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.

People with a passion for seeing local health and social care services changed for the better are being sought by us, the county’s independent health and social care champion. 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 a permanent Chair to lead our Board, as well as additional Board members. Emily Taylor, Healthwatch Somerset Manager, explained: “We welcome interest from all sections 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.” Board members will oversee and contribute to the work programme and play a crucial role in monitoring its delivery. They also play a part supporting the organisation to adhere to our principles, purpose and vision and ensuring that we operate in a moral and ethical way. “The people of Somerset need a champion to express their views” Retired ambulanceman and current board member Bob Champion, from Shepton Mallett, said: “I enjoy being a Board member, as I like to help people to get the proper advice and help that they deserve about health and social care. “I’ve many years of experience with the Health Service, which adds to the experience and knowledge I can give by being a Board member, and I am happy that I am not wasting the experience that I have had both in working as a paramedic and as a carer. Being a Board Member also helps me to keep my brain active and my legs working!” Fellow Board member Mike Hodson, from Spaxton, in the Quantock Hills, added: “I want to continue to be a Board member as we’ve made such a promising start and there is a lot more work to do, and I want to follow this through. The people of Somerset need a champion to express their views on health and social care and its improvement and Healthwatch Somerset is at the forefront of that effort.” Volunteer Rachel Mason from Somerton, who has two adult sons with autism and learning disabilities, said: “I volunteer to encourage the local authority and health bodies to see the value and benefit of working together to shape local health and care services. Volunteering could simply mean giving a few hours a week to pop some leaflets into your local library, shop or GP surgery to help raise awareness about Healthwatch and the difference we can make by working together.” Board meetings are held every two months. In addition, Board members will need to spend about two days a month on 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 an initial period of two years, with an option to extend by a further two years.

Here we look at six things you should expect when making a complaint about social care services. If you have a bad experience and your care goes wrong, it’s vital that services put things right as soon as possible and learn from what happened. However, we know from our conversations with you that making a complaint isn’t always straightforward. Some people worry that by speaking up their care will be affected or that they won’t be taken seriously. Others find the process too complicated. To make it clear what to expect when making and dealing with complaints about social care services, we’ve been working with the Local Government and Social Care Ombudsman to develop a  Single Complaints Statement  for both professionals and the public. Together, we’ve worked with organisations from across the social care sector as part of the Quality Matters Initiative to tackle people’s concerns. Three steps to follow when making a complaint about your social care It’s usually best to tell the organisation that provides or pays for the service if you need to complain. Doing this as soon as possible gives the best chance to put things right. If this doesn’t solve the problem, ask the organisation for a copy of their complaints process and make a formal complaint. If you are unhappy with the result, you can contact the Ombudsman for an independent investigation of your complaint. So what should you expect? Encouragement and reassurance:  You should feel encouraged to give feedback about the care you received and be given any information you need to do so. Your treatment should not be unfairly affected because you shared your views. You should receive reassurance that if you need to make a complaint, your care or the care of others will not be affected. Respect and involvement:  You should feel listened to, respected, and involved throughout making a complaint. You should receive the proper support to make your complaint, including independent advocacy where appropriate. A simple process with well-trained staff:  The complaints process should be easy to find. Organisations and their staff should have the skills to listen and understand your feedback and deal with it openly and transparently. To be taken seriously and to know what will change as a result:  Your feedback should be taken seriously. You should receive an explanation of the next steps outlining how your concerns will be addressed. It should also be made clear how the organisation uses people’s feedback to improve their services. A simple process to follow for when there’s more than one organisation involved:  There can often be more than one organisation involved with your care. If your complaint covers more than one organisation, you should be signposted to the right organisation, be able to make one complaint and receive a joint response from those involved. Clear information on what to do if you’re not happy with the result:  If you are unhappy with the result of your complaint, you should be given clear information about how to contact the Ombudsman for an independent review. However big or small the issue, if it’s important to one person, it’s very likely that it affects others, too. By sharing your story, you can help doctors, dentists, hospitals, and care homes understand what’s working and what could be better for you and your community.

People in Somerset are being asked for their views on using the county’s 111 non-emergency phone line. We are asking people to share their experiences of using the service – so that the public voice can be fed into any decisions made by the commissioners later this year. The Care Quality Commission (CQC) recently rated the NHS 111 non-emergency phone line in Somerset as ‘requires improvement for being safe and effective’. Our survey aims to capture the patient voice to ensure their views are taken into account. This is ahead of the move to a new Integrated Urgent Care Service for the county where Somerset Clinical Commissioning Group will be incorporating the views of service users and the public into the development of the new service model. Emily Taylor, Manager at Healthwatch Somerset, said: “We feel that we are undertaking this piece of work at a critical point in time. We have seen no evidence that patient feedback is being collected about the service and therefore the views of the users are not being considered in decision making. “Going forward, we want to be in a position to let Somerset Clinical Commissioning Group know where the issues are and actively encourage changes to be made.” We have a seat on the Somerset Clinical Commissioning Group’s Governing Body and will monitor any actions taken following the survey.

Share your experiences of local health and care services and make it better for everyone – that’s our message as we celebrate our fifth birthday next week (April 1). Healthwatch Somerset, along with 147 other healthcare organisations in England, was set up in 2013 as a result of the Health and Social Care Act 2012. Our role is to listen to the views of the public on local health and care services. We then use this feedback to help influence decision-making at a local level, shaping services for the better. Community Interest Company Evolving Communities took over the contract to run the local Healthwatch service in October last year. Since then, we have set up a new staff team recruiting a manager, volunteer officer, engagement officer and signposting officer. Over the last few months, our staff and volunteers have been out and about in Somerset visiting community hubs to encourage more local people to volunteer with the Bridgwater-based organisation and help shape health and care in the county. Emily Taylor, Healthwatch Somerset Manager, said: “As we celebrate our fifth birthday, our real focus is now on talking to more people than ever before through a strong network of volunteers. “We plan to run a more diverse range of engagement activities to reach more people. No matter how big or small the issue, we want local people to share their stories of local health and care services with us, so that we can share these ideas with those with the power to make change happen.” Five ways to share your views on health and care in Somerset: Talk to a Healthwatch Somerset volunteer or staff member on an information stand in the community. Check our events  for an up-to-date venue list. Pick up the phone and talk to a friendly member of staff to share your experience: 01278 264405. Email your story to  info@healthwatchsomerset.co.uk . Share your views online Join our growing team of volunteers – and help give people a powerful voice to make a real and lasting change.

As the county’s independent health and care champion, we welcome news a new provider will run the out-of-hours GP services in the county. Somerset Clinical Commissioning Group (CCG), the NHS organisation responsible for the planning and funding of local health services, announced today Devon Doctors Ltd would manage the county’s GP out-of-hours service. Last April, government inspectors from the Care Quality Commission found the out-of-hours service run by current provider Vocare to be inadequate and rated the NHS 111 non-emergency phone service, also provided by Vocare, required improvement. Emily Taylor, Healthwatch Somerset Manager, said: “We are pleased to hear that prompt action has been taken by Somerset CCG to address the ongoing concerns with Vocare’s delivery of the out-of-hours services. “We welcome the change to improve the out of hours service received by Somerset residents. We will be closely monitoring the public’s experiences of the new service delivered by Devon Doctors from April and invite local people to feed back to us about their experiences of using the service.” In February, members of Somerset CCG's Governing Body, agreed to procure a new urgent care service for Somerset within the next 12 months. This new service model will be consistent with guidance issued by NHS England in August 2017. Nick Robinson, Somerset CCG’s Chief Officer, said: “New nationally issued guidance aims to create Integrated Urgent Care Services across England, this should deliver a more robust and responsive service to patients and Somerset CCG supports this objective. “The procurement of the new urgent care service for Somerset will be subject to a competitive tendering process and we expect expressions of interest from any qualified service provider later this year. The current provider of service, Vocare Ltd, is able to bid to provide this new model of urgent care service if they wish. “By mutual agreement and on an interim basis, Somerset CCG has also agreed with Vocare Ltd, to transfer the management of the county’s GP out-of-hours service to neighbouring Devon Doctors Ltd. This management transfer is expected to be completed by the end of April 2018.” The Somerset CCG added that the development of a new urgent care service in Somerset and interim change of management for the GP out-of-hours service is not expected to inconvenience patients or the public in any way.

We are encouraging local people to give their views and experiences of local health and care services following a recently published report on Mendip House in the county. The Safeguarding Adults Review, commissioned by Somerset’s Safeguarding Adults Board, found that autistic residents at the Highbridge care home were subjected to 'cruel behaviour', bullying and humiliation. We are keen to hear from patients, carers, staff and families on any health and care services in the county, so that any common themes are picked up and presented to the decision-making organisations – so that the public voice is heard. Judith Goodchild, chair of Healthwatch Somerset, said: “We are sad to note the recently published report on Mendip House in Somerset run by the National Autistic Society. It was particularly traumatic for those who had loved ones in care they thought was of a high standard and trusted. “The courage of the two members of staff who worked at the home reporting their concerns has led to the inspection and ultimately closing of the home. “Healthwatch Somerset is always open to listening to the concerns from the general public about any issues they have with the healthcare they, or friends and relatives, are receiving.”