As local health and care services come under increasing pressure due to the coronavirus, and access to services becomes more challenging, we are reminding people that we're here to help. As the county’s independent health and care champion, we are well known for our work gathering public feedback about health and social care services to help make care better in the county. In addition, we provide an information and advice service to help people find information about local health and social care services and support. Healthwatch Somerset Manager, Hannah Gray , said: “Coronavirus is having a huge impact on how health and social care services are being delivered locally. These are challenging and unsettling times for everyone. We recognise that keeping up to date with information and advice can be difficult in such a fast-changing situation, but we are here to help. We are in regular contact with health and social care providers in Somerset, so that we have the most up to date information to share with the public about how to access the services and support they need. Sometimes just talking to someone about what to do and where to go can be reassuring, so do please get in touch if you need our help.” As part of our ongoing work promoting public feedback to influence positive change in local health and social care services, we want to hear from local people about how the virus has affected their access to care. Feedback will be analysed to help highlight what works well and to identify where things need to be improved. For information and advice about local services and support, or to share your views and experiences:

If you or a loved one are affected by incontinence, find out where you can go for support. Incontinence is a condition that causes the involuntary passing of urine and/or faeces and affects approximately 14 million people. Read our advice on where to go for help if you suspect you may be affected by incontinence and the services available to support your needs. Where can I go for support? Incontinence is a common problem, but many people feel too embarrassed to seek help. However, talking to your GP is the first step towards finding a way to manage the condition effectively. Incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination. Find out more about diagnosing  urinary incontinence  and  bowel incontinence . Treating incontinence Initially, a GP may suggest some simple non-surgical measures to see if they help improve your symptoms, such as: Lifestyle changes, like cutting down on caffeine and alcohol. Bladder and bowel training. You may also be offered continence products, such as absorbent pads or medication to help you manage your symptoms. Surgery may also be an option. The procedures that are suitable for you will depend on the type of incontinence you have. Find out more about treating  urinary incontinence  and  bowel incontinence . What continence products are available? Incontinence pads, products and devices can make life easier for you while you wait for a diagnosis or a treatment to work. A wide range of products and devices are available for incontinence. They include: Pads and pants Bed and chair protection Skincare and hygiene products A special key (Radar key) that can help you access public toilets Where can I get continence products? If you have mild to moderate incontinence, you can buy thin, discrete pads or pull-up pants for men and women from many supermarkets and pharmacies. The NHS does not recommend using incontinence pads without advice from a doctor or continence adviser. Still, they can improve your quality of life as a temporary measure and save you from being housebound or spending all your time in the toilet. The charity Bladder and Bowel UK gives independent advice on products that can help manage bladder and bowel problems. For more information on products and how to order them, you can call its helpline on 0161 607 8219 or visit the  Bladder & Bowel UK website . The  Continence Product Advisor  also gives independent advice on choosing and using suitable continence products. Is financial help available? You may be able to get incontinence products on the NHS, such as incontinence pads or devices like handheld urinals. This depends on your local NHS organisation. To qualify for incontinence products, you may need to: Be assessed (which may involve keeping a diary of your bladder for three days) and start a treatment plan. Meet the criteria set out by NHS Somerset (ICB). Where can I dispose of products? It is essential you know how to dispose of your continence pads safely. It depends on the type of product you use as to how you should dispose of it correctly. The best way of disposing of used pads is to place them in a small bag or nappy sack and then dispose of them in the standard family dustbin for local refuse collectors. Never attempt to flush any incontinence pads down the toilet. Continence services should tell you: How to dispose of your continence products. How you can return unused continence pads when someone has died. Find out more about  disposing of continence products . Continence support for children and young people Like adults, children and young people should visit their GP if they are experiencing bladder and bowel problems.  Eric , the children’s bladder and bowel charity, has information for children and teenagers and parents and carers about the care and treatment options available. Incontinence in Confidence  also provides confidential advice on incontinence for teenagers. The Continence Foundation of Australia created this website with lots of information about practical and emotional support. Continence support in care homes Incontinence can be a reason someone is admitted to a care home. While living there, they are entitled to the same level of support from NHS continence services as those living in their own homes. Residents should be taken to the toilet frequently and provided with the appropriate continence products. Care home staff should treat residents with compassion and empathy. If you or a loved one are unhappy with the support you receive, it is crucial to speak up about the issues you face to ensure your care meets your needs. What are urinary catheters? A urinary catheter is a flexible tube used to empty the bladder and collect urine in a drainage bag. It is usually used when people have difficulty peeing (urinating) naturally. It can also be used to empty the bladder before or after surgery and to help perform specific tests. It can also be a last resort for treatment for urinary incontinence when other types of treatment have been unsuccessful.  Look at the NHS website for more information about  urinary catheters  and support for people living with them. Support for your mental health It can be challenging to adjust your life around incontinence, leading to many people feeling depressed or deflated when they cannot continue their everyday routine. If incontinence affects your mental health, you should visit your GP to receive further help and advice. The charity Mind also provides  advice and information  about mental health conditions and support. Where to go for further advice Bladder & Bowel UK gives independent advice on products that can help manage bladder and bowel problems. 0161 607 8219, Monday to Friday, 9am-4.30pm. Eric is the children’s bladder and bowel charity. They offer a helpline for families and online information about bladder and bowel problems. 0808 169 9949, Monday to Thursday, 10am–2pm. Bladder Health UK have been offering advice and support about bladder conditions for the past twenty years. They have a free confidential helpline. 0121 702 0820, Monday to Friday, 9.30am-2.30pm. Bladder and Bowel Community support millions of people in the UK are living with conditions that affect their bladder or bowel. They run a closed  Facebook group  for people looking for peer support or email  help@bladderandbowel.org . Continence Product Advisor gives independent and evidence-based advice on how to choose and use suitable continence products.

We are asking local people to complete a survey to share their experiences of accessing primary care through GP surgeries in Somerset. We want to identify the barriers that make it difficult for people to get the care they need and highlight the ways that GP surgeries can make it easier for people to access care. We are the county’s independent health and social care champion.  We find out what matters to local people and makes sure that the public’s views are heard and acted on by those providing health and care services in the county. During 2018/19 we received a lot of feedback from local people about getting access to primary care within their GP practice.  Primary care means the first place people go when they need health advice or treatment for symptoms that are new, or for concerns about physical or mental health.  GPs are one of the main primary care services. Get involved If you or someone you know, have visited a GP surgery in Somerset in the past 12 months, you can complete the survey online.  [Survey now closed]   Hard copies are available from Healthwatch Somerset by calling: 01278 264405.  All feedback and responses will be anonymous.  The survey closes on  Friday 13 March 2020. We will also be visiting a sample of GP Surgeries across the county to listen to people’s experiences and to answer questions about this research. The survey findings will be used to produce a report highlighting common themes and recommendations for improvement.  This will be shared with those who commission and deliver GP primary care.

Our report following a visit to Oak Meadows in Taunton, a care home that was adapted some years ago from an original military building on the site. The home specialises in the care of older people living with dementia. The home is able to care for up to 86 residents. On the date of the visit there were 61 residents living in the home. Recommendations Consider developing a group of external volunteer visitors for those residents who have no visitors. Healthwatch supports the home’s plan for a quiet spiritual/contemplative area. Consider ways of making Willow Unit less clinical and more homely, e.g. with the addition of clocks and calendars. Consider an information booklet about the home and services to be given to residents and their relatives on arrival or soon afterwards. Sutherland Specialist Dementia Unit – it may be helpful to consider an association of individual residents to their bedrooms, e.g. a photo, a colour or related item on the door. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Help shape the future of services for people living with a life-limiting illness. Dorothy House Hospice Care is looking for people who have used their services to join a new virtual quality improvement panel, to help develop the care and support services they provide for patients living with life-limiting illness, their families and carers.  They provide care and support for people in their own home, in the community, and through day services and residential care provided at the Hospice. They work across Bath & North East Somerset, parts of Wiltshire and Somerset. Voluntary panel members will be able to share their views from the comfort of their own home by completing one or two online surveys and possibly a telephone interview each year. Volunteers don’t need any qualifications, just personal experience of using any one of the services provided by Dorothy House. Working through Evolving Communities, a Wiltshire-based community interest research company, Dorothy House is inviting people to get involved now to help inform priorities for 2021. Evolving Communities wants to hear from people who would like to join the panel and they will be gathering views from January to March 2020. Dr Sara Nelson, Head of Research and Insight at Evolving Communities, said: “Every year Dorothy House produces a quality improvement plan setting out its development priorities for the year ahead. They understand the value of listening to the people who use their services and they are now seeking views to inform their priorities for 2021. Previous priorities have included, for example, improving gym facilities and developing an online patient feedback system. “Evolving Communities is setting up a virtual quality improvement panel for Dorothy House to make it easier for people to share their views from the comfort of their own home. We want to hear from people who are currently using Dorothy House services and those who have used them previously, including patients, family members and carers. This is a great opportunity to help Dorothy House improve the quality of life for those living with a life-limiting illness.”

Our report following a visit to Oak Lodge in Chard, which is a purpose-built care home and provides accommodation for frail older people. The home is able to care for up to 47 clients. On the date of the visit there were 34 residents living in the home. Recommendations Ensure the entrance door and bell is clearly signposted for visitors. Our team were unsure which door to use on arrival at the home. Consider sourcing external volunteers who could support quieter residents who may value 1:1 interactions and may not wish to partake in the larger, group activities on offer. Consider staffing levels over busier periods such as lunchtime to prevent delays in answering call bells, and moving residents from the first floor down to the dining room area. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

We are the county’s independent health and social care champion and are seeking people with a passion for seeing local health and social care services change for the better. We have an important role in assessing the quality of local health and social care services and influencing the design of future services, and are looking for local people to join our Local Board, a group of volunteers who help the team shape our workplan. Hannah Gray, Healthwatch Somerset Manager, explained: “We welcome interest from all parts of the local community.  We’re looking for local people with a passionate interest in helping the local community shape the way their health and social care services are run. “Although not essential, if people have knowledge or experience in social care, children and young people, mental health, equalities and diversity this would be beneficial.” Healthwatch Somerset Local Board members will oversee and contribute to the work programme and play a crucial role in monitoring its delivery.  The Local Board will also play a part in supporting the organisation to adhere to its principles, purpose and vision, ensuring that it operates in a moral and ethical way. Judith Goodchild, Chair of the Healthwatch Somerset Local Board feels volunteering with Healthwatch is a great way to champion the voices of people and are vital to capturing the views of the local community .  She said: “All of us hear concerns expressed by people we work with, from neighbours and from people we meet socially about the current state of the NHS and Social Care. “By volunteering for Healthwatch you are in a position to raise these concerns and as an organisation we can bring them to the attention of the decision makers.  The Board is made up of volunteers.  We are a statutory partner of the Clinical Commissioning Group and Health and Wellbeing Board.  All the information gathered by volunteers is used to help improve the quality of care that patients receive by asking questions at strategic meetings. “Volunteers for Healthwatch carry out a range of tasks that fit in with their other commitments such as undertaking surveys, taking part in Enter and View visits, manning stands at various events and leading focus groups.  Volunteers are well supported through training programmes. “One of the main benefits of being a volunteer, and Chair of the Board, is that I feel that my time is well used and contributes to our role of representing the public voice when decisions are being made.” Interested? Healthwatch Somerset Local Board meetings are held monthly.  In addition, members will need to spend about two days a month on Local Board matters, plus emails and occasional meetings, both day-time and evening.  The role is voluntary, but all out of pocket expenses will be covered.  The term of office will be for a maximum of three years.

Dorothy House Hospice Care wants to hear from those with a life-limiting illness, their carers and families about what Day Services they think would improve their wellbeing. Working through research consultancy Evolving Communities, Dorothy House is carrying out a review of their current Day Services and wants to find out if they are providing the right information and activities to support patients and families. The information gathered from the research will be used to develop and shape Dorothy House’s future provision of Day Services. Dorothy House want to hear from people who are living with a life-limiting illness, carers/family members/close friends and people working closely with people who have a life-limiting illness. Dorothy House supports people from Bath and North East Somerset and parts of Wiltshire and Somerset. There is a common misunderstanding that hospices are places where people go to die, are only for those with advanced cancer, or those that are elderly. In reality, hospices are much more than this: “Palliative hospice care is not just for people in the last days of life, it is there to provide support for anyone with a life-limiting illness and their families, to help them live well until they die.”   Dr Sarah Russell, Head of Research at Hospice UK Dr Sara Nelson, Head of Research & Insight at Evolving Communities, said: "A life-limiting illness is one that is incurable and that will get progressively worse over time; ultimately shortening a person’s life. However, with appropriate support, a person with a life-limiting illness may continue to live well for a long time. “We want to find out if and how people use the Dorothy House Day Services and what could be done to improve them. We are appealing for a wide variety of voices including anyone over 18 living with a life-limiting illness, whether they access Dorothy House Day Services or not, along with carers, family members, close friends and people who work closely with someone with a life-limiting illness.” Ruth Gretton, Director of Patient and Family Services at Dorothy House Hospice Care said: "We are delighted to be working with Evolving Communities on their research into Day Patient Services at Dorothy House.  We look forward to hearing constructive feedback from people in the local community affected by a life-limiting illness, including those we’ve yet to engage with as well as our existing patients so we can review and improve our services for the future. Our sincere thanks to all who take part in the survey before 5th January.”

People in Somerset looking for health advice and support want to see better access to their GP to get the information they need, rather than looking online for help. Research carried out by us, the county’s independent health and social care champion, reveals 46% of people surveyed encountered difficulties in accessing information, advice and support when they needed it. We carried out a survey and ran focus groups to find out if local health and care services are doing enough to help people get timely, effective advice and support when their health and wellbeing is at risk. Over 230 people responded and the findings are now published in our new report  Accessing Information about Health and Support in Somerset . This will be presented to Somerset Health and Wellbeing Board to ensure the public voice is considered when planning future health and care services. Key findings in the report reveal: Many people said that access to GP appointments and referrals was the main barrier to getting help and support. Many of the respondents reported waiting between two and three weeks to see someone about their health condition. One person spoke about their frustrations to us. They said: “It’s difficult trying to get through on the phone at the local surgery, then obtaining an appointment that can be two or three weeks away. I could be dead by then!” There was also concern about access to information from GPs during weekends and public holidays, and in urgent situations. People reported it was difficult to tell if information presented online was trustworthy. Many experienced difficulties in recognising the legitimacy of information, especially when it was inconsistent.  Out-of-date information on websites, especially about locations and times of groups or clinics was frustrating. People also spoke about how it was more difficult to access information and advice after they, or someone they cared for, had been diagnosed with a long-term condition. People often felt that they had been left to find the information themselves, with little to no signposting to support. One person said: “I search mostly online for extra advice. From diagnosis I was pretty much left alone, apart from one review.” Lucie Woodruff, interim Healthwatch Somerset Manager, said: “Over the next couple of years Somerset County Council and Somerset Clinical Commissioning Group are developing a neighbourhood approach that will bring health, care and community partners together to deliver services to local people in a more joined up way. “Healthwatch Somerset wanted to understand where people currently access information, advice and support to manage their health, and how this could be improved.  We hope these views, presented in our latest report, will help to shape future services.” We have set out a list of recommendations for commissioners and health care providers based on the findings from the report. These include: Provide training for patient facing staff in GP surgeries, so they can give the right information and signposting to alleviate the pressure on doctors. A centralised, up-to-date and promoted website so people can access health and support information in one place. Better support for those with long-term conditions. Identify carers, so that the appropriate help and support can be offered to them. Pip Cannons, from Somerset County Council, said: “Somerset County Council and Somerset Clinical Commissioning Group are developing a new neighbourhood approach to health and care that aims to strengthen individual and community resilience and wellbeing and help people stay as independent as possible for as long as possible in their own home and community. “I would like to thank Healthwatch Somerset and everyone who took part in the survey. The information and recommendations gathered have provided us with valuable insights that will be used to help make changes across the whole health and care system to ensure that access to information and support is in the right time, place and proportionate to people’s needs.”

We have been talking to local people about their experiences and views of the accessing health and support information in Somerset. This report tells you what people said when we spoke to them about this. Key findings Most people access information, advice and support about their health via the GP, online, and via friends and family. People currently access information in more than one place, depending on the severity and type of issue. Many people would like to access information from one centralised place (either online or in the community). People would most like to receive information via face-to-face interaction, leaflets/books and online. For those who like to receive information face-to-face, lack of access to GP appointments and transport links are seen as the main barriers to accessing information and support about health. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

As the independent health and social care champion for Somerset, we are calling on local services to make more space for new parents in the county to talk about their mental health. A new report exploring the experiences of women with mental health problems during the journey to parenthood has found that many people are not experiencing the consistent support they should expect if services were following NHS guidelines. Published today by Healthwatch England, the report –  Mental health and the journey to parenthood  – focuses on a survey of 1,738 women and draws on the research undertaken by Healthwatch Somerset.  These women reported either having a mental health condition diagnosed by a doctor before, during or after having a baby or they said they had experienced a mental health problem which had not been diagnosed. With the NHS committed to providing maternal mental health support for more than 30,000 extra women by 2020/21, the work undertaken by Healthwatch can help local services understand what’s working for new mothers and what isn’t. Variable mental support for new parents However, the national and local research also indicates that many women are not experiencing support that meets national NICE guidelines which set out what mothers should expect when it comes to the recognition, assessment and treatment of mental health problems during and after pregnancy. Action needed to tackle fear and promote mental wellbeing With one in four women experiencing mental health problems in pregnancy and the 24 months after birth, analysis of the stories women shared also highlights the need to provide more opportunities for new parents and health professionals to talk about mental health during the journey to parenthood. Common themes highlighted by the experiences of women include: The range of issues that can help contribute to mental health problems:  Severe pregnancy sickness, the physical health of babies, a history of mental health problems, feelings of isolation and a lack of empathy from professionals can all play their part. People don’t know where to turn for help:  Despite the increased focus on NHS support for mental health, women told us about not being given enough information about the mental health support available and what to do if they need help. Women feel scared about speaking up:  Even though women know they are struggling with their mental health, factors such as fear that they will be judged as bad parents or healthcare staff attitudes can act as a barrier to seeking support. Sharing her experience Kristy said: “I fell into this feeling of failure. I’ve failed to breastfeed. I’ve failed to have a girl. I’ve failed to create the perfect family. I didn’t recognise I was ill, I just thought I had failed, that the boys deserved a better mother, and I thought everything would be better once I was physically well. I was so ashamed to talk about how I was feeling, because we’re told how lucky we are to have a baby. “There needs to be more support for women who are pregnant and aren’t well. I started feeling so miserable when I was pregnant because I couldn’t enjoy it and no one understood. I didn’t know what obstetric cholestasis was until I got it and if I’d been able to reach out and get some support, it might have made it easier.” Other national findings When asked about the support they had received: A third of women (33%) who had a diagnosed mental health condition said they were not given any advice about maternity and mental health at any point. Nearly half (47%) of all women described getting support for their mental health as ‘difficult’ or ‘very difficult’. More than half of all women (58%) said they did not get a care plan that considered their maternity and mental health needs, while 36% reported not feeling involved in decisions about their care. A third of all women (36%) rated the quality of mental health support given by health professionals (e.g. GPs, midwives and health visitors) as poor or very poor.   Commenting on the findings Judith Goodchild, Chair of Healthwatch Somerset, said: “This new Healthwatch England report highlights more needs to be done to make sure all women get the right help, at the right time. We welcome feedback from new parents in Somerset so they can share their experiences of local health services to help shape and improve these services for future patients.”

The UK’s largest independent regulator of official statistics wants to hear from patients, carers and their families about how they access and use statistics on mental health in England. If you or someone you care for use special care dental services in Somerset, then NHS England and NHS Improvement (NHSE and NHSI) would like to hear from you. We are collating the views of patients, potential patients, parents, carers and advocates to help shape future developments of special care dental services in the region. Special care dental services focus on improving the oral health of people who have a health condition or have circumstances which prevents them from using a high street dentist. It is these people that the NHS would like feedback from about their awareness and experience of using these services. NHSE and NHSI are working in partnership with local Healthwatch to run focus groups and ‘speak up’ groups which aim to capture the views of those using the services or are eligible to do so.  You can also get involved by completing the online survey [now closed] . The engagement work will run until 4 October 2019 .  NHSE and NHSI will then analyse the feedback, publish the findings and explain the next steps.