duplication

- We are fed up of multiple visits - care should be coordinated

We did

Over the last 12 months Stockport Together partners have been collaboratively developing plans for a new 'Integrated Service Solution'. Full report here http://www.stockport-together.co.uk/application/files/3614/6943/4316/Business_case_-_Stockport_Together_Overview_Design_Business_Case.pdf

The feedback from these events alongside other views, professional expertise, national direction, data and information from elsewhere was used by the practitioners to develop this overview and the more detailed business cases for change.

We asked

The CCG was looking at the way it provides information to the public and stakeholders via the website and how this could be improved. There had been several requests by members of the public, staff and stakeholders to the communications team to improve the website.

You said

The results of the survey itself showed that generally people thought the overall layout of the website was fit for purpose however many did not know it existed. Respondents found the text to be too dense and difficulty finding statistical or perfromance information about the CCG.

Outside the survey we received comments about information being difficult to find on the website.

We did

A new website was designed and developed taking into account the comments in the survey.

The new website is much more user friendly and is more widely promoted through the advertising of CCG campaigns via social media. The information is being improved on a daily basis.

View here:     http://www.stockportccg.nhs.uk/

 

We asked

The Communications and Engagement Team attended the festival on both Saturday and Sunday, with around 60 blood pressues being taken.   The team took this opprtunity talk to local people about the 'Stockport Together' programme of work.

You said

After discussing the proposed changes a number of local people expressed an interest in receiving updates about the programme and invitations to attend any events being held to update people in person.

We did

These local residents were added to the distribution list to receive the Stockport Together newsletters.

We asked

In light of new NICE guidance, how should NHS Stockport fund IVF?

You said

Should extend criteria to include: • women up to 42 • same sex partners • former private patients and offer 3 cycles.

We did

We have extended the criteria to include: • women up to 42 • same sex partners • former private patients and will offer 2 cycles this year. Next year we will see if we can fund 3 cycles.

We asked

For your views regarding:- • appointments with the Nurse • the healthcare you receive, • contacting the Practice by telephone, • use of our web site, • the general waiting room area, • the overall service the practice provides • recommending the practice to others • possible future health promotion events.

You said

• You told us that it was now easier to book an appointment with the Nurse. • The majority of our patients were satisfied with the healthcare they received from the practice. • All responses indicated that it was either easy or very easy to contact the Practice, • A large majority of our patients do not use the Practice website. • We received a number of suggestions regarding improvements to the waiting room. • Overall 86% of patients were satisfied with the overall service. • A huge 94% of our patients would recommend the Practice to someone moving into the local area. • Patients told us that they would be most interested in attending events around Diabetes and Heart conditions.

We did

.• Employed a Phelbotomist to take blood test to alleviate the Nurse appointments • The practice staff hold regular clinical update meetings to help us improve the healthcare you receive, • Practice staff now undertake structured training including communication skills? • We will endeavour to advertise our website to patients. The site is regularly updated and includes detailed responses to patient comments. • The overall service we provide to our patents is regularly reviewed by the PRG, • Suggestions given for future events will be discussed with the practice Patient Reference Group.

We asked

What do you think about the CCG's priorities for the next few years?

You said

We also need to prioritise children's health.

We did

Children's health has been added as a priority project to the CCG's 2013/14 operational plan. Work will include improvements to children's services in primary care.

We asked

We asked for your views on key criteria which we intend to specify for the MInor Eye Conditions' Service.

You said

89% of you indicated that you are in favour of the development of the new Minor Eye Conditions' Service. The majority of respondents agreed with the key criteria. However, 42% felt that routine onward referral from the service to secondary care should not take place via the GP (as is currently the case for ophthalmology referrals); respondents commented that they felt that providers of this service should themselves be able to make routine referrals directly to secondary care.

We did

We have used your feedback to help inform the content of the service specification. We will also investigate the feasibility of implementing suggestions made in your feedback.

We asked

We asked for your views as to what was important in the design of our new Minor Eye Condition's Service. We also asked if you would use the service if you had a minor eye condition.

You said

You told us that the things that are most important to you are that the service is safe and effective and run by well trained staff who know when to refer urgent cases on, that the service is accessible i.e. well publicised, it is easy to book and get an appointment, it is in Stockport and easy to get to on public transport and that it meets the needs of different population groups such as travellers, those who need interpretation services and workers. 83% of you told us that you would use the service if you had a minor eye condition.

We did

We have used your feedback to help us to write the service specification for the MInor Eye Conditions Service. We will also use your responses to help us to inform people about the new service and how it will work through patient information leaflets, local publications and other forms of communication.

We asked

What do you think about our plans?

You said

Too many acronyms in the detailed plan which was handed out as additional information.

We did

We've published a list of the acronyms in the detailed plan and will ensure that all future public documents are in plain English.

We asked

Tell us what you think about our plans for the future of Stockport's NHS

You said

Need to add in a section about Patient Choice

We did

We have added Patient Choice into our plans.

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.

We asked

What do you think about our plans for the future of the local NHS?

You said

Carers need more information about what to expect when caring for someone with certain health conditions.

We did

We have set up a carers working group and are working with the Carers Forum to provide expert speakers at new training courses for carers.

We asked

Please prioritise from the 3 following areas you would like the practice to improve on Also what we do well, and what we dont do so well in Is there anything we could improve on?

You said

1st - You said you would like us to look at another way for getting an appointments as they are hard to get with the current appointment system, needs something different. 2nd - You said we need more staff in the morning to answer phones or maybe another phone line. 3rd - You said that on the whole the premises are ok! nice seating area, nice posters and a TV with adverts and cookery for better health You said that the care you recieve from your GP was excellent

We did

The practice has had a meeting and is currently auditing the appoinments to see when we are busiest at and to find out our problem areas. These results will be printed in our newsletter, after which we shall be asking you the patients to give us your views on how we can improve the way we give appointments out

We asked

How do local women feel about Stockport's breast screening service?

You said

Most women were happy with the service. However issues were identified for women with disabilities who could not access the mobile unit. It was felt that travelling to Macclesfield Hospital for screening instead was too far.

We did

We invested in new screening technology at Stockport NHS Foundation Trust (Stepping Hill Hospital) so that women can now be screened there if they cannot use the mobile unit. 82% of local women now rate the service as good or excellent.

We asked

What works well for you as a patient at Springfield Surgery? What does not work well for you as a patient at Springfield Surgery? Do you have any suggestions on how we could make improvements?

You said

Happy with the Practice Short notice appointments can be a problem Congestion in the waiting room Consider texting patients

We did

Sit and wait surgery every morning and emergency appointments in the evenings available Review seating arrangements A text service is being considered.

We asked

The Government wants to extend patient choice. What services do you think should be opened up for any qualified company to deliver the service to the NHS?

You said

You said you would like to have more choice on a range of healthcare services. The majority of local people suggested the following areas: * Adult hearing services in the community * Adult Primary Care Psychological Therapies * Services for back and neck pain * Podiatry * and Diagnostic tests

We did

NHS Stockport is now part of the Greater Manchester PCT Cluster. All ten Greater Manchester PCTs submitted their proposals for extending choice of provider to the Cluster Board, where it was agreed that NHS Greater Manchester will extend choice to 'any qualified provider' for: * diagnostics * podiatry * and adult hearing services. This should be in place by Spring 2012.

We asked

How long should we consult on individual policies and service changes?

You said

Consultation periods should be proportional to the size of the decision being taken. Changes that will affect lots of people or involve large budget should be open to the public for longer than small changes.

We did

We used these votes to decide our consultation period: http://www.citizenspace.com/stockport-haveyoursay/consultation-and-engagement/consult-policy

We asked

How can we improve access to our services?

You said

Deaf people, who use sign language as their first language, find it very difficult to understand health information leaflets. Information should be made available in sign language to help deaf people take control of their health.

We did

NHS Stockport developed 16 video clips in sign language explaining how the NHS works, how to get involved or make a complaint, how to book sign language interpreters, and health information on a wide range of topics.

We asked

What are your views on the government's proposals to change the NHS?

You said

There should be more clinical input into decision making. Private companies should have to meet the same high standards and training as NHS services before they are allowed to take on NHS contracts.

We did

Fed local views into the national listening exercise.