Big Health and Care Conversation

Event summary and report

The NHS is under financial pressure with growing demand for services. It has never been more important to involve people in changes so that the NHS can help people to help themselves.

As a result NHS Coastal West Sussex Clinical Commissioning Group led the Big Health and Care Conversation (BHCC) engagement events during 2018-19 to engage with our local population about the challenges facing the NHS and how people can get involved in the work to address them.

This report summaries the aim of the events and highlights the key themes of discussions that took place.

Accessibility of this report

Please note that this report can be made available in alternative formats, such as easy read or large print, and may be available in alternative languages, upon request.

Please contact the communications team at contactus.coastal@nhs.net or by calling 01903 708400.

Overview

The ‘Big Health and Care Conversation’ was a programme of engagement activity designed for hearing the community voice across the eight Clinical Commissioning Groups (CCGs) in Sussex and East Surrey.

It has been an opportunity for our population to find out more about plans to change the way services work together, improve care and ensure that people can continue to receive high quality affordable care for years to come.

The key messages for the BHCC events have been:

  • Talk with us about how the NHS is changing and where the priorities are.
  • Share your ideas with us about how health services can improve.
  • Hear the latest about the Sustainability and Transformation Partnership (STP).

BHCC events in Coastal West Sussex

In Coastal West Sussex we held three public events, located in our rural community of Billingshurst and our more urban communities of Chichester and Worthing.

These events have provided opportunities for people to hear from commissioning leaders and to feed in their opinions both during and outside of core working hours.

The events took place on:

  • 12 September from 2pm to 4pm in Billingshurst
  • 30 October from 10am to 12pm in Chichester
  • 08 November from 5pm to 7pm in Worthing

The public meetings were individually tailored to reflect the audience in attendance.

In Billingshurst it was a smaller less formal focus group style event with 12 attendees. Both Chichester and Worthing events were larger in scale with each attracting 35-40 people, representing both their community and professional partner organisations.

The topics suggested to prompt conversation were related to the commissioning priorities and the CCG’s delivery plan:

  • Hospital services and urgent care
  • GP services​
  • Prescription services and using medication
  • How partners in local health and care services are working together
  • Mental health care and wellbeing​ services
  • Anything else related to health and social care locally

At each event, notes from discussions were captured by the table facilitators and were collated and analysed to identify key themes. There were many similarities in the opinions and experiences shared and also some that were unique to the community and population of the geographical area.

Overall across the three events there was generally a very positive consideration of integrated working across health and social care. There was strong emphasis on prevention, early intervention and the fundamental importance of looking at patients as individuals when considering their care.

The importance of relationships was heard throughout all three events, be that the relationship between health professional and patient or between organisations and professionals. The notion of respect was a common thread throughout many of the discussions.

“The bedside manner of GPs and all professionals is so important for making patients feel listened to and like they matter.”

Feedback by discussion topic

Hospital services and urgent care

The general thought about hospital and urgent care was positive with many personal experiences shared. The Associate Director for Primary and Community care integration at the CCG, Sarah Henley, shared information during table discussions about the plans for improving urgent care locally. Sarah was able to explain how the model for Urgent treatment centres will simplify services and make it easier to see the right professional at the right time.

GP services​

Around the tables, there was some talk of digital appointments and questions asked as to when these might be more available locally. The topic of digital appointments created some positive thoughts around the idea and some scepticism. It was noted round some tables that there is a vast disparity across the area with the quality and suitability of the buildings that GP services occupy. Thinking around how best the NHS can use its building assets continued with some conversation around putting wellbeing services into GP surgeries or council buildings that are most likely to be visited by people in the community.

Working in partnership

Many conversations included thoughts around social care and the experienced or perceived lack of it. The integration of health with social care seemed to make sense to people in the main with many conversations steered towards the challenge of knowing what services are where, how duplication can be avoided and making the best use of volunteers. The idea of better supporting and utilising volunteers is something that came up several times across many subject discussions;

“…there is a wealth of skill and resource available in the number of volunteers in this area and the NHS would do well to tap into this”

The concept of social prescribing was discussed and there were experiences shared by people whom had personal experience or knowledge of being offered non-medical support through their GP surgery, such as housing advice and there were professionals in the room whom were able to explain about how social prescribing and community referring are the same thing, aimed at addressing people’s needs in a holistic way.

Mental health care and wellbeing​

This subject area was very popular and more people chose to sit at the designated tables to talk about this, than for other subject areas. There was some concern shared about the amount of money that is spent on mental health services.

The CCG’s Associate Director Martin Pannell was able to reassure people with some useful insight about the actual spending on mental health in our area:

“The CCG has increased expenditure on mental health care over the past few years in line with the ‘mental health investment standard’ (MHIS) requirement. As demand for mental health care continues to rise, the opportunity to discuss with colleagues and our local population how to most effectively meet those needs was invaluable. The rich and varied contributions will make a real impact on our thinking and actions going forward’.”

On the Mental Health tables there were concerns voiced over the large numbers of anti-depressants being prescribed and a perceived lack in the provision of talking therapies. Treating the cause rather than the symptoms was something of importance for many and there was consideration given to how the stigma of mental health still exists. A fuller understanding of what is meant by the term mental health would be helpful for people to know as there were some variations in what people considered it to include.

“…the term mental health covers such a range of issues, from anxiety that is affecting regular everyday things to a diagnosis of schizophrenia and people don’t always know the breadth that the term covers”

Dementia care was highlighted as an area of great importance and there was some discussion about perceived and experienced long waiting lists and the need for more specialised care in the community.

Child and Adolescent Mental Health Services (CAHMS) was perceived by some people to be lacking in capacity and there was conversation around how vital it is to address the issues of mental health at a young age to attempt to prevent issues from escalating. There was a perception that during the transition phase between CAHMS and adult services there is a real risk of people falling through a gap between the two different provisions.

Access to services

This was particularly mentioned at the Billingshurst meeting in one of the CCGs rural communities. Specifically there was mention of people having access to public transport as a means to getting to services that are branded as ‘local’. It was encouraged that when planning services there should be consideration of what means ‘local’ to one person may be very different to someone else’s reality.

Online community

There is an ongoing digital mechanism for capturing people’s thoughts and feedback about local health and care services areas available on the CCG website, which has been promoted through our core channels.

There was comment made about digital poverty and recognition that not everyone can easily access information when its online.

Promotion

Information about the events was sent in hard copy and electronically to all of our GP practices – and particular emails were sent to the chairs and members of the Local Community Networks. An article was sent to our Patient Participation Groups (PPGs) for insertion into their newsletters and wider circulation and there was a newsletter article in the July and August edition of the Coastal ePanel newsletter, which reaches around 500 people.

A regular article was promoted in the Johnston Press suite of newspapers and posters were sent electronically to all of the libraries in the Coastal West Sussex area as well as all of the parish councils.

The CCG contacted supermarkets, children and family centres and voluntary/community organisations, community centres (such as The Grange in Midhurst) - particularly in the rural areas - to ask for support in promoting the events.

The health and social care providers and partners in Coastal West Sussex also supported promotion of the events via their organisational mechanisms i.e. West Sussex County Council residents ePanel.

Thank you…

The CCG would like to thank all of the people who were able to attend the BHCC events and would encourage others to feedback their opinion through the online form.

Coastal West Sussex CCG are committed to working with the public as partners and in involving them in commissioning work.