Agenda item

The Board received a report and presentation from Baz Tameez on progress within Healthwatch Staffordshire and in particular an update on the three deep dives undertaken:

-      Root causes of good and poor teenage mental wellbeing and health outcomes when you’ve been in care as a child

-      Access to primary care

-      Seldom heard groups

Healthwatch Staffordshire had been working with Healthwatch England to use a theory of change model to focus resources in areas in the deep dives where it was most needed. This sought to increase chances of successful outcomes, identify what was working and what wasn’t, so the approach could be adjusted and resources targeted.

The theory of change model also sought to measure and communicate the effectiveness of the work undertaken and evidence the outcomes achieved.

The methodology for the deep dives was presented to the Board, which included:

-      Face to face events

-      Surveys and questionnaires

-      Focus groups

-      Case studies

-      Social media

-      Desktop research; and

-      Partnership working

The slides further demonstrated the root causes of good and poor teenage mental wellbeing and health outcomes when you’ve been in care as a child. Healthwatch had been working with the County Council and the ICS to co-ordinate and contribute to the development of a new ‘Staffordshire Joint Mental Health Strategy’. This seeks to address and help improve the mental health and mental wellbeing of young people and uses six key outcomes identified from engagement activities.

Early key themes and recommendations showed that primarily young people prefer to have face to face appointments with the flexibility of other means to engage, the transition from Child Adolescent Mental Health Services into Adult Mental Health Services needed to be smoother, reducing the risk of vulnerable people slipping through the net and reducing waiting times by utilising more referrals to other providers.

The Access to Primary Care deep dive showed that 92% of NHS consultation took place at the GP and this was where Healthwatch was receiving the most feedback, along with dentistry. Feedback showed that one patient made over 210 calls over two days before they got through, but did get the treatment they needed once booked in.

Healthwatch had been supporting the ICS with their Primary Care Access Campaign in line with the new delivery plan, by promoting the Additional Roles Reimbursement Scheme (ARRS).

Early key themes emerging from patient feedback included:

-      Neurodiversity – reasonable adjustment was required for patients with communication needs

-      Cost of living was making it difficult to afford prescriptions and travel to appointments

-      Telephone access remained an issue for patients and found waiting times frustrating

-      Patient registration which were specific to Burntwood and East Staffordshire

-      Digital communication challenges including the use of the NHS App

-      Mixed views on patient experiences with NHS 111

The Board were informed of next steps on this deep dive which included the potential role of PPGs, supporting changes in local practices, the continuation of the work with ICB primary care managers to understand countywide implementation of the Primary Care Improvement Plan, development of a simple guide to secure the best out of Primary Care and consideration of an event and looking at patient feedback in early 2024 on effects of changes on patients.

The final deep dive focused on 3 seldom heard groups:

-      Transgender community (LGBTQIA+)

-      People with Neurodiverse Conditions (co-occurring needs)

-      Those in Rural Areas (rurality)

Feedback showed that patients felt that GPs were generally unsure how to support them when they wanted to transition, and that transitions were taking longer than the initial promised timescales.

Surveys were formulated which gathered feedback around wanting professionals to have more of an understanding on co-occurring needs which would improve access to services.

Survey feedback on the rurality strand showed that people had concerns around time and money for travelling to GP appointments, opticians, pharmacists and health centres along with wishes that services were available closer to home. In addition, the survey highlighted feedback around the lack of public transport to get to appointments.

Councillor Jessel provided comments around self-diagnosis of young people’s mental health conditions and whether feedback was based on professional diagnoses or self-diagnoses. In response, Baz highlighted that feedback was mixed between self-diagnoses and formal diagnosis with a health professional. The latest data showed that 12 in 100 young people had a diagnosable mental health condition.

Tim Clegg highlighted the points raised around digital communication and the excessive amount of phone calls to get an appointment, considering the use of a digital triage system. Baz further commented on the barriers in place affecting peoples use of digital options, however stated that those who are supported to use digital do use it.

Garry Jones reminded the Board that the role of Healthwatch was to shine a light on things that were most important to the public and patients, which may not always be the same things that are important to service providers. As this was the first year under new arrangements for Healthwatch, learning from the deep dives shows that collaboration was good but future deep dives would be even more focused and therefore may reduce the breadth.

Resolved – that the Board consider and comment on the progress made by Healthwatch Staffordshire service on the three deep dives.