The NHS is reviewing how it provides Same Day Urgent Care in Somerset, and we want to hear your views to help shape and improve access to services in the future. Same Day Urgent Care services treat people with urgent problems that have been caused by an accident or illness. Urgent care might be provided, for example, by your GP, minor injuries unit, NHS 111, pharmacy, dentists, or opticians. We are working in partnership with NHS Somerset to find out what you know about Same Day Urgent Care, where you get information about these services, and how you use them. We also want to hear how you think urgent care services should be provided going forward. Healthwatch Somerset is the county’s independent health and social care champion. We have the power to make sure NHS leaders and other decision-makers listen to your feedback and use it to ensure services meet the needs of the community. You can share your views, confidentially, by 30 November 2022, by completing a short online survey [now closed] or by calling Freephone 0800 999 1286. In coming months, you will also be able to talk to us face-to-face. Between November 2022 and summer 2023, we will visit community groups across the county to gather more feedback about Same Day Urgent Care. This public engagement project follows on from our March 2022 consultation on people’s views of urgent care in West Somerset. Read our report,  Same Day Urgent Care in West Somerset , which includes recommendations, based on public feedback, for how to improve information and access to urgent care services.

Quarterly feedback to the NHS Local Dental Network from local Healthwatch in the South West. Data from Healthwatch Somerset is included in the report. Number of responses: 27 Sentiment: All negative Themes: Unable to find a dentist in Somerset; Not being able to afford a private dentist. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

When you need specialist NHS support, like hospital tests or treatment, you often need a referral from your GP first. Find out what this includes and what to expect. What is a referral? Your GP is often the first person you speak to when you have a health issue or symptoms you’re worried about. GPs and other health professionals at the practice are highly skilled and can offer medical advice, provide diagnoses and prescribe medicines for lots of common conditions. Sometimes, your GP might decide you need to see another healthcare professional for specialist tests, treatment or care. When they request specialist tests or treatment on your behalf, this is known as a referral. Examples of referrals could include: Scans or tests for a diagnosis of a condition or health issue Wellbeing services, like smoking cessation or diabetes management Physiotherapy Minor surgery In most cases you need to see your GP or speak to a doctor at a hospital to get a referral to another NHS service. Although sometimes, other healthcare professionals, such as a nurse, can make referrals as well. You can also sometimes self-refer to further NHS support, like mental health talking therapies. What's your experience? Waiting for your GP to refer you for more support can take time. Help us identify what can be better by sharing your feedback with us online. Whether positive or negative, the NHS needs to hear your views. What can you expect? Unless you can self-refer, specialists will only see people with a letter of referral from their GP or a hospital doctor. Your GP or the hospital doctor supporting you should: Discuss why they want to refer you and what tests or treatment they think should be carried out Provide choices of where and who you can be referred to, with information about the hospitals and doctors working there Give you information on the referral letter about how to make an appointment as each service uses different ways of arranging appointments. What are people’s rights? The  NHS Constitution for England  formally states that: People have the right to access NHS services People will not be refused access on unreasonable grounds People have the right to receive care appropriate to their needs and preferences People have the right not to be unlawfully discriminated against when trying to access services on grounds of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity, or marital/civil partnership status The Constitution also sets out that once you’ve been referred, you have the right to start some treatments within a specific timeframe. This time starts from the day your appointment is booked, or when the hospital or service received your referral letter: 18 weeks maximum for a first appointment for elective/routine/planned/non-urgent consultant-led treatment Two weeks maximum to see a specialist for suspected cancer The NHS  also states that in terms of choice and preference, you are entitled to ask for a referral for specialist treatment. However, the final decision will always be down to your GP or the hospital doctor responsible for your care. If you have been denied a referral you are also allowed to seek a second opinion from another doctor.

Find out the signs and symptoms of monkeypox, what to do if you think you have it and who is eligible for a vaccine. A  small number of people  in the UK have recently been diagnosed with monkeypox. Most of these cases are in London and the risk of getting it is still currently low. Although anyone can get monkeypox, most cases in the UK have been in men who are gay, bisexual or have sex with other men. If this is you, it’s important to be aware of the symptoms of monkeypox and what to do next.    What is monkeypox? Monkeypox is a viral infection, which is spread by very close contact with an infected person. Initial symptoms: Fever Headache Muscle aches and back ache Swollen glands Chills Exhaustion Joint pain A rash usually appears one to five days after your first symptoms. This can be on any part of your body, including your face, hands and genitals. You may also have anal pain or bleeding from your bottom. Usually symptoms are mild enough to not require hospital admission but can last up to four weeks. What should you do if you think you have monkeypox? You should call a sexual health clinic if you have a rash with blister, anal pain or bleeding from your bottom and have either: Been in close contact, including sexual contact, with someone who has or might have monkeypox (even if they’ve not been tested yet) in the past three weeks. Had one or more new sexual partners in the past three weeks. Been to West or Central Africa in the past three weeks. Before visiting the clinic, you should call them first and tell the person you’re speaking to if you suspect you have monkeypox. You can also call NHS 111 if you’re unable to contact a sexual health clinic. What should you do if you think your child has monkeypox? You should call your GP if your child has a rash with blisters and has either: Been in close contact with someone who has or might have monkeypox (even if they’ve not been tested yet) in the past three weeks. Been to West or Central Africa in the past three weeks. Call the surgery before you visit and tell the person you speak to if you suspect your child has monkeypox. Do you need to self-isolate if you have monkeypox? While you have symptoms, you can pass monkeypox onto other people. You should stay home and avoid close contact with other people, particularly young children, pregnant women and immunosuppressed people. Children should also stay at home and avoid close contact with other people. The UK Health Security Agency (UKHSA) has produced detailed advice about  how to isolate safely at home . You should self-isolate at home until: You have not had a high temperature for at least 72 hours. You have had no new blister in the past 48 hours. All your lesions have scabbed over. You have no lesions in your mouth. Any blisters on your face, arms and hands have scabbed over, all the scabs have fallen off and a fresh layer of skin has formed underneath. If you meet all the points above, you may be able to stop self-isolating, but you should seek medical advice first. You should also continue to avoid close contact with young children, pregnant women and immunosuppressed people until all the scabs have fallen off and a fresh layer of skin has formed underneath. It is not known whether monkeypox can be transmitted through genital secretions, and so it is recommended to use condoms for 12 weeks after your rash has scabbed over and fallen off. What should you do if you are a close contact of someone with monkeypox? If you are a close contact of someone with monkeypox and you have symptoms you should isolate for 21 days. If you test positive you will need to continue to isolate. If you do not have symptoms you do not need to self-isolate, but you should follow guidance from the UK Health Security Agency (UKHSA): Contact NHS 111 or a sexual health clinic if you develop a fever or any of the other monkeypox symptoms. Avoid skin to skin contact with others. Refrain from sexual or intimate contact. Avoid international travel if possible. Let any health or care staff know you’re a close contact before you attend any appointments. Is there a monkeypox vaccine? Yes. Monkeypox is caused by a similar virus to smallpox. The smallpox (MVA) vaccine should give a good level of protection against monkeypox. The UKHSA and the Joint Committee on Vaccination and Immunisation is recommending the use of the smallpox vaccine as part of our response to the rise in cases of monkeypox in the UK. Currently, the NHS is offering smallpox vaccines to people are most likely to be exposed to monkeypox. This includes: Healthcare workers who are caring for and who are due to start caring for a patient with monkeypox. Gay, bisexual and other men who have sex with men. Your clinician will advise vaccination for you if you have multiple partners, participate in group sex or attend ‘sex on premises’ venues (staff who work in these premises may also be eligible). People who have been in close contact with someone who has monkeypox. You should receive a single dose of the vaccine as soon as possible, ideally within four days of contact, but it can be given up to 14 days after. If you’re at risk of exposure, your local NHS services will contact you and offer you a vaccine. You can also check the website of your local sexual health service for more information. Further information about monkeypox GOV.UK : general monkeypox information Latest GOV.UK updates on monkeypox in the UK NHS: general monkeypox information Terrence Higgins Trust: monkeypox in the UK UK Health Security Agency: Protecting you from monkeypox Groundswell: monkeypox

Last year (April 2021-March 2022), we supported almost 2,900 people to have their say on health and social care and to get the right information and advice about local services. In our latest Annual Report,  Championing what matters to you , we highlight how we've worked throughout the year to understand people’s health and care needs, and to use public feedback to help NHS and social care services improve care in Somerset. The report also outlines our work planned for 2022-23. The year in numbers In total, 2,896 people shared feedback or sought information about health and care services. 1,903 people shared their experiences of local health and social care services. 996 people asked for information, advice, and support on how to get the care they need. 35 volunteers supported us last year, giving up 92 days of their time to make care better for their community. We published five reports about the improvements people would like to see to health and social care services. Our reports and how public feedback has made a difference 1. District Nursing Service:  We found that most people were very happy with the care they get at home, but they would like the District Nursing Service to offer weekend and evening visits and many people are cautious about digital consultations. Somerset NHS Foundation Trust is using this public feedback to develop their transformation plan for the District Nursing Service. 2. Young people’s health and care services:  Young people told us they want more joined up services and better communication. Somerset’s NHS Clinical Commissioning Group are using the insight from this report to inform delivery of the NHS Children and Young People’s Transformation Plan. 3. How are patients affected by waiting for surgery?  Our report alerted the NHS that patients believed their condition deteriorated while waiting for surgery and they want more support and better communication while they wait. The NHS in Somerset is now piloting a scheme offering exercise to patients waiting for joint replacements to help maintain mobility; they now contact people on the waiting list to check on them; and the Trust is creating information materials to support patients on waiting lists. 4. Patient experiences of the NHS 111 service in Somerset and Devon:  This report informed the service provider, the Care Quality Commission, the Clinical Commissioning Groups (CCG) and the NHS in Somerset and Devon, of common and continuing areas of concern. Public feedback influenced Devon CCG to recommission the NHS 111 service in their area. 5. Same day urgent care services in West Somerset:  Somerset’s NHS Clinical Commissioning Group wanted to find out what local people know about these services and how they think they should be provided and promoted. Our report went to Somerset NHS Fit for My Future Board to inform the ongoing review of how NHS urgent care is provided in Somerset. Announcing the annual report, Judith Goodchild, Chair of the Healthwatch Somerset Board, said: “Despite another challenging year due to COVID, we have covered an extensive programme of work and made sure your views were heard by health and care decision makers to inform positive change in the services you use. Going forward, we are committed to championing better care for everyone, including those who often go unheard. We will continue to work closely with the NHS, local councils, care providers and the voluntary sector, sharing people’s concerns and queries to help improve access to services and quality of care.” Our priorities for 2022-23 Reducing the barriers people face when accessing services  – particularly around access to face-to-face appointments and digital access. Championing the voices of those who often go unheard  – including young people in need of mental health support. Influencing decision makers on a local level as services evolve  – including working with Somerset’s new Integrated Care System (ICS) and looking at people’s experiences of being discharged from hospital to intermediate care or back to their own home. Read the full  Healthwatch Somerset Annual Report 2021-22  to find out more about our work during the past year, including findings and recommendations for changes to services.

As Somerset’s new Integrated Care System (ICS) becomes a statutory body and formally starts work on 1 July 2022, we look forward to a productive partnership to make care better. Integrated care systems are partnerships that bring together providers and commissioners of NHS services across a geographical area with local authorities and other local partners, to collectively plan health and care services to meet the needs of their population. Gill Keniston-Goble, Healthwatch Somerset Manager, said: “The introduction of Somerset’s Integrated Care System gives us an opportunity to feed people’s views into the planning and running of services – especially the voices of those who are not being heard now. “We will work hard to make sure the views of local people are represented in the new structure. We are also committed to playing our part by championing equality and inclusion, and helping services reach every bit of the community. “When services listen and act on the experiences of patients and service users, it results in better care. We have a real chance to create a true partnership between services and the public here in Somerset.”

Information and advice from Somerset NHS Clinical Commissioning Group, May 2022 Summertime sniffles, bites and rashes? Think Pharmacy – a new service launches for quicker treatment of minor conditions in Somerset A new GP community pharmacy consultation service (CPCS) is being rolled out across Somerset to help patients with a range of minor conditions, such as skin rashes, aches and pains, access quicker treatment via their local community pharmacist. Patients using the service for minor conditions are already freeing up approximately 1,000 GP appointments every month in Somerset for patients with more complex conditions. Now, when you contact your GP regarding a minor condition, after discussing your condition, where appropriate, the receptionist will offer you a same day appointment with a community pharmacist of your choice – in person, or over the phone. Community pharmacists have already successfully seen thousands of patients in Somerset for a consultation for a minor condition since the scheme was piloted in Somerset GP practices. The service is proving particularly popular with parents of toddlers and teens and older people for conditions such as eye and ear infections, sore throats, skin infections, sprains, and urinary tract infections and for those with common summer conditions such as hay fever, insect bites and skin rashes and those with sprains and falls. A minor illnesses or injuries could include: Ankle, foot, knee, leg or arm strains and aches Bites or stings Coughs and colds Eye and ear infections Hay fever Headaches Mouth ulcers and blisters Rashes Skin conditions Sore throat Urinary Tract Infections (UTI’s) How the service works You will be contacted by your nominated community pharmacist to arrange any appointment for a consultation in person or on the phone. When you have a consultation for a minor condition, your pharmacist will take your medical history, ask about your symptoms and any current medication you might be taking. Following the consultation, they will offer you clinical advice and if appropriate, offer you an over-the-counter product. Increasingly pharmacies can also prescribe medication such an anti-biotics and are often open at evenings and weekends. The pharmacist will make a record of the outcome of your consultation and send it to your GP. If having given you advice or treatment, your pharmacist thinks you may need further specialist help they will be able to refer you back to your GP or recommend another health service for support. Dr Jeremy Imms, Associate Clinical Director, Somerset Clinical Commissioning Group, said : “The Somerset Community Pharmacy Consultation Service will be of huge benefit to many of our patients as lots of minor conditions are more appropriate for a consultation with a community pharmacist, rather than a GP. “This will improve access for patients with minor illnesses and will also help us to free up GP appointments for people with more complex health needs; helping ensure everyone gets treated at the right time, by the right healthcare professional. “At this time of year people are beginning to experience seasonal conditions, such as hay fever, insect bites and rashes, and more sporting and other minor injuries from just being outdoors more. Our community pharmacists are highly experienced in diagnosing and treating common complaints, and patients will now the ability to choose to have their consultation with a pharmacy close to home at a convenient time.” Michael Lennox, CEO of Community Pharmacy Somerset, said: “Community Pharmacists are highly trained healthcare professionals with five years training and spend a high percentage of their time helping treat patients with minor illness and recommend over-the-counter treatments where necessary. “Pharmacies across the area are often open during evenings and throughout the weekend and can provide support on the same day via the phone, with most having rooms available for a private consultation. “As well as saving you time, getting support from your community pharmacist frees up appointments for your GP to see more urgent patients. If we think you do need to see a GP, we’ll always advise you to do so.” Find out more  about the community pharmacist consultation service (CPCS), answers to frequently asked questions and a short animation at:  nhssomerset.nhs.uk/my-health/my-local-health-services/pharmacies/

Confused about Long Covid? Find out the common symptoms and how to get support. After contracting COVID-19 it can take up to 12 weeks for your symptoms to disappear and for you to make a full recovery from the virus. For some people, COVID-19 can cause symptoms that last weeks or months after the infection has gone. Symptoms that go on longer than 12 weeks are known as ‘Long Covid’. The chances of having long-term symptoms are not linked to how ill you were when you first got COVID-19. What are the symptoms of Long Covid? There are wide-ranging symptoms of Long Covid, making it difficult for doctors to diagnose. Everyone’s condition and symptoms are slightly different.  The main symptoms are the same as COVID-19: Fatigue Shortness of breath Changes to the sense of taste or smell Difficulty concentrating Muscle ache Headache Cough Memory Loss High temperature Sore throat Additional symptoms fall into one of three main categories: Physical symptoms Joint pain Chest pain or tightness Breathlessness Heart palpitations Dizziness Pins and needles Tinnitus or earache Feeling sick, diarrhoea, stomach aches or loss of appetite  Cognitive issues Memory problems Concentration problems (‘brain fog’) Depression and anxiety Fatigue Extreme tiredness Low energy Difficulty sleeping Needing a lot more sleep than normal When should I contact my doctor? Advice from the NHS suggests you contact your doctor if you are worried about continuing symptoms more than four weeks after having COVID-19. To contact your GP surgery, you can: Visit their website Call them Use the  NHS app Your doctor will need to rule out other causes for your symptoms and may wish to conduct some tests before reaching their diagnosis. These tests can include blood tests, measuring your oxgyen levels or an x-ray.  If your doctor thinks you have Long Covid, they will look at your medical history and ask questions about your symptoms and the impact they are having on your day- to-day life. What support should I receive after I’ve seen my doctor? After you have seen your doctor, they will talk to you about what they think is happening and discuss any support they think you need. They will also rule out any other conditions or illnesses that might be causing your symptoms.  Your doctor may give you advice about how to manage and monitor your symptoms at home. If your symptoms are having a big impact on your life, you may be referred for: Support from primary care services, community services or mental health services. Specialist care. If you need specialist care you may be referred to a Post COVID Service, where you’ll be looked after and supported by a range of health care professionals. Do I need to attend a Post COVID Service? Post COVID Services were launched in December 2020, bringing together a wide range of healthcare professionals including doctors, nurses, physiotherapists and occupational therapists. The clinics offer physical, psychological and rehabilitation needs assessments, with the aim to bring a more holistic diagnostic approach and referral for long COVID treatment, management and support. Referrals to the specialist services  are made based on someone’s ongoing symptoms and the impact on their day-to-day life. They are not based on the severity of the initial illness, or a positive COVID-19 test. Other support available The World Health Organisation has produced a helpful guide for managing your illness yourself. This includes advice on managing different symptoms, returning to work and a tracking diary to record your symptoms. You might be able to get support for your symptoms from pharmacies and community groups.  Tell us your story If you’ve had Long Covid, then help us improve services and support by telling us about your experience. Tips for managing Long Covid symptoms There are lots of small things you can do to manage your symptoms. Ensuring you get enough sleep, and eating a healthy balanced diet are two important ways to look after yourself.  It’s also important to conserve your energy. To make sure you don’t burn out before the end of the day try following the 3 P’s Principe – pace, plan and prioritise. Pace Be kind to yourself and allow yourself to slow down. Break activities into smaller tasks and spread them out throughout the day. Stop when you get tired, don’t push yourself until you are exhausted – you’ll recover quicker this way. Build rests into your tasks and plan breaks between activities. Resting is key to recharging your energy. Plan Look at the activities you need to do on a daily and weekly basis and spread them evenly across the week. Think about which activities are going to tire you out the most, and make sure these don’t happen on a busy day. Avoid planning activities at times of day when you are often more tired. Think about whether there are ways you can adapt tasks to make them easier – for example sitting down whilst doing the washing up or getting equipment to help you around the home. Prioritise Some daily activities are necessary, but others aren’t. There might be some tasks you can stop, do less often or ask someone to help you with until you are feeling better. Make sure you do a balance of necessary tasks, like washing, but also the things you enjoy doing, such as walking the dog or meeting friends. Start the day by asking yourself: What do I need to do today and what do I want to do today? What can I put off until another day? What can I ask someone to help me with?

We are investigating people’s experiences of using GP websites to get health and wellbeing information and support. Our roadshow and survey starts 9 May. We want as many people as possible to share their feedback to help identify what works well, what doesn’t, and how things could be done differently to improve access to information on GP websites for everyone. Survey You can share your views by completing a survey which is available in print and online [survey now closed] , or you can complete it over the phone by calling Healthwatch Somerset on Freephone 0800 999 1286. The survey closes on Sunday 22 May. Healthwatch Somerset Roadshow From  Monday 9 May to Saturday 21 May , the our roadshow will be visiting community venues across the county, to gather your feedback about GP websites and digital access, and to find out about the health and care issues that matter most to you. You will also be able to find out about  Somerset’s GP Community Pharmacy Consultation Service  which is being rolled out across Somerset this year. Somerset CCG (Clinical Commissioning Group) will be joining us to raise awareness of the new service which offers a same day consultation for over 40 minor injuries and illnesses with your local community pharmacist, via your local GP. The CCG will also be asking for your experiences of using the service to help shape the service going forward. Mayor of Taunton, Sue Lees, will join our Chair, Judith Goodchild, and staff and volunteers, to launch the roadshow in Fore Street, Taunton, at 12 noon, on Monday 9 May. Dates and venues* for the Healthwatch Somerset roadshow are: Mon 9 May (11am-4pm) –  Taunton , Fore Street Tues 10 May (11am-4pm) –  Minehead , The Beach Hotel (outside) Weds 11 May (11am-4pm) –  Bridgwater , Angel Place Shopping Centre Thurs 12 May (11am-4pm) –  Burnham-On-Sea , The Esplande Fri 13 May (11am-4pm) –  Wellington , Wellington Medical Centre (outside) Sat 14 May (9am-1pm) –  Shepton Mallet , Dobbies Garden Centre (outside) Sun 15 May (9am-1pm) –  Cheddar , Hillier Garden Centre (outside) Mon 16 May (11am-4pm) –  Chard , Minor Injuries Hospital (outside) Tues 17 May (11am-4pm) –  Yeovil , Asda (outside) Weds 18 May (11am-4pm) –  Wincanton , Balsam Centre (outside) Thurs 19 May (9am-1pm) –  Street , Street Market Fri 20 May (11am-4pm) –  Frome , Boyle Cross, Market Place Sat 21 May (9am-1pm) –  Somerton , Brunel Shopping Precinct * Check our social media channels for event updates if there’s bad weather. We have also held focus group discussions with communities which tend to be underrepresented, including care leavers and people with sight impairment. Launching the project, Healthwatch Somerset Manager, Gill Keniston-Goble, said:  “The use of digital technology is rapidly becoming the main way to find information about your health and wellbeing from your GP surgery, but not everyone can use digital methods and some people choose not to. We want to understand more about the impact of digitalisation – the benefits and the barriers this can create. “The NHS England national GP patient survey 2021 shows that 58% of those who completed the survey in Somerset did not use GP online services to book appointments, order repeat prescriptions, access their medical records, or for consultations or appointments. 50% said they had not tried to use their GP’s website to look for information or to access to services. “By going out and talking to people in communities across Somerset and gathering feedback via our survey and focus groups, we hope to hear from a diverse mix of people with varying health, care, communication and access needs. We will then identify where change is needed and make sure that NHS and care leaders listen to public feedback to improve access to care for everyone.” Healthwatch Somerset Chair, Judith Goodchild, said : “Our roadshow is a wonderful opportunity to be able to engage with people and find out what they really feel about the health and social care services in Somerset. Your views are really important and will be used to help commissioners when developing future services.”

A new survey of public attitudes to NHS dentistry shows that half of the adults in England find dental charges unfair amid escalating living costs. Healthwatch England has warned decision-makers that NHS dentistry is in desperate need of reform. With living costs on the rise, Healthwatch England’s new findings show that health inequalities are widening as people in every part of the country struggle to pay for dental care. When people find it hard to access NHS dental care, they feel pressured to go private, which is not an option for many. And even NHS charges can be hard for some to afford. A representative poll of 2,026 adults based in England found nearly half (49%) of respondents felt NHS dental charges were unfair. What are people saying? The poll, which looked at people’s experiences of NHS dentistry, including costs associated with dental care, found the following: 41% of respondents said they found it difficult to book an NHS dental appointment, whilst one in five (20%) couldn’t access all the treatments they needed. One in four (24%) respondents said they had to pay privately to get all the required treatment. One in six (17%) reported they felt pressured to pay privately when they booked their dental appointment. Similar numbers (17%) said their NHS dentist didn’t explain the costs before starting treatment. More than one in ten (12%) reported that their NHS dentist charged more for the treatments than the advertised NHS charges. Almost a third (29%) of respondents said a lack of access to dental care led to more serious problems, making them feel anxious. Others said that a lack of timely dental care made it hard to eat or speak properly (16%) and made them avoid going out (14%). Widening health inequalities  The shortage of NHS appointments has hit people on low incomes hardest, meaning they are less likely to have dental treatment than those on higher incomes. The poll suggests that people from social economic group (SEG) A, including high-ranking managerial, administrative and professional roles, are six times more likely to be able to pay for private dental care if they can’t find an NHS dentist to treat them than people from SEG E, which includes pensioners, low-paid workers and unemployed people on state benefits (48% and 8%, respectively). The new data also reveals a significant North-South divide regarding how affordable people find dental care. While one in five people (20%) living in the South of England said they could afford private dental care if they can’t find an NHS dentist, just seven per cent of those living in the North of England said they could afford private treatment. Overall, 38% of the respondents feel they are less likely to visit a dentist, despite clinical guidelines recommending regular dental check-ups to keep people’s mouths healthy. Fewer NHS dentists The findings come as more than 2,000 dentists quit the NHS last year, according to recent data obtained by the  Association of Dental Groups , suggesting a growing trend towards private provision. Healthwatch England has repeatedly raised concerns over the last two years as the twin crisis of access and affordability has continued to grow. Between October 2021 and March 2022, the Healthwatch network heard from 4,808 people about their experiences of dental care, many of whom were struggling to access timely care. Therefore, Healthwatch England is making renewed calls on NHS England and the Department of Health and Social Care to put a reformed dental contract in place before formal responsibility for dental services passes to the 42 new Integrated Care Systems in April 2023. Louise Ansari, national director at Healthwatch England said: “Access to NHS dentistry has been one of the most significant issues people have raised with us in the last two years. There is now a deepening crisis in dental care, leaving people struggling to get treatment or regular check-ups on the NHS. “The shortage of NHS appointments is creating a two-tier dental system, which widens inequalities and damages the health of the most disadvantaged communities. With millions of households bearing the brunt of the escalating living costs, private treatment is simply not an option, and even NHS charges can be a challenge. This needs urgent attention if the Government is to achieve its levelling up plan and tackle health disparities. “We are once again calling on the Department of Health and Social Care and NHS England for greater ambition and urgency from NHS dental reform plans to create a fair and inclusive dental service. We strongly recommend that a new dental contract is in place before Integrated Care Systems take on formal responsibility for dentistry from next April.” Difficulties finding NHS dentists in Somerset  Healthwatch Somerset Manager, Gill Keniston-Goble, said: “Dentistry continues to be one of the main issues raised with us by the public. In the past year, 22% of our feedback has been about people not being able to find an NHS dentist. People are telling us they have called many dentists but cannot find one taking new patients. We are also hearing from the public that NHS England is advising there are no dentists taking new NHS patients in Somerset. “One memorable piece of feedback we received was about dental care in care homes. Residents who were registered with NHS dentists pre-Covid, have now been removed from their original dental practices lists because they were unable to visit as they were bed bound or immobile. “We therefore welcome the news from NHS England and NHS Improvement South- West that changes have been made to the Somerset Dental Helpline, and from Friday 29 April people living in Somerset, who are not registered with a dental practice, should call NHS 111 if they need urgent treatment or advice.” Lydia’s story Lydia, from Somerset, has been suffering from gingivitis, and her gums frequently bleed when she brushes her teeth. On top of this, she needs a couple of new fillings and wisdom tooth removal. Not being able to find an NHS dentist in her area, she gave in and reached out to a private provider. Lydia said: “Sitting in the dentist’s office, listening to the list of treatments, the cost of £1,100 brought me to tears. These costs were on top of the £50 I had to spend to have the appointment.” Lydia is constantly worried about her dental problems. “Whenever I eat and feel a twinge my heart drops. I panic that something terrible is happening.” She thinks that the NHS needs to view dental care as just as important as other aspects of healthcare. She thinks the two shouldn’t be separate, and dental care should be available at no cost – just like other areas of the NHS. “MPs have money to get care if they need, most people don’t. There’s no version of private dentistry that’s affordable. The word affordable is a slap in the face.” About the poll Yonder Data Solutions polled 2,026 adults (aged 18+) based in England in February 2022. Key findings from Healthwatch England’s national dental polling

Take a look at our advice article on the organisations and groups that can support you if you’re grieving. What is grief? Grief is something we experience when someone close to us dies. There is no right or ‘normal’ way to feel, as everyone experiences grief differently.   As it is natural to have a strong reaction to someone dying, you may feel: Shocked about what has happened Pain and distress Anger Guilt Depression Longing Worried about other people’s reactions When you’re grieving, it’s important to not put too much pressure on yourself to feel better. To help you support yourself and others experiencing grief, Cruse Bereavement Care have put together a series of useful articles, including practical advice on what to do when someone dies. COVID-19 and grief Increased public talk of death can be distressing for people who are already grieving. For example, the COVID-19 pandemic may have brought up painful or traumatic memories. Thousands of people are also grieving the loss of a loved one  due to COVID-19 . Because of restrictions brought in during the pandemic, some people did not have the chance to spend time with a dying person or did not get to say goodbye. This can make it difficult to accept the reality of grief. Where can you go for support? Grief is a natural response to loss that many people will cope with through support from family and friends. However, if you want to talk to someone else about your grief, there are services, organisations and community groups that can help you. NHS support If you need support, you can use NHS talking therapies, like Cognitive Behavioural Therapy (CBT). These are free and you can refer yourself directly. Bereavement counselling Some local areas might have specific bereavement counselling services, but they might not be free. For local information, you can find out more online about Somerset Council's  Bereavement Services . When should you see your GP about your mental health? You should go to the doctor if: You’re struggling to cope with stress, anxiety or a low mood You’ve had a low mood for more than two weeks Things you’re trying yourself are not helping You would prefer to get a referral to a service from a GP If you're in a crisis and need urgent help: If you don't feel you can keep yourself safe right now, seek immediate help by visiting your nearest  Accident & Emergency (A&E) department  or call 999. If you need urgent support but don't want to go to A&E: Call Samaritans on freephone 116 123 – they're always open and are there to listen Contact your GP surgery and ask for an  emergency appointment Contact  NHS 111 Online bereavement support Find support on social media Lots of people have set up their own online communities or accounts exploring grief and bereavement. For example, the  UK Motherless Daughters Facebook group  is a closed space for people to share their experiences and feelings. These groups can be particularly helpful if you’re waiting for NHS support or are currently unable to access traditional support because of COVID-19. You can find these groups by searching key words, like grief and loss, on different social media channels. Some examples that might help you are: Griefcase  (Instagram) The Grief Gang  (Instagram) The New Normal  (Instagram) Siblings Grieve Too  (Instagram) Live. Death. Whatever  (X / Twitter) The Loss Project  (X / Twitter) Other types of online support Apart of Me  is a game designed to help young people cope with the death of loved one. The Griefcast  is a podcast where comedians talk about their own experiences of death and bereavement. Grief Encounters  is a podcast about love, life and loss. Charities and community organisations There are lots of organisations that can help you if you’ve been bereaved. This article has a selection of national charities and community groups, but to find the full range of support available to you, visit the  At a Loss website .  Many of the organisations below run helplines, online chat services or are arranging digital meet ups to continue providing supporting during the pandemic.  Organisations supporting adults Cruse Bereavement Care  provides bereavement support to people across the UK. If you need someone to talk to you can call their helpline. 808 808 1677 Death Cafes  are local groups of people getting together to drink tea, eat cake and discuss death. They are run entirely by volunteers. Find your nearest Death Cafe on their website. WAY Foundation   is a national charity that supports people who have been widowed before their 51st birthday. Survivors of Bereavement by Suicide  is a self-help organisation which exists to meet the needs of those bereaved by the suicide of anyone close to them. 0300 111 5065 (Monday to Friday, 9am-9pm) Macmillan Cancer Support  provide information and support for anyone affected by cancer. 0808 808 0000 (Monday to Friday, 9am-5pm) Sue Ryder charity  provides palliative, neurological and bereavement support from their specialist centres. They also offer online bereavement support which provides useful information, advice and resources to help you cope if you are struggling with the loss of someone.  0808 164 4572 Untangle Grief  are a grief support community who offer a range of practical and emotional support to those that have suffered a bereavement.  07932 317 923 (Monday to Friday, 9am-6pm Organisations supporting children and their families Grief Encounter  is a charity supporting children and their families who have experienced the death of someone close to them. 0808 802 0111 (Monday to Friday, 9am-9pm) Winston’s Wish  support children and their families after the death of a parent or sibling. If you need advice on supporting a bereaved child, you can phone their helpline. 0808 802 0021 (Monday to Friday, 9am-5pm) Child Bereavement UK   supports families and educates professionals both when a baby or child of any age dies or is dying, and when a child is facing bereavement. 0800 028 8840 (Monday to Friday, 9am-5pm) Organisations supporting young people Hope Again   is website set up by Cruse Bereavement Care for young people. Let’s Talk About Loss   is a peer-led meet up group in cities across the UK for young people aged 18-35 who have been bereaved at any stage. Follow them on  instagram . The New Normal   runs grief support meetings to connect young adults who have all experienced loss and are looking for others who understand. Follow them on  instagram . The Grief Network  is a London based network for people bereaved as a teenager or in their 20s and 30s. End of life organisations Somerset End of Life Care and Bereavement Support is a website providing information and resources for people in Somerset. Compassion in Dying   is helping people to prepare for end of life. 0800 999 2434 (Monday to Friday, 11am-3pm) Hospice UK  is a national charity for hospice and palliative care.

For new arrivals to the UK it can be confusing where to go if you need medical assistance. Here we outline your rights as a refugee, where you can access emergency help and how to register for a GP. In need of urgent medical care? If you urgently need medical help or advice but it’s not a life threatening situation call NHS 111 if you are living in England. If someone is seriously ill or injured and their life is at risk call 999. What are my rights as a refugee when it comes to healthcare in the UK? Refugees' and asylum seekers are entitled to NHS care. In all four nations of the UK, refugees and asylum seekers with an active application or appeal are fully entitled to free NHS care. But let’s break this down a bit: Pharmacies Pharmacists can offer clinical advice and medicines for a range of minor illnesses, such as coughs, colds, sore throats, tummy trouble and aches and pains. The pharmacist will let you know if you need to visit a doctor or direct you to other healthcare professionals to make sure you get the help you need. You can also buy medicines for minor illnesses or first-aid supplies in a pharmacy or supermarket. Dentists and Opticians You’ll have to register for a Dentist or Optician. Here’s how: If you’re in pain, you should call 111 for Urgent Dental Care Services. GP practice or medical centre A GP can offer medical advice, provide a diagnosis and prescribe medicines. They might be your first point of contact for many physical and mental health concerns. The GP practice is also responsible for coordinating and managing your long-term healthcare and they can refer you if you need more specialised hospital services. Everyone has the right to register for a GP. You don’t need proof of address, immigration status, ID or an NHS number. Find your nearest GP practice and  register online For help if you are having difficulty registering with a GP you can: •  Download  a GP Access Card and show this to the GP receptionist • Phone NHS England (0300 311 22 33 ) or Doctors of the World (0808 1647 686) What to do if can't register with a GP? Find out about your rights and what do to if you are refused the right to register. Community health services (pregnancy, child health, contraception services) Some health services are accessed in the community, and not in hospitals. These include mental health, child health and antenatal services and sexual health and family planning clinics. Find out more about  community health services  and what they look like. Walk-in or Urgent Treatment centres (minor injuries or urgent medical advice) If you need urgent medical care for minor injuries such as cuts, sprains and small fractures, or urgent medical advice, you can directly go to a walk-in or urgent care centre without an appointment. These centres are usually open during daytime hours. Emergency services (medical emergency or life-threatening situation) Call 999 if someone is seriously ill or injured and their life is at risk. The telephone operator will advise you what to do or where to go next. An ambulance may be sent to provide treatment or transport the patient to hospital. Hospital Accident and Emergency (A&E) departments are open 24 hours every day of the year. You can access these services directly and without an appointment. Emergency mental health (suicidal thoughts or serious self-harm) If you have seriously harmed yourself or are about to do so, call 999 for an ambulance or go straight to A&E. If you are thinking about suicide, talk to someone at the Samaritans by calling 116 123. Welcome: a guide for new refugees A guide for adults who have been granted asylum in England to access public services and make the most of the opportunities in the UK.