What you said in 2016

Each year the CCG runs an engagement campaign focusing on key issues.

In the autumn and winter of 2016 the engagement team took to the streets and areas of high footfall with four questions and our oversized blackboards!

What we asked:

  • Prevention and self-care: What one thing could keep you/your family healthier?
  • Primary and urgent care: How can we reduce the pressure on GPs/A&E/the NHS?
  • Waste: The NHS wastes £300m per year on unused medication – why do you think this is?
  • Coordination of care: We think that health and social care need to work better together – what do you think?

Where we went:

  • 15 September ~ Angmering ~ Haskins garden centre
  • 6 October ~ Worthing ~ Town centre
  • 20 October ~ Chichester ~ Town centre
  • 8 November ~ Worthing ~ St Lawrence Surgery flu clinic
  • 26 October ~ Petworth ~ Children and family centre
  • 26 October ~ Midhurst ~ Children and family centre
  • 17 November ~ Pulborough ~ Tesco supermarket
  • 1 December ~ Bognor Regis ~ Sainsbury’s supermarket

What we heard:

In total the team collected over 700 comments from the four questions broken down as follows:  

  • Prevention and self-care - 178
  • Primary and urgent care - 230
  • Waste - 169
  • Coordination of care - 125

In addition members of the public were also asked if there was ‘anything else’ that they would like to tell us and a further 44 comments were captured. 

Prevention and self-care: What one thing could keep you and your family healthier?

There were eleven themes that emerged from this question the most popular being diet including healthy eating closely followed by a similar amount of responses for exercise and education and information. The number in brackets indicates the count of responses.  

  • Diet including healthy eating (56)
  • Exercise (44)
  • Education and information (40)
  • Healthy lifestyle (e.g. lose weight/stop smoking/drinking) (35)
  • Personal responsibility and self-awareness (29)
  • Screening and wellbeing checks (11)
  • Positive mental health/wellbeing (11)
  • Support from family and community (9)
  • Better access/shorter waiting times (6)
  • Better social care including access to services (3)
  • Honesty from health professionals (2)

Some comments include:

‘Eat healthily more emphasis on exercise. Good advice is available such as Change4Life app but got to want to do it. Education is important for people who don’t know what healthy looks like’

‘Education at an early age – teach children to cook and eat healthily’

‘More holistic check-up: doctors inform about Tai Chi (for example)(rather than) dish out prescription’

Screening and wellbeing checks was also a popular theme suggesting that regular health ‘MOT’ checks could identify health concerns early and possibly reduce intervention at a later stage.

‘The one thing I would urge all doctors to do is to give their patients a once-a-year medical check-up or M.O.T. whether they need it or not. We do it to our cars but not ourselves, which is more important? A half-hour medical check-up may catch important issues of health and be re-assuring to the patient who may only come to a surgery once in e a blue moon, especially men! Make it a necessity of joining a surgery’

Primary and urgent care: How can we reduce the pressure on GPs/A&E/the NHS?

Perhaps unsurprisingly, this question prompted the most amount of comments from members of the public. There were fourteen themes that emerged from this question the most popular being appropriate use of services.

  • Appropriate use of services (including choose well) (43)
  • Staffing (less agency/training/specialists) (32)
  • Generate revenue (missed appointments/A&E/overseas) (28)
  • Funding (investment/taxes) (24)
  • Expectation/perception (21)
  • Less red tape/managers/bureaucracy (15)
  • Alternative/timely access (i.e. telephone consults) (14)
  • Access and quality of GP services (14)
  • Improve OOH/111 (12)
  • Support/mental health support/counselling (9)
  • Government/political/privatisation (9)
  • Efficiencies/pressures (9)
  • Plaudits (8)
  • Learn from others overseas/volunteers/private & third sector (7)

 A common suggestion was around using services other than your GP including pharmacists:

‘Use pharmacists – no queuing and great service’

‘People don’t always trust pharmacists so let’s re-educate the public about the training and experience of pharmacists – they are great’

The next two most popular themes were for staffing  

‘need more GPs – population bigger but same number of GPs’

‘keep foreign workers – we need them’

and generating revenue

‘fines for missed appointments’

‘pay for visits with GP like with dentist and optician’

It was encouraging to hear a variety of plaudits about NHS services particularly about our local hospitals 

‘Worthing Hospital is fantastic’  

‘had brilliant experience both myself and husband – cancer and heart – Chichester hospital is great’

as well as more general positive comments

‘NHS best system in the world. Had experience in other countries and always glad to come back to UK’

Waste: The NHS wastes £300m per year on unused medication – why do you think this is?

This question prompted eleven themes and although this question was predominantly aimed at medicines waste, comments were also received about wastage in other areas such as equipment  

‘what a waste – reuse zimmer frames and crutches etc.’

and

‘£1000 equipment not re-used – crutches and bed thrown away. 3 bin bags full checked paperwork phoned everyone.’

  • Improve prescribing practices (short courses/smaller packs) (38)
  • Repeat prescribing (35)
  • Re-use medication/equipment (throw away unused) (34)
  • Medicines review (26)
  • Attitude (i.e. its free so gets abused/ask for what need) (24)
  • Stop taking (feel better/side effects) (18)
  • Patient expectation (i.e. always expect a prescription) (12)
  • Reminders/checks for elderly and dementia patients (9)
  • Prescribing of Over The Counter medicines (7)
  • Management/staffing (6)
  • Drug companies (4)

A clear message around repeat prescribing and improving prescribing practices came across. Comments on these themes include:

‘Changed meds but old ones still come’

‘Got a repeat prescription for all my meds but only needed one’

‘(GPs) Need confidence to not prescribe’

‘Time pressures – GPs prescribe to move the patient on’

Twelve comments were given around patient expectation in that people should not always expect to get a prescription when they visit their GP 

‘expectation that patients will leave with a prescription – need to change attitudes.’

One area that was highlighted is the prescribing of Over the Counter medicines, i.e. medication that is readily available to buy at a pharmacy such as paracetamol and ibuprofen.

‘Stop prescribing Paracetamol unless it is absolutely necessary – it is cheap enough to buy’

This is quite topical as neighbouring CCGs have made a decision to cease funding the prescribing of paracetamol and ibuprofen for short term minor ailments.

Coordination of care: We think that health and social care need to work better together – what do you think?

  • Better working practices including the sharing of information was the most popular theme. 
  • Integration: sharing information/working practices (34)
  • Communication/information (25)
  • Community service/support District Nurses etc.(20)
  • Funding: investment and joint budgets (10)
  • Better pay/working conditions (9)
  • Access to service/more accessible care home beds (8)
  • Agreement/no suggestions (8)
  • Mental Health access (5)
  • Plaudits (2)

Some of the comments focused on IT issues  

‘computer systems don’t work well together’

while others were directed at the sharing of notes and better communication between social and health care services and staff to avoid duplication  

‘better communication, departments need to talk to each other – non-attendance isn’t always the patients fault’

and

‘share information and records so not having to repeat.’

An interesting comment highlighted the frustration that some are feeling

‘Been talking about this for 25 years – need some action!’

Anything else?

In addition there were 44 comments that did not fit into the above questions and was an opportunity for members of the public to let the CCG know of any other issues.

  • Positive comments/plaudits (23)
  • Access to services (8)
  • More resources (staff/funding) (5)
  • Modernisation including learning from overseas models (3)

At a time of huge pressure it is encouraging that members of the public are still extremely positive about their NHS services and the majority of comments reflect this:

‘Thank you for looking after my husband’

‘Fantastic when you need it in an emergency’

‘Very good here. Very busy in London. Waiting times and appointments are good. Maternity brilliant here. Son has health issues and is being treated well. NHS is brilliant. Had lots of intervention here – no complaints.’

A selection of other comments include:

‘NHS needs a complete overhaul – working on 1947 model which did not deal with the level of complexity and diagnoses of today. Need to look at European models.’

‘Reduce the cost of parking’

‘Don’t let frail elderly become invisible esp. if unsupported (dementia)’

‘Had echocardiogram at surgery – better than travelling to the hospital’

‘Charge for appointments/missed appointments – deterrent against people wasting time - If it’s free it’s abused’

What happens next?

The report was represented to our Public Engagement Committee (PEC) in March 2017 and published on the CCGs website. In addition it will be circulated to our interested parties and stakeholders including:

  • CWS CCG ePanel
  • Patient Participation Groups
  • Council for Voluntary Services
  • Healthwatch