Voluntary Sector Networking Event

Voluntary Sector Networking Event

Feedback Report

Voluntary Sector Networking Event Feedback

The Voluntary Sector Networking Event took place on 8 February 2017. The event was promoted on two occasions via Healthwatch to voluntary and community groups, charities and social enterprises across Stoke-on-Trent and Staffordshire. An advanced notice to ‘save the date’ and details of the event/venue were circulated. In addition members of staff were asked to circulate via their networks.

A total of 67 people attended the event, representing a cross section of voluntary, statutory sector and communities of interest groups, and a further 12 apologies were received. To help to inform the round table discussions, guest speakers provided an overview of:

·  Local health economy – where we are now

·  Current position / implementation of new models of service delivery

·  Domiciliary care consultation

·  Patient experience (Healthwatch)

·  Funding opportunity

Following the presentations, attendees were asked to consider two questions (detailed below). The contribution from all organisations resulted in a richness of conversations, and the views / ideas / suggestions / questions were recorded by a facilitator at each of the roundtable discussions, which is summarised into key themes and detailed below:

Question 1

·  How as a local health economy can we support people in Stoke-on-Trent to prevent and/or reduce hospital admission:

o  What additional support initiatives can the voluntary sector provide?

o  Are there missed opportunities which health and social care are unaware of which with funding can make a positive impact and provide a true measurement of reducing / preventing hospital admission?

o  What collaborative approaches can be provided by the voluntary sector? Are there any barrier to collaborative working that commissioners can help resolve

Question 2

·  How as a local health economy can we support timely hospital discharge?

o  What are the gaps impacting upon delayed discharges?

o  Are there missed opportunities which can make a positive impact and demonstrate realistic measurable evidence to support timely hospital discharge?

o  What collaborative approaches could be provided by the voluntary sector? Are there any barriers to collaborative working that commissioners can help resolve?

o  Are there any different ways a person’s identified care and support needs could be met?

Additional support initiatives

·  Prevention – do we actually know why people are being admitted, further analysis to gain greater understanding of the reasons is a good starting point

o  Major causes are falls and excess cold

·  Preventative service – increase the usage of assistive technology

·  Reablement and independent support – the voluntary sector could help with this, could provide ‘pop in’ calls to known service users to check that they are ok and have a chat this would help

o  Build a rapport with the individual, notice any changes, which may prevent someone reaching crisis / deteriorating to such a point that requires further medical intervention and/or admission to A & E

o  Physical support could be provided around the home e.g. checking windows / doors, moving any trip/falls hazards etc.,

·  Proactive / preventative approaches need to be undertaken to:

o  reduce admission before crisis e.g. contacting residential homes where admissions are high

o  understanding non-medical issues e.g. family pets, key safes

·  Social isolation – befriending and community resources

·  A coordinated approach to help to support relatives for people who live alone, the coordinator could pull in all relevant services to help support the individual

·  Take into account the differences between assessment locations and the impact of this, too many times people are assessed in an acute or community hospital but their presenting needs are very often different once they are in their home environment. Voluntary sector could help with home environment assessments when service users are still in hospital

·  Home help / domestic calls the voluntary sector can do this for a price which will again reduce the need for qualitied carers to do this and should free up some domiciliary care capacity where by domiciliary care providers are currently delivering cleaning and/or domestic calls

·  Developing a different way of communicating such as accessing social media as a way of alerting the public to key messages for example, accessing Twitter as to find out for example … ‘does anyone know how we can access….. and encourage responses then choosing the one that’s right for you…..’

·  Care and support hotline / advice line (similar to 111)

o  A telephone number similar to the clinical 111 service, but for social care issues and queries

o  Voluntary sector could help to take the calls and provide advice

o  May reduce the pressure and volume of calls to the emergency duty team and 999

o  The service could have qualified care workers aligned, who would then be able to respond quickly, instead of paramedics attending

·  ‘Teach back’ is an easy to use technique to check that the health professional has clearly explained the information to the patient and that the patient has understood what they have been told. This technique goes beyond ‘have you understood everything’, instead the health professional asks the patient to explain or demonstrate, using their own words, what has been discussed, this technique could be replicated across the local health and social care economy. (Scottish Health Council adopted this approach)

·  Additional support activities the voluntary sector could provide

o  It is vital that carers and family members

·  Falls prevention / home assessments / a coordinated approach to prevention and addressing falls is required

o  New slipper scheme – falls prevention (targeted groups)

·  Age UK work with a handful of GP across the city providing navigator type services, but all are slightly different. Some work is based on risk stratification with patients consent. Prevention / early intervention – local variation on national model (Local Enhanced Services funding), trying to engage with commissioners and upscale, could we scale up across the city?

Gaps / Barriers

·  The city council should support short focused information sharing events to discuss ideas / share existing services to raise the profile (e.g. DWP have recently had same approach)

·  Recognising that demands means that sharing information will not jeopardise service delivery

·  Need to understand inappropriate admissions

·  Cultural issue needs addressing between clinical priorities and importance of timely coordinated discharge

·  Improve training and learning for hospital staff

·  Access to domiciliary care

·  Appropriate time of discharge / is the home environment ready – e.g. food / heating / minor adaptations in place in readiness for discharge

·  Voluntary services could be ward based / locations to support discharge ‘ out of sight, out of mind’ services not used if not visible

·  Statutory services are creating barriers or not working effectively as they could, and should stop seeing the voluntary sector as ‘an add on’

·  Small practical things should be straight forward to resolve but turn into major issue e.g. keys to get back home

·  Befriender to support people who may not have informal support/carer

·  Resources where there are commissioned services already working at capacity and cannot deliver more, although demand is outstripping need, no resource for 7 day working

·  Gap / barrier is created by the length of time funding is available

·  Transport is both a barrier, and gap

·  Asking a patient / carer to contact agencies can be overwhelming and may not happen better to refer on their behalf

Communication / listening

·  Understanding the person, at the earliest opportunity, including the unpaid carer / family connections. Very often there is an assumption that family and/or carers are a support mechanism for the individual, having an ‘open conversation’ with the individual

·  The system needs to listen to the persons wishes and act on them appropriately

·  Educating families to better understand when it is appropriate to go to A & E as oppose to ‘taking them’ to be on the ‘safe side’

·  Question on assessment process – are you happy for your details to be shared with providers?

o  This would enable the voluntary sector providers to get involved a lot quicker and earlier in the process (instead of an afterthought for small add on services)

·  People are proud and reluctant to engage, more accepting of informal care e.g. not someone in a uniform, doctor etc.,

·  Initiate a conversation/chat with the individual to engage people and understand the person

·  Communication – make people aware of local activities and services to reduce the need for other local authority or health services

o  Marketing and engagement (either local authority or funding source)

o  Voluntary sector do not have data to reach people but also do not have the funding to mail out to every single person in the city, there needs to be a target to potential service users but this cannot be done without data sharing

o  Voluntary sector workers can support people to access online information and advice when needed if the service user does not have access to the internet

·  Improved / open door referrals / barriers to ‘professional’ making referrals to a ‘identified funding stream’ driven from commissioned service

·  A conversation can remove barriers better than a form

Pathway – discharge

·  Appropriate time of discharge / is the home environment ready – e.g. food / heating / minor adaptations in place in readiness for discharge

·  Hospital staff need to consistently embed good practice discharge principles

·  Discharge planning

·  Voluntary services could be ward based / locations to support discharge ‘ out of sight, out of mind’ services not used if not visible

·  Implementing a checklist for people before discharge, to reduce duplication, using technology on the ward such as handheld devices (Ipad/tablet)

·  Every delay impacts on settlement at home, increasing change of a readmission

·  Consider holistic need – make it a positive experience

·  Navigator / coordinator / befriender to follow up and visit person day of discharge or next day, to ensure that patients are alerted to the types of services available and that planning could start at the earliest point prior to discharge

·  Collecting medication would speed up the discharge process

o  Would the voluntary sector be able to help out, if so would dedicated parking spaces be available, or funded motorbike/pushbike as these are easier to park

·  Clear pathways need to recognition of the person as the ‘carer’ as professionals and others do not recognise for example that a younger carer is fulfilling a caring role and very often are not acknowledged, once the cared for leave the hospital setting the younger carer continues to fulfil a caring role which has been overlooked by health and social care professionals

Voluntary sector

·  Voluntary sector can sometimes struggle to demonstrate the impact of service provision

o  Give the sector the ability to provide / demonstrate what the impact will be rather than being governed by outcomes already decided when commissioning services

·  Start taking responsibility to share information

·  Voluntary sector learning from each other, what works, what doesn’t work

·  Involving the voluntary sector – a change to the system is required

·  Lack of involvement from health professionals regarding voluntary sector

o  If known to either health or social care needs to be a link to the voluntary sector

·  Voluntary sector works well together and should be recognised for the partnership working that takes place and also recognise that the sector are experts within their own field

·  Raise awareness, there is a richness of support available in the city which the voluntary sector offers to individuals

·  Health and social care should be proud of the sector

·  Health / CCG evidencing savings / any support for the voluntary sector to evidence savings would be appreciated by the sector, need to look at work being undertaken by Wakefield saved approximately £5.5m

o  Other examples, Rotherham, Wakefield, Sheffield making impact of service and savings achieved

·  Recognising the contribution of the voluntary sector

Domiciliary care

·  Domiciliary care – start up times / cessations of care packages due to hospital admission / discharge and reinstatement

o  Patients in hospital losing their care when in hospital, more coordination needed with all social care/community service providers to reduce delayed discharges whilst person is waiting for services

·  Social workers thinking of packages as a priority volume is self-perpetuating

Carers

·  Carer support – presence in hospital for advice / signposting

·  Training for carers, and for professionals regarding caring

·  What are the links with the number of carers registered with their GP? What happens with the data, could this be used more effectively?

·  If carers supported / educated more likely to reduce hospital admission / GP visit

·  Where informal caring in place work with the carer to support them when things become unmanageable or extra support required

·  Include carers earlier in discharge planning process of assessment rather than after thought

·  More support for informal carers / relatives

o  Domiciliary carers provide prompts to people in the community, they are under used resource for sharing and providing information about for example, the local area, activities and support opportunities

·  It is vital that carers receive the right support, if a carer is unwell this can lead to carer crisis / breakdown, there have been occasions where both the carer and the cared for have both had a hospital admission

·  Important to recognise the needs of the carers and that commissioned services meet their needs, additional needs such as break opportunities and peer to peer support are considered

·  There needs to be recognition across the sector that both the younger and older generations fulfil a caring role

·  Carers to advocates / more people meet the criteria for accessing advocacy services but there is a lack of referrals to the service

Volunteers

·  Pool of shared hospital volunteers who are aware of training / available services who can advise / refer and give people the confidence that support is available