Today we celebrate six years as the county’s independent health and care champion. Healthwatch Somerset Manager Emily Taylor said: “We’re here to make sure that those running services, and the government, put people at the heart of care. We find out what people want and champion for services that meet the local community’s needs. “These views are then shared with the decision-making organisations in the county, so together we can make a real difference.” Healthwatch Somerset is currently encouraging people to share their views on how an extra £20 billion per year from the Government should be spent on local NHS services as part of the NHS Long Term Plan. You can participate in the  What Would You Do?  campaign via an online survey [closed 30 April 2019] and by speaking directly to Healthwatch. Questions will focus on local services in the following areas: Cancer Mental health Dementia Heart and lung conditions Learning disabilities and autism Sir Robert Francis, Chair of Healthwatch England said: “Services won’t get these changes right unless they engage people in a debate and find out what really matters most to people. This is where we help, supporting services to move beyond just seeking feedback, to a position where they truly put people’s views at the heart of the decisions they make. “Our sole purpose is to help make care better for people. We have the power to make sure their voices are heard.”

Healthcare in Somerset will only work if people get to have their say – urges former ambulanceman Bob Champion. 82-year-old Bob, from Shepton Mallet, is encouraging others to speak out as part of What Would You do? , led by us as Somerset's independent health and social care champion. The What would you do? campaign aims to encourage people in Somerset to share their views about how extra money from the Government should be spent on local NHS services. The Government is investing £20 billion a year in the NHS as part of the NHS Long Term Plan. Local organisations are now being asked to explore how services should change locally to make the NHS work better for people. Widower Bob said: “By talking and listening to people who have been ill – you get fantastic knowledge and feedback about health services, which we will all have to use at some stage in our lives. “Patients are the experts, each and every one of them has a story to share – whether that’s good or bad. I would encourage others to take part and make sure their voice is heard.” Bob has had plenty of first-hand experience with health and care services in Somerset, having worked as an ambulanceman for over 30 years. He was also the main carer for his wife Shirley before she passed away in 2010. His 52-year-old daughter Michelle is also in long-term care, after having a stroke several years ago. People can share their views via an online survey, and by speaking directly to Healthwatch. Questions will focus on local services in the following areas Cancer; Mental health; Dementia; Heart and lung conditions and Learning disabilities and autism. Emily Taylor, Manager at Healthwatch Somerset, added: “The NHS only works when the voices of the people who use it are heard. This is a once in a generation chance for local people to help decide where this extra money from Government should be spent in our NHS services in Somerset. “We want to hear from as many people as possible about what works, what doesn’t and how they think local health services should be improved. No matter how big or small the issue, we want to hear about it. Sharing your experience with us is quick and easy – and could make a big difference.”

Our Manager and a Local Board member attended a Young Carers Forum meeting to hear the views of young carers on the Somerset Young Carers Service. This took place at the Young People’s Centre in Street. Key findings Several common issues that affect both their wellbeing and ability to reach their potential were identified by the young carers. Feelings of both physical and emotional isolation. Lack of confidence and low self-esteem. Difficulty in making friends and building relationships with peers. Lack of support and understanding about their caring responsibilities from school and the effect that caring has on issues such as attendance, punctuality and ability to undertake homework. A feeling of missing out on their childhood. Constantly worrying about their parents and/or siblings when they are not at home. Read our report If you need this report in a different format, please email info@healthwatchsomerset.co.uk or call 0800 999 1286.

Our staff and volunteers will be taking to the roads of Somerset in March to find out what people think about their local health and care services. We aim to speak to at least 500 people from all corners of the county as part of its ‘Campervan and Comments Tour’. The roadshow will travel almost 260 miles zig-zagging around Somerset in a classic 1969 VW campervan and park up at key locations around the county to gather the views of people of all ages. Emily Taylor, Healthwatch Somerset Manager, explained: “We want to reach at least 500 people from all over Somerset in just one week. We thought it would be a great idea to hire a campervan and visit places where people might not have heard of Healthwatch before. “The role of a local Healthwatch is to make sure the health and care system in the area meets the needs of the people who use it. Feedback is gathered from patients and their families on services such as GP surgeries, care homes, hospitals, mental health and social care. These findings are then taken to the organisations which plan, pay for and deliver health and care services. “Somerset is a very rural county and we thought a roadshow would be a great way to reach more people and give them the opportunity to have their voice heard.” The roadshow will visit: Friday 15 March Frome  Cattle Market Car Park – 2.30pm to 5pm Saturday 16 March Cox’s Yard Public Car Park,  Somerton  – 9am to 12 noon Goldenstones Car Park,  Yeovil  – 12.30pm to 2pm Yeovil  District Hospital – 2.30pm to 5pm Sunday 17 March Shepton Mallet  Market – 10am to 12.30 St Dunstan’s Car Park,  Glastonbury  – 1.30pm to 4pm Monday 18 March South Petherton  Hospital – 10am to 12 noon The Meadows Surgery,  Ilminster  – 12.30pm to 2.30pm Staff Car Park at The Lace Mill,  Chard  – 3pm to 5pm Tuesday 19 March Fore Street, Taunton – 9am to 11am Richard Huish College,  Taunton  – 11.15am to 1.15pm Asda Supermarket Car Park,  Wellington  – 2.30pm to 4.30pm Wednesday 20 March Morrisons Supermarket Car Park,  Minehead  – 9.30am to 12.30pm Harbour Road Car Park,  Watchet  – 1.30pm to 4.30pm Thursday 21 March Fore Street,  Bridgwater  – 9am to 12 noon Highbridge  Medical Practice – 12.30pm to 2.30pm Tesco Supermarket Car Park,  Burnham-on-Sea  – 3pm to 5pm Friday 22 March Cheddar  Medical Centre – 9am to 12 noon

Parents of young children in Somerset are being asked to share their views and experiences about the health visiting services they have received in the County, to help shape the service going forward. As the county’s independent health and social care champion, we want to find out about parents of under 5s experience of the Health Visiting service, as well as how they currently get information and support on child health and development, to inform their parenting. An online questionnaire [survey now closed] has been created for parents to take part in and share their views and experiences. Our staff and volunteers will also visit a variety of settings across the county to listen to parents and carers and note their experiences. Cllr Christine Lawrence, Cabinet Member for Public Health and Wellbeing at Somerset County Council said: “From 1 April, the County Council will be responsible for delivering health visitor services across the County. It is important to us to find out parents’ current experience of the service and how we can best support them. Please complete the survey and help shape the service going forward.” Emily Taylor, Manager at Healthwatch Somerset, said: “With the transfer of Somerset Health Visiting Services to Somerset County Council, we want to ensure the public voice is heard for future planning of the services. “We want to know what parents and carers think about the information and support they received from the service in Somerset and to better understand where families of young children go for support and information. “We would encourage as many parents as possible to take part and help make this service better for all those who use it.” The survey will run until 22 April and the findings from the engagement will go into a report to help inform the Family Support Service team at Somerset County Council on ways to develop health visiting services. The final report will be presented by Healthwatch Somerset to the Health and Wellbeing Board and shared with the Children’s Trust board later this year.

To mark the start of 2019, Healthwatch England has published its annual network priorities list – setting out the key health and care topics which local teams will be working on over the year ahead. GPs, dentists and other primary care services most common issue to be explored Needs of children and young people to feature strongly Mental health and social care appear in the top five for third year in a row Over the last year Healthwatch engaged with over 400,000 people about their experiences of care. Drawing on the wealth of qualitative data they collect, and through additional activities such as high-street surveys and townhall events, each local Healthwatch works with their community to set out a number of priorities for their area. Healthwatch England has analysed 139 of these local plans and compiled a national list of the top issues. The top five priorities for 2019 are: Primary care (including access to GPs) – 64 Children and young people – 57 Mental health – 50 Services working better together – 49 Adult social care, including residential care homes or care at home – 41 The projects undertaken by Healthwatch will build on the day-to-day activities of the network visiting hospital, GPs and care homes etc. and engaging with local people at events and in public spaces to gather their views. At a national level we will look to use the combined findings to provide insight for decision makers across the NHS, social care sector and Whitehall about the sorts of improvements people want to see. To do this we need the support of local people. We need more willing individuals to join our 5,000 volunteers and help us smash last year’s recording breaking efforts – which saw us increase the number of experiences we collected by an impressive 19%. We also need more people to come forward and share their experiences and ideas with us, and help us reach our goal of hearing from more than one million people a year. Focus on primary care With the vast majority of people’s experiences of the NHS coming through their GP, it is not surprising to see it top this year’s list. And while problems getting an appointment is a common issue, it’s by no means the only thing people feedback about. Online booking systems for example. Previous research by Healthwatch has shown that this the direction they want primary care to go in, but they want it to go further. They want to be able to book appointments with a variety of primary care professionals, from practice nurses to pharmacists, not just the GP. On mental health too, Healthwatch research has shown that people recognise the improving support on offer through their GP, but that they want to see more peer support rather than having to see their family doctor. These issues and more will be explored by the Healthwatch network in 2019 to help services make the improvements people want to see. Sir Robert Francis, Chair of Healthwatch England, said: “Taking the time to listen to people’s experiences of care and what they want to see done differently is enlightening and often generates a range of practical solutions that can help services better meet the demands being placed on them. “This is what we do at Healthwatch. We take the time to listen, and encourage others across health and care to do the same, building vital insight that helps services make the right changes first time. “As well as GPs, it’s really encouraging to see the needs of young people as a key area of focus. The fact that social care appears in the top five for the third year in row also shows the increasing attention communities want to see placed on creating a system that works for them. “But we cannot improve things on our own. If anyone has a story they want to share or an idea they think might help, I urge them to make it their New Year’s resolution to get involved and speak to their local Healthwatch.”

Have your say on the future of health and social care in Somerset – by joining a new Public and Patient People’s Panel. Somerset Clinical Commissioning Group are looking for people to join the panel and subsequent focus groups, so the public can have their say on the joint Fit for my Future strategy. Fit for my Future is a new health and care strategy for Somerset, created by Somerset Clinical Commissioning Group and Somerset County Council, in partnership with the two acute hospital trusts and Somerset Partnership to deliver more efficient and effective services. Emily Taylor, Healthwatch Somerset manager, explained: “The public have been giving their views over the last few months on the 10 year strategy and now it’s important people have their say on what proposals should go forward to formal public consultation this autumn.” An online questionnaire closed last month and the feedback will now be collated and shared with Healthwatch Somerset this month. Fit for my Future will be asking people to help decide which proposals should go forward to formal public consultation in autumn 2019.  The Healthwatch Somerset Board will be involved in the selection of the appraisal criteria, along with two independent focus groups run by research and engagement consultancy Evolving Communities, and a wider online survey. If you’d like to join the Panel and possibly take part in one of the focus groups – email  somccg.fitformyfuture@nhs.net .

The health and care issues affecting children and young people in Somerset have been the focus of our recent work. Our staff have been busy around the county – speaking to Somerset’s Youth Parliament to explain the role of the organisation and visiting a CAMHS (Child and Adolescent Mental Health Service) participation group meeting to understand young people’s experiences of using mental health services. Also, our first young volunteer has joined the team and the 17 year old student is keen to make a difference. Tadgh, who is currently studying international baccalaureate and wants to go into medicine, said: “I am really interested in what Healthwatch does and I understand the vital impact it has on public services. I want the opportunity to be able to understand all the essential background work for the various health and care services and how they can make a difference. “There is so much more that happens in the background to holistically create our health service and I don’t want to remain unaware of them.” Our new Healthwatch Somerset board member Virginia Roberts joined Tadgh at a Children’s and Young People’s planning day to give their views on what should be in the next Children’s and Young People (CYP) plan for 2019-2021. Virginia commented: “It was really uplifting to see so many young people giving up a day of their half term holiday to take part in this event. They all seemed really engaged with the process and their insights were often profound and really thought provoking. “It is really useful for Healthwatch Somerset to engage in the CYP Plan’s development and hear what young people want from health and care services in Somerset. Our involvement is assisting us to plan and target our future engagement with families, children and young people so that we can help Somerset County Council and local health services to hear their voices and respond to their feedback.” Virginia is also representing Healthwatch Somerset on the Children’s Trust Board – helping us to be much more informed and engaged in issues affecting children and young people in Somerset.

We will be monitoring the progress of a new strategy, launched this month by Somerset’s Health and Wellbeing Board. The  Improving Lives  strategy is the 10-year plan for the Somerset Health and Wellbeing Board, which Healthwatch Somerset has a place on. Following a consultation earlier in the year, the  Improving Lives  strategy has now been finalised and will be launched on Thursday, 13 December in Taunton. Judith Goodchild, Emily Taylor and Virginia Roberts will be attending the launch to understand the positive impact it should have for local people. Emily Taylor, Healthwatch Somerset Manager, explained: “The strategy sets out a vision for Somerset. It wants all organisations to work together as a partnership to make Somerset a thriving and productive county where all partners, private and voluntary sector, focus on improving the health and wellbeing of all our communities.” The strategy also sets out how partners can make Somerset: A thriving and productive county that is ambitious, confident and focused on improving people’s lives. A county of resilient, well-connected and safe and strong communities working to reduce inequalities. A county infrastructure that supports affordable housing, economic prosperity and sustainable public services. A county and environment where all partners, private and voluntary sector, focus on improving the health and wellbeing of all our communities. Our Healthwatch Somerset Chair, Judith Goodchild, will be monitoring the progress of the board against the strategy.

To choose the right care home and support for your needs, or the needs of a loved one, it's important you have the right information to make your decision. Here are six things you should consider when choosing a care home. If you’re finding choosing a care home stressful and confusing, you’re not alone. It can be challenging to find the information you need to help you make important decisions about the future.  The Competition and Markets Authority has produced  guidance published in 2018  to help you better understand your rights as a resident or the rights of your loved one.  Knowing your rights and what questions to ask will help you and anyone assisting you get the information you need and help ease the pressure of this difficult decision.  Six areas to consider at when choosing a care home or nursing home.   1. What do I need to know to choose a care home?  When you first contact a care home, you should receive key information that is clear and easy to understand. This information should be made available on the care home's website and any information packs that they may provide.   Key information includes:  Whether the care home accepts both people paying their fees and whose fees will be paid for by the local authority  An overview of the types of care, facilities and activities the care home can offer you.  An outline of the number of staff and their roles  Where applicable, the latest inspection rating for the home and where to find the most recent inspection report.  Any important terms and conditions that may apply to you, for example, if the home requires you to prove that you can pay for your care for a minimum period or how your fees might change during your stay.  How much you will pay to stay in the home, including an estimate of the weekly fees. (The exact amount will depend on an assessment of your care needs and the type of room you choose).  What services are included in the weekly fees, and whether there are any additional fees (for example, for being accompanied by staff to hospital appointments) or optional 'extras' (for example, hairdressing)  Information about a trial period – if they offer these.   To find out more about what information you should expect to receive, check out the complete guide .   2. What should you expect from your terms and conditions?   If you’re paying for your care, there will be a contract between you and the care home.   The terms and conditions should:  Be simple and straightforward, avoiding jargon so that you can easily understand your rights and responsibilities.  Be written and agreed with you openly and fairly.  Avoid unfair terms. If a term in a contract is unfair, it will not be valid, and the care home cannot hold you to it. Unfair terms include those which put the resident at an unfair disadvantage (For example, 'hidden' terms that you had not had the opportunity to read or terms that allow the care home to make unexpected changes to your fees).   If you don't understand any of the terms and conditions, question it before you sign.  3. What if something changes when I am in the care home?   There will be limited situations in which your care home can change your contract. If the care home make changes, you should get at least 28 days to consider the new terms. These changes include an annual review of your fees or where your care needs change significantly.  4. Can the care home ask me to leave?   Before you agree to move into the care home, they should clearly explain why they might need to ask you to leave. All these reasons must be included in your contract.   The care home should not ask you to leave without consulting you, anyone assisting you, and other relevant independent professionals. You should get at least 28 days written notice to leave the care home.    5. What level of service can I expect?  The care home staff must act with reasonable care and skill, providing the service agreed in your contract.  If they don’t, you may be able to claim compensation for breach of contract.  6. What can I do if something goes wrong?  You always have the right to complain about your care or your treatment.  Your care home should:  Make it easy for you to complain.  Deal with your complaint quickly and fairly.  Direct you to people that may be able to support and assist you.  Staff must never discourage you from making a complaint.  The care home must have their complaints procedure set out in writing. The complaints procedure must be easy to find both on their website and in the care home, be easy to understand and available in different languages and formats.   Learn more about your rights  To learn more about your rights, take a look at the Competition and Markets Authority's guidance on Care homes: consumer rights for residents and their families .  Help and advice Do you need advice on your finances? Perhaps you are unsure of what you are entitled to receive? Visit Age UK for independent advice on this and a range of other issues with your care needs.

We are calling for the NHS non-emergency phone line to provide better communication with the public Long waiting times, repetitive assessment questions and ‘robotic’ phone operatives were just some of the issues raised by members of the public when we asked about Somerset’s 111 non-emergency phone service in a recent survey. Despite two thirds of respondents saying they felt the 111 service did not meet their needs, 90 per cent said they felt they were treated with compassion, dignity and respect and a high proportion rated their experience as very good or good. More than 650 people took part in the survey, which was carried out to ensure the public voice is used to help shape a new Integrated Urgent Care Service, being introduced by Somerset Clinical Commissioning Group in February 2019. Our staff and volunteers visited events and community venues over the summer to capture people’s views on the 111 service. Some people said they liked the 111 service, as it provided reassurance and help in a time of need, commenting on how polite the advisors were. While other people reported being frustrated about the assessment questions, finding them irrelevant, lengthy and repetitive. Emily Taylor, Healthwatch Somerset Manager, said: “There appears to be a lack of understanding about the relevance and importance of the assessment questions. We would recommend better communication with the public about the service and how it works. “People also talked to us about waiting long periods of time for a call back from a medical professional. Many told us about not knowing when they would receive a call back. Some suggested that they could have been kept updated via a text message, email or an online app system. Where people were left too long, they often called 999 or went to A&E. Again, we would suggest better communication with people who are left waiting for a call back.” Emily continued: “People often referred to the 111 phone operatives as robotic because they were following a script. While people are happy that the service exists, there was a keenness that advisors be more willing to enter into a conversation about the issues and to be more flexible around the script. Additional staff training was mentioned on numerous occasions.” Following analysis of the survey results, we recommend: Better communication with the public about the service and how it works, as well as keeping in touch with those who are left waiting for a call back. Additional staff training for operators so they can enter into a conversation with the caller and be more flexible around the script. Collecting further data on high user groups and communicating with them on alternative options. (Around 85 people were regular users of the service calling between 10 and 60 times in the last three years. Providing a different phone number for health care professionals, particularly care home staff, so they can get access to other services without being taken through all the questions. Emily added: “We know that it is important that people know what has happened as a result of them sharing their experiences with us. We are already working with commissioners to respond to the issues raised in this report. We will be sharing this report with key partners and will be presenting our findings at the Somerset Health and Wellbeing Board and NHS Local Quality Surveillance Group.” The report will be sent to Healthwatch England, and a follow up meeting will be arranged with NHS Somerset Clinical Commissioning Group ahead of the launch of the Integrated Urgent Care service in February 2019. A spokesperson for Somerset Clinical Commissioning Group said: “Somerset CCG welcomes the publication of the Healthwatch Somerset’s NHS 111 public experience report. We will be incorporating its insights and recommendations into local urgent care planning and the county’s forthcoming health and care strategy. “Many of the issues raised, like the length of time it might take some patients to receive a call back after initially calling NHS 111, we expect to be addressed by the new Integrated Urgent Care Service for Somerset. This will be up and running from February 2019 and will be provided by Devon Doctors Ltd. “NHS 111 remains the essential number to call if you become ill after your GP surgery has closed or when you need medical advice fast, but it is not a 999 emergency. The number is free to call, available day or night and is still the quickest way to get timely access to health advice you or your family may need.” Case studies Asthmatic Joanna had to wait 12 hours before speaking to a medical professional on the 111 line after gasping for breath. Mum of one Joanna Boyer from Bridgwater had a nasty chest infection and was using a nebuliser but was feeling worse and couldn’t get her breath. She rang 111 a number of times and each time was promised someone would call her back within two hours. First time she rang after four hours of waiting to be told they had no record of her calling and that they would ring her back. This went on for 12 hours before she spoke to someone. In the end she went to her GP surgery and they sent her straight to A&E at Musgrove Hospital where she was treated. She said: “I know the 111 service is very busy but having to wait for 12 hours for a response is not good when you feel ill.” A similar thing happened when Joanna rang 111 after her 5 year old son was gasping for breath due to a chest infection. She called on the Sunday at 10pm and got a response at 6am the next day. She then went to her GP who sent the boy to Bridgwater Hospital to be treated. 71 year old suffers a heart attack but it goes unmissed by 111 telephone operator. Back in February this year, pensioner Marguerite Gill started to feel ill on a Sunday afternoon and rang 111 for advice. She said she felt quite poorly and frustrated by all the questions being asked over the phone. The operator said they felt she didn’t need to be seen that day by a doctor as she had previously been to the GP earlier that week and records showed nothing was picked up. She was advised to contact her GP on the Monday morning. Still feeling unwell, Marguerite went to see a neighbour and straight away they said: “She looks white as a sheet and needs to see someone, this can’t wait!” Her friends took her to A&E and in the early hours of Monday she was told she’d had a heart attack. She stayed in hospital for a week and had stents put in. Marguerite, who lives alone with her pet dog in Taunton Deane, said: “I just felt ill and wanted to see a doctor. To be told to make an appointment with my GP for the following day – I was just tired with it all. Thanks to my neighbours I got the medical help I needed.” Special educational needs advisor praises 111 service for talking her through an emergency. Ruth Hobbs from South Somerset is the director of the Somerset Parent Carer Forum. She was visiting a child at their family home when she noticed the father was showing signs of a stroke. Ruth said: “I had just walked into this house and wasn’t completely sure what to do. The man’s speech was slurred, he was struggling to move one side of his body and he was in distress. “I rang 111 and the operator talked me through the situation in a calm way and it was decided to get an ambulance to the house. They were amazing and through the help, advice and speediness of the 111 operator and the ambulance service – this man was able to get the care and attention he needed. “I would have no concerns in calling 111 again, I have full confidence in this service.” Healthwatch Somerset volunteer Rwth said: “The 111 service possibly saved my life” In September 2016, retired office worker Rwth Hunt started to feel unwell, having bouts of sickness and not being able to keep any food down. She rang 111 and described her symptoms to the phone operator who got a doctor to call Rwth back. The doctor decided to send Rwth to Musgrove Hospital for tests and an ambulance was sent. Rwth told us: “I just had enough time to get my dog to the neighbours and then when I returned the ambulance was waiting. “They diagnosed an umbilical hernia and I was operated on that same night. If it hadn’t been for 111 and them taking me seriously, I don’t know what would have happened. They set everything in motion and I was really impressed with how it all worked. They possibly saved my life.”

New Healthwatch Somerset volunteer Stephen Sharples is urging people in Somerset to be more actively involved in the decisions around their health and wellbeing Stephen, from Langport, moved to the area last year and previously chaired a successful Patient Participation Group (PPG) in the West Midlands, as well as helping to set up a multi-practice PPG which promoted health and wellbeing in the community and put forward ideas to the local decision-making groups. As a volunteer with us, Stephen hopes to encourage others to work with Healthwatch so that their voice is heard. The married father-of-two said: “Healthwatch is a brilliant idea, it’s there to help you share your experiences with those who make the decisions. “I know people don’t like to complain but if the health services don’t hear about a problem, then nothing changes. When a complaint is made, it’s usually put right and then all those who go after you have a much better experience. “Local people can help shape health and care services in Somerset by letting Healthwatch know what their concerns are, so that they can be collated and fed back to the local NHS management. I would urge people to have a go, whether that’s volunteering or sharing your views with Healthwatch – it’s not just about your own health matters, it’s for the people of Somerset!” Stephen plans to attend community events and help to man stands around Somerset to gather feedback from the public on local health and care services. This feedback will then be collated by us and the common themes are presented to the decision-making organisations in the county, who plan and pay for health and care services. We are currently looking for new volunteers to help us to champion the views of Somerset residents. Julie Draper, Healthwatch Somerset Volunteer Officer said: “Volunteers like Stephen are at the centre of everything we do, from talking to people about their experiences of local health and care services, to sitting on the board of directors. “Whatever your background, we are keen to hear from you if you think you could fill one of these roles. People can make a real difference to their communities and help to shape their local health and care services.” All of our volunteers go through a full training and personal development programme. They are given a comprehensive volunteer handbook and welcome pack, as well as having access to an online volunteer portal with up to date policies and procedures. Out of pocket expenses are also reimbursed.