Local Engagement Board (LEB)

Local Engagement Board (LEB)

Event Summary

Jubilee Community Centre, 19 November (10.30am – 12.30pm)

Stadium of Light, 27 November (6.00pm – 7.30pm)

Introduction

The Local Engagement Board(LEB) is a public meeting, for all in Sunderland who have an interest in health. It is held 5 times a year (now including daytime and evening meetings using the same agenda) and aims both to inform the people of Sunderland what health initiatives are being developed and to gather public opinion, experience and preferences with respect to developments.

What did we look at?

Please refer to the attached agendas. The evening agenda was shortened slightly to enable us to cover the topic in the allotted time. This meeting included presentation and discussion of the Intermediate Care Service and how this is changing to become ‘Recovery at Home’.

Who Attended?

5 people attended the daytime event and 4 different people attended in the evening, apart from CCG staff.

What did the public say?

Feedback from 19th November

The following points were raised and discussed:

In general the Recovery at Home service was considered a good idea which would enable people to get better care and to get this at home.
There was some scepticism in the room that the change would occur as it seemed the PCT had tried something like this in the past.
The patient / family should have one contactphone numberonly – very important.
Important to have a named contact who sorts everything out.
People need to know what’s available – list of services.
If it’s not a GP then people must be visited by someone who can prescribe.
How will the GP be tied into the loop?
Who would be best placed to deal with short term & long term issues? Needs

may well evolve and change.

If the system is meant to be flexible then patients can stay longer in hospital and block beds. It is not thought this will be a problem; most people go home and want to do so.
It was noted that visiting care workers are not good at introducing themselves. Obviously you can’t have the same person working 24 / 7 so it is important people know who is visiting (especially if there is hearing or sight impairment).
Could young people use this service? They can if it is appropriate, but as it is community based it is thought there will not be a huge demand from the young.
Mental Health has yet to be considered. May need specialists in the team for this area.
The Mental Health Recovery Team might do this but the detail is needed.
Concern was expressed regarding the potential increase in demand for GP home visits, as they are already very busy. The hope is that if the person is well cared for then GP visits will be less of a requirement.
It is necessary however, to look at how out of hours GPs fit into this.
The implementation date is anticipated as September 2015 but some of the work has already started and new support services will start to emerge. Hopefully on the ground it will feel much better coordinated.
Questions were asked regarding where this had been discussed and it was noted Age UK, Carers Centre will contribute and many other stakeholders and professionals are involved.
It was suggested the CCG could use Healthwatch and Supermarkets to get the word around.
It was queried whether hospitals have a discharge protocol – as it regular seems to go wrong. There needs to be co-ordination through a single point of contact.

Feedback from 27th November

The following points were raised and discussed:

The model sounds good but will it work in practice, it seems there have been a number of attempts to resolve this?
An example of unhelpful practice was a given: Father in Law who is a carer for his wife who has dementia, is hospitalised every 4 months. Nothing is done and he comes home and goes back in again. Creates great difficulty as his wife has lost her4 carer when her husband is in hospital.
It is not only patients that do not know who is in the care teams. GPs don’t either as they were not involved with the design of intermediate care or never see the teams. Some GPs use them too much and others not at all. If a GP is uncertain they will default to hospital admission rather than leave someone without appropriate care.
It was noted a single point of contact is very important.
Visiting nurses now have a much higher level of competence which can diminish the need for hospital admission. The new teams under ‘recovery at home’ will be able to offer different types of support.
Revision should also mean anyone in the system can pick up a problem and respond accordingly.
The family will also be able to self-refer.
The intention is to reduce the number of people visiting but this will involve major cultural shift as it will no longer matter what your job is or who you work for – if there is a need then all should be able to deal with it.
Dr Pattison commented it was very much about relationships between people. If you don’t know someone it is easier to not see the significance of action needed for that person. The teams will be based together so they will all know each other.
Someone queried whether the change of the service would enable her ‘carers’ to go out for food when she wasn’t well enough to do so. She was reassured this was the case.
It was noted that this style of working means workers have to have good information on what support can be offered by the voluntary sector when a non-medical need is identified - which may well lead to illness if not addressed.
Comment was made on the importance of having the right mix of people and how flexible teams could be. It was acknowledged this is important but the details at this point are not fully thought through.
If people are to be kept out of hospital will this mean a greater demand for care homes?
It was acknowledged this may be the case but development of care homes is being managed alongside the recovery at home, so hopefully they can work together.
It is important to have all the practitioners seeing the patient as a whole – not a set of symptoms.
This relationship based approach should also help with enhancing knowledge and self-help ability of the patient.
People may also be willing to wait until the next day if they feel poorly as they know a trusted person will be coming to see them. If alone and anxious it is more likely people will ring 999.
It was queried how the message would be got ‘out there’ - people will only use it if they know about it. There will be a campaign raising campaign nearer the time and obviously all health and social care staff will be looking to spread the word. It is a bit early yet as not all the details are agreed.
Dr Pattison commented the longer term evidence of success would be increase in people using the services.
How much money is there for this – enough? Less hospital admissions, less people visiting and improvements in physical and mental health will in itself save a lot of money.
Will services such as house repairs, gardening etc. be covered? Age UK offer such services, but currently have a waiting list.
Comment was made on the value of good neighbours and people looking out for one another.
It is intended information will be available that lists all the services so people know what is available.
As things progress the public will be given a date when services ‘go live’. This will be around September 2015.
At the moment 75% of intermediate care team activity is to get people out of hospital. This needs to be better balanced where activity keeps people out of hospital in the first place.
The biggest concern voiced was the use of private care providers who promise a lot and provide awful care. There seems to be a gap between the organisations, the workers and the patients.
It was noted any care providers must be performance managed and incur penalties if not providing appropriate care.
There will not be private companies involved in the ‘Recovery at Home’ work.

What Next?

Feedback will be collated and incorporated into future CCG plans for developing the ‘Recovery at Home’ programme. There will be additional opportunity to become involved with this work and the CCG will contact their membership through My NHS, or people can keep an eye on the CCG website for further information.

Action taken will be reported at a future LEB and recorded on the CCG website under ‘Get involved , ‘you said / we did’

Next meeting

There are 2 meetings in February 2015, one in the daytime and one in the evening. They will both have the same agenda sopeople who cannot come along during the day can also share their views.

Please refer to the website for further details:

Friday 13th February, 2.30pm – 4.30pm, Washington Millennium Centre Library, NE37 2QD

Thursday 19th February, 6.00pm – 7.30pm, Stadium of Light, SR5 1SU

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