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We appreciate the time and effort that people give to get involved with our engagement activities and consultations. What you share matters and is included in NHS Canterbury and Coastal CCG’s formal decision making process. 

On this page you can find out what happened next with the projects or proposals that you have commented on or been involved with. Some of our projects and processes can take a long time to complete so if you don’t see the update that you are interested in keep checking this page and our newsletter.



In April and May 2019 Millbrook Healthcare and the Kent and Medway CCGs invited service users, carers, relatives, representatives and stakeholders of the Wheelchair Service to attend engagement events in Rochester, Canterbury and Whitstable.

These events have provided an excellent opportunity for Millbrook Healthcare staff and commissioners to hear directly from service users about their experiences and listen to suggestions that can inform further improvements in the service. More than 60 people who use NHS-funded wheelchairs took part and initial feedback from the events has been positive, with the majority feeding back they had found them informative sessions where they have gained a better understanding of the service and Millbrook Healthcare’s plans to improve.

You Said, We Did:

There was a lot of useful feedback from the events, with service users saying they wanted Millbrook Healthcare to review the complaints process, improve how the service communicates with them and explain better the process for issuing new wheelchairs. Thanks to feedback gathered from the discussion groups at the events, a number of changes to the Wheelchair Service have been made, or will shortly be implemented.

You Said

Some of you told us that you had experienced poor customer service and felt there was a lack of lived experience and understanding of service users.

We Did

The customer service teams in the Gillingham and Ashford depots have merged and are now all based in Ashford which has improved communication between the team.  The Customer Service Supervisor is providing training for staff to ensure standardisation of service delivery across the team, this will help to improve responses to service users queries and complaints.   Millbrook Healthcare has also successfully recruited a Community Liaison and Engagement Officer with lived experience who has been in post since November 2019.  Staff at Millbrook Healthcare, service users and other organisations/forums are already seeing the benefits of having this person in post.  This role will be pivotal in building and strengthening relationships with all stakeholders.

Alongside this, Managers within Millbrook have attended Disability confidence for managers training which was run by Disability Rights UK. 

You Said

You wanted communication to be improved such as staff being able to answer your queries and questions in a more timely manner. 

We Did

  1. Millbrook Healthcare continues to invest in technology to better meet the needs of service users and staff. 
  2. A better internal information system for the Kent and Medway Wheelchair Service was introduced in January 2019, which collects more accurate and timely information to be seen by staff and better supports patients through the 18 week pathway.
  3. Millbrook Healthcare is planning to introduce a service user portal so patients can  track their referral and see how their case is progressing.   
  4. We will be piloting a text message appointment reminder service later this year to reduce the number of people who miss their appointment.
  5. Improvement of  Customer Service induction programme.  The induction now includes specific wheelchair equipment training and customer service staff spend time shadowing field service engineers

 

You Said

You wanted to hear more about the service and be kept informed of updates and ongoing improvements to the service. 

We Did

The new service user portal will be one way to keep service users informed with ongoing improvements.  We will be introducing a quarterly electronic newsletter to email to service users to keep them up-to-date with the service and its improvements in 2020.  We are planning a number of listening cafés across the region to gather feedback from service users and their carers and relatives, which also provides opportunities for us to feedback our progress on improving the service.  We are also working on improving our use of social media as another way to interact with service users. 

You Said

You wanted better handling of complaints with better communication and progress updates.

We Did

A Complaints Concerns and Compliments Steering Group has been established with service user representatives, CCG and Millbrook Healthcare colleagues working together to improve the handling of complaints and to ensure that learnings from complaints help drive further improvements in the service and deliver better outcomes for service users.  Whilst there is no denying that the complaints process had previously not worked in the best interests of service users, efforts made over the last year driven by the Operations Manager have seen marked improvements in the timeliness of responses and engagement on a local level to achieve a resolution. The complaints policy and local service processes have been reviewed and the newly appointed Community Liaison and Engagement Officer will continue to drive this work forward to improve communications relating to complaints.

You Said

You told us about engineers not having all the equipment or spare parts required to complete repairs and not being able to request time slots for repair appointments.   

We Did

There has been significant improvement in the number of repairs being completed in a timely manner however there is still more to do.   Millbrook Healthcare has taken a number of actions to improve this area.

  • A full review of the current routing system to ensure all localities in Kent and Medway are visited by engineers within the three working days target.  
  • The service has introduced a more flexible user-friendly offer of morning or afternoon and ‘first slot’ appointments.
  • The new and improved real-time software reporting system which launched in January 2019 ensures that both sites are able to pro-actively manage and review repairs.
  • Continuous review of stock holding to better align with repair requirements.
  • New tracking system to enable better visibility of engineer location and therefore improve emergency response times.
  •  Increased focus on process, to maintain adherence whilst driving improvement.

 

Alongside these changes, field service engineers have provided a crib sheet for the customer service team to use, and are available to speak with service users in advance of visits to try and ensure that repairs were done correctly first time.  And a new dedicated Kent and Medway wheelchair service website is now available which enables service users to report repairs and upload photos of parts which need repair to support engineers to understand and decide how best to resolve the repair prior to the appointment.

You Said

You wanted more information about how to get involved with helping drive through improvements in the service. 

We Did

We have established a Service Improvement Board involving service users, carers and family members.  These meetings are held quarterly and play a pivotal role in monitoring progress against the service improvement plans and driving further improvements.  In addition to the Complaints, Concerns and Compliments Steering Group, service users are being involved in task and finish groups for Personal Wheelchair Budgets and the Eligibility Criteria. 

We welcome more service users getting involved so if you are interested please let us know by emailing the Wheelchair Service directly or Thanet CCG on tccg.wheelchairs@nhs.net to find out more.

Earlier this year, the East Kent Joint Committee of NHS Clinical Commissioning Groups gave the go-ahead to the formal evaluation of two potential options for the future health services at East Kent Hospitals University NHS Foundation Trust. The aim of the transformation of services is to make sure local people get the best, most effective hospital care when they need it – and more care, treatment and support out of hospital when they don’t.

This is the final stage in the overall process of developing options, a process which started in 2016 with a long list of options that had to meet hurdle criteria or be discounted. Followed by an evaluation of the medium list, and now there is the formal evaluation of the two potential options to agree a suitably robust shortlist which can then be consulted upon.

In July 100 clinicians, patients and the public attended an event to scrutinise proposals for how the evaluation of the two options would be carried out.  A ‘dress rehearsal’ to test both the evidence and the criteria; hundreds of volunteers came forward and 50 were chosen to ensure people with a mix of views and experiences of services were able to take part:

  • patients and carers who are young people, parents, working age adults, or retired
  • people with experience of using A&E for physical or mental health problems
  • people with experience of inpatient treatment at Kent & Canterbury, Queen Elizabeth the Queen Mother and William Harvey hospitals
  • people with long-term conditions that have led to regular hospital visits, or their carers
  • parents with experience of maternity or hospital services for children in east Kent.

An independent engagement/research company attended the event to record their observations and also analysed the feedback from the table discussions. Their full report will be included as part of the information supporting the PCBC and was shared with the evaluation panellists as part of the contextual information to consider.

You said

Both clinicians and patients studied the patient experience criteria, the factors identified and the data supplied to enable panellists to evaluate the options against the criteria.

There was general agreement that the measures are broadly right but seem to be more about quantity rather than quality/safety and patient outcomes. 

Both patient and clinicians questioned the use of increased single rooms as a key differentiating factor, but approved of: fewer hospital transfers, more four bedded bays, the separation of adult and children’s services, more bathrooms, more communal spaces for patients and an increase in parking spaces.

Accessibility was also looked at recognising the public interest this criteria elicits.  The factors chosen did not generate whole hearted support – but this was to do with the information provided to measure the criteria with, rather than the factors themselves.  For instance emergency travel times there was a general feeling that the data presented did not give a full picture of the travel time issues for emergency ambulances and therefore was not a good measure.  A common point was the need to look at the time frame from 999 call to arriving at hospital, not door to door of the ambulance journey.

We did

The report on the views from the public and health professionals at the workshop was used by panellists as qualitative data to inform their deliberations.  It was also used to influence the range of evidence being gathered as part of the pre-consultation business case, which will leads to the recommendation on which options go forward to public consultation.

This evaluation is the one of the final steps in preparing the business case, which now needs to be assured by the south east clinical senate and NHS England before the public consultation on the options can take place. No decisions will be made until after a formal public consultation.

For information about the two options go to the transformation partnership site https://kentandmedway.nhs.uk/where-you-live/plans-east-kent/east-kent-options-summary/

You can also find out more details on the next steps in the link below.

https://kentandmedway.nhs.uk/where-you-live/plans-east-kent/east-kent-next-steps

Across Kent and Medway we have a rapidly aging population with the number of people over 65 set to increase to by 14% by 2021, with many people living longer and healthcare improving people are often living with two or more long term conditions and managing increasingly complex circumstances to maintain their independence and quality of life as they get older.

It is estimated that 23,488 in Kent and Medway have dementia, 14,166 (60.2%) of which have a formal diagnosis.  The prevalence of dementia in Kent and Medway is expected to increase by approximately by 18% between 2020 and 2030. 

It is important that we have the right mix and range of services to support people to live well and independently for as long as they choose to.

This summer our engagement team in east and west Kent CCGs have undertaken an outreach process of 16 visits to dementia cafes, peer support groups and specific-interest groups such as older adults’ forums to involve 266 people living with dementia, their families and carers, volunteers and community based support organisations to see what they thought about the support services they are currently using, how they could be improved, whether there were any gaps, and if so what additional support might they need. 

You said

The findings show consistency across groups visited in both east and west Kent, and between types of group/VCS providers.

  • There is a great deal of variation across Kent in the range and availability of community support services and activities for people living with dementia and their carers
  • Patients, families and carers particularly value the voluntary and community led peer support and social groups such as dementia cafes and feel these are essential for (a) informal respite/break in routine; (b) carer to carer advice and support; (c) getting access to information on local activities and services; and (d) for people living with dementia to have safe places and activities to socialise and maintain their independence.
  • Carers and volunteers indicated that if patients are to remain where they usually live for longer, these community based activities would need to be more evenly distributed across Kent and be more frequent, at least once a week.
  • the range of activities and social opportunities currently available aren’t varied enough.
  • There should be more activities that promote physical activity and more activities with access to outdoor space and or garden settings.

 

The full report on our findings is here.

We did

Health, social care and voluntary sector organisations are now working together across Kent and Medway to address the issues highlighted above.  We have developed a dementia pathway which identifies the sorts of services which should be provided to support people with dementia and their families as needs change.  We are currently identifying the service gaps at each step of the pathway.

In order to help people with dementia to remain in their normal place of residence for as long as possible, we have started to describe a service which can provide support to people in their own homes, as well as in care homes at times of crisis and transition.  This was also a service gap which was identified by care homes during recent engagement work.

We are also looking at how we can improve the process of memory assessment and enable people to obtain a diagnosis of dementia and access post diagnostic support in a timely manner.

This work will feed into our dementia transformation action plan, which is currently being developed, with our partners at Kent County Council, and has already fed into our joint consultation on ‘community wellbeing services’ which was consulted on from October to December 2019, the results of which will be known in July 2020. 

Having listened to our patients, carers, clinicians, staff, stakeholders and the public Kent and Medway NHS is transforming both itself and the way it intends to deliver health and care

2019 was a momentous year for the NHS in Kent and Medway as they worked with staff, stakeholders, partners and patients, carers and the public on their future plans.

Seeking views on how health services are commissioned (planned and purchased). There are eight GP-led clinical commissioning groups (CCGs) across Kent and Medway, responsible for planning and spending the health budget to meet local needs. Although each of the CCGs has much to be proud of over the last six years, we now believe a single CCG is needed for Kent and Medway as part of other changes which will see all health and care services working much more closely together. 

 

In June 2019, we published a leaflet Helping local people live their best life which set outs more details. This included a survey which ran until August, to get people’s initial views on the suggested changes. The changes include GP practices working much more closely together in primary care networks, and all the services in given areas (such as east Kent) joining up to deliver care for local people together, as an integrated care partnership (ICP).

 

 In September we extended the engagement process to include discussions about the next five years and what were the priorities for Kent and Medway residents, i.e. what should be in our 5 year Kent and Medway response to the NHS Long Term Plan? 

 

In east Kent we held public roadshows in shopping centres, children’s centres and at community events to share the information and answer any questions. We involved 131 people, meeting them  in places of high footfall such as shopping centres and community events, and between 20 - 45 parents at children’s centres. To read more see the full engagement report below

You said, we did engagement report (273 downloads)

 

Earlier from 2017 to 2019, we had worked together as the Kent and Medway sustainability and transformation partnership, to involve patients, carers, staff, partners and stakeholders in helping us to discuss our challenges and priorities, both as a health care system and with patients and the public, staff and stakeholders as to what improvements were needed?

 

Through a series of surveys, listening events, workshops, summits, conferences, focus groups and patient stories we set up 16 workstreams for more details go please use this link below to https://kentandmedway.nhs.uk/workstreams/  or sign up to receive our regular bulletin: via this link https://kentandmedway.nhs.uk/kent-medway-stp-bulletins/ 

 

We spent time assessing our populations needs through the Public Health Observatory who have created area profiles see here, and working together with our partners on the Kent KID.  So we already had a shared sense of purpose and common vision, see here.  

 

Autumn 2019 we have asked local people to help us agree on what our top priorities and needs were to guide the next 5 years work.  In East Kent a hundred people came to an event at Canterbury Cricket ground and helped contribute their views to help us develop our 5 year plan which has been submitted to NHS England, and will be published in full once approved, but to read more about what we have put forward go to

To find out more read this

 

Once NHS England have approved of our plans we will publish them together with a summary and easy read version. 

 

We also have approval to form a single commissioning organisation for Kent and Medway and working towards launching this in April 2020, having recently appointed its first clinical chair Doctor Navin Kumta from Ashford.

Following discussions with families, we are delivering a pilot programme of support for parents/carers and children and young people in Canterbury, Herne Bay and Whitstable area who are waiting for an NHS assessment for Autism Spectrum Disorder. Some children and young people currently have to wait over two years for an assessment and during this period there is uncertainty about how to access support that understandably causes frustration and upset for the whole family.

The pilot was designed through a process of co-production with parents/carers. Initially we undertook a survey with families on the waiting list to understand what assistance they were particularly looking for.

You said

What families have told us is – they need help with:

  • Sleep/bedtime, managing anxiety and sensory difficulties were key areas of need
  • Parent wellbeing/support, and help working with their child’s school were key additional support needs
  • Information about a range of services, also face-to-face support (parent support groups, child groups, schools, etc) was most popular for families
  • Families want services that are non-judgemental, realistic, honest and fair
  • Parents want advice on how to better meet their child’s needs, and their child to have access to medication and therapeutic treatment
  • The majority of parents only partially knew or didn’t know at all what would happen next after referral for assessment
  • Most families said that after referral for assessment there was no real difference in level of wellbeing for either the child being referred or their family in general

We did

We then planned an event and created a handbook of information detailing the support currently on offer to meet identified needs.

We also involved many of the organisations who currently offer support in the pilot area both as an opportunity to showcase the support they can offer, and as a chance for children, young people and their families to discover more about the type of assistance available to them in health care, education and within the voluntary and community sector so that they can then access the help they need as individuals and families. 

The first “Understanding Autism” event held in Canterbury in October 2019 was very well received by the 39 families who attended with over 50 per cent of adults who filled in an evaluation form rating it 10 out of 10 (15 out of 28) and everyone rated the event positively. A mid-term report has been produced for the Kent and Medway Joint Clinical Commissioning Group, and the 0-25 Health and Wellbeing Board. This can be viewed here.

Next Steps

Again we are working with children and young people, parents and carers (including some who attended the first event) to further improve the support on offer – we have taken a more detailed look at the handbook to amend the information on offer.

Another event will be held in mid February 2020 for those 70 families who could not book a place at the first event but had expressed an interest in attending. This event will include specific sessions for children and young people to help them learn more about autism.

Following the second event we will be able to share a model which could enable the delivery of a similar approach across Kent and Medway as part of the response to the 2019 Ofsted and the Care Quality Commission (CQC) joint inspection of SEND provision in Kent.

A written statement of action (that responded to the inspection’s findings) made a commitment to “transform the way that we engage with parents and carers through the development of a new practice model based on openness, partnership and co-production, working with parent and carer forums”. The Canterbury pilot is helping to deliver on that commitment.