We talked to Mr. Smith during our time in West Somerset to hear his story about taking care of his wife. We spent time with him for four months at the end of 2024. Caring for a loved one with mobility challenges is a full-time commitment, a reality faced daily by Mr. Smith, a 77-year-old primary caregiver to his wife, Mrs. Smith. At the age when most people are enjoying a slower pace of life, Mr Smith’s days are filled with healthcare appointments, coordinating home visits, and managing the complexities of medical equipment. This blog explores the couple’s experiences with the healthcare system, highlighting both the support they receive and the challenges they continue to face. The Financial Strain of Mobility Aids One of the aspects of Mrs. Smith’s care involves specialised mobility aids. The couple secured essential equipment from Mediquip, including a hospital bed, loo riser, and a Zimmer frame. However, the financial burden of acquiring a wheelchair and installing ramps for access to their home fell on them. Mr. Smith went onto explain that they had some savings that they were able to use, the wheelchair cost £1,000. Despite these expenses, Mr. Smith acknowledges that the £9.00 donation they pay for Mrs. Smith’s daily personal care assistance is reasonable, and they are glad of the support which provides some respite for Mr. Smith. Hospitalisation, Discharge, Transfers of Care: Gaps in support  In November of 2023, Mrs. Smith experienced a fall inside their home. The couple were impressed with the prompt ambulance response, which arrived within 15 minutes. During Mrs. Smith’s hospital stay, she had her wounds tended and multiple arthritis injections. However, the experience post-hospitalisation was less positive. Upon discharge, Mrs. Smith was released without a care plan or transportation arrangements back to their home in Porlock, fortunately, Mr. Smith was able to drive and ensure his wife’s safe return. Ambulance Wait Times: A Mixed Experience The couple has faced varying ambulance response times over the years. While the initial response to Mrs. Smith’s first fall was swift, a subsequent fall required a grueling two-hour wait. Moreover, Mr. Smith recalls two additional ambulance calls over the past three years, with wait times ranging from five to seven hours, which caused anxiety for the couple.   Wound Care Complications Another healthcare challenge arose from a wound care incident. Mrs. Smith developed a wound on her leg that was dressed, but later began seeping fluid. Despite a visit from a nurse, the wound dressing was not checked. When Mrs. Smith was hospitalised, the wound was discoloured which was the effect of a seaweed dressing, it was also found to be weeping and in a poor state. Despite this setback Mr. Smith commended the hospital staff for the overall quality of care they provided, but this visit could have been prevented if Mrs. Smith’s wound had been checked whilst at their home. Key Challenges and Takeaways Mr. and Mrs. Smith’s story sheds light on several critical issues in the healthcare system, including: Timely Access to Healthcare: The couple generally experience prompt doctors appointments and reliable home visits, which are vital for managing chromic conditions. Financial Burden of Mobility Aids: Out-of-pocket expenses for essential equipment add financial stress. Hospital Discharge Planning: The absence of a care plan or transport upon discharge presents a gap in continuity of care. Ambulance Response Time: Extended wait times during emergencies can have serious health consequences, creating stress for both the patient and caregiver. Wound Care Management: Inadequate wound care oversight led to complications. A follow–up with Mr. Smith: Addressing the struggles of a Carer in Minehead in November 2024 Healthwatch Somerset visited a carers’ group in Minehead, where we had the opportunity to catch up with Mr. Smith, a dedicated carer whom we first met back in August 24. This follow-up visit revealed just how complex and challenging the caregiving journey can be. Mr. Smith shared a distressing experience that took place around Mid-October 2024. His wife suffered a fall inside their home, becoming trapped when she landed on top of her Zimmer frame. The impact caused painful cuts under her armpits, and despite Mr. Smith’s best efforts, he found himself unable to lift her due to her size. Realising the gravity of the situation, he called for an ambulance, which had an estimated wait time of an hour. When the paramedics arrived, their efforts to help Mrs. Smith proved insufficient. Lifting her was too challenging for the two paramedics, and they advised Mr. Smith to call the fire service for additional support. Thankfully, the fire service arrived within ten minutes and successfully helped lift Mrs. Smith back onto her bed. However, the incident did not end there. The paramedics voiced concerns about Mrs. Smith’s hospital bed, noting that it was too small, making it impossible to turn her properly. They recommended that Mr. Smith contact Mediquip to arrange a more suitable bed. Mediquip, a supplier of mobility aids and essential equipment, agreed to provide the necessary bed but mentioned that an occupational therapist should be present during the installation of the hospital bed. Despite placing an order in mid- October, Mr. Smith expressed his growing frustration, by the time of our visit in mid – November, the new bed had yet to arrive. The prolonged wait has caused both stress and worry for Mr. Smith. We will keep in touch with Mr Smith. We would like to thank him and his wife for sharing their story which highlights the challenges faced on a regular basis by carers navigating the health and social care system.

In November 2024 we undertook an Enter and View visit to Oakhill Surgery to observe the quality of service, and talk to people using the surgery. The purpose of this Enter and View visit was to talk to patients, their family members, caregivers, and staff to understand how they felt about their experience at Oakhill Surgery. Summary Our visit had been advertised within the surgery and on the surgery website We spoke to over 14 people Observations were made throughout the visit What we found This practice serves the local community, and patients feel it is an integral part of that community. Patients said staff are friendly, and go above and beyond to be helpful. We were told that staff get to know the patients and in turn patients feel listened to. The surgery places importance on good communication with patients. This includes knowing patients’ names and telling patients what is going on. We observed staff being polite and courteous to patients. Patients spoke highly about the attitude of staff and quality of care they receive. Our recommendations include: It would be helpful to have photos of the staff so that patients can recognise them. Investigate the possibility of enlarging the size of font on the TV screen and slowing the speed of screen changes. Continue to host the annual carers event (or similar) to showcase the surgery and to pass information to patients. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk   or call 0800 999 1286.

Our February newsletter includes updates about our work, information about health and care services, and helpful advice. Snowdrops in Somerset To read our February newsletter - click on the pdf below If you need this newsletter in a different format, please email: info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Our January newsletter includes updates about our work, information about health and care services, and helpful advice. To read our January newsletter - click on the pdf below If you need this newsletter in a different format, please email: info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Tell us what you want us to report in the next 12 months Your vote matters Every year, we create a work plan for the next 12 months. This plan is shaped by your feedback and what we’ve learned about health and care services in Somerset over the past year. We've picked four possible projects for 2025/26 and would love your help in choosing which topic you’d like us to focus on. A. Waiting lists for procedures Waiting times for medical procedures are a problem across the country, but here locally, we’ve noticed that people are not getting clear updates about their wait times and the procedures themselves. We want to look into how and when patients are being informed while they’re waiting for their medical treatments. B. Hospital transport Somerset's rural nature makes travelling to and from hospital appointments challenging for those unable to use standard transport. We aim to understand the experiences of people booking hospital transport and the service's communication with patients. C. Transfer of Care/Discharge from hospital - excluding dementia During 2024 people have shared with us the difficulties they have experienced when moving from the hospital to back home. We want to listen to patients and carers tell us what they need when leaving hospital. D. Long wait for/no support for children and adolescents experiencing poor mental health The Child and Adolescent Mental Health Services (CAMHS) in Somerset provides mental health evaluations, support for children and young people up to 18 years old, and can direct you to other helpful services. We aim to explore how help is given and what procedures are in place for those who do not qualify. Voting is easy Call us free: 0800 999 1286 Scan the QR code Go online: www.smartsurvey.co.uk/s/PeopleVote2025/ Complete your vote below: You can also download and print the attached voting leaflet to send your vote to us by post to: Healthwatch Somerset Suite 12, Wellworthys Business Centre Parrett Way Colley Lane Bridgwater TA6 5LB Voting leaflet Spread the word We want to hear from as many people as possible so please tell your family and friends. If you would like to display or share our poster, download it below.

On March 13 2025 Prime Minister Keir Starmer announced that NHS England will be abolished and the management of the NHS brought back to ministers. If you are concerned about what this means for NHS services, we have put together some information to help you understand the change. What is NHS England?  NHS England leads the National Health Service (NHS) in England and has a wide range of statutory functions, responsibilities and regulatory powers. NHS England was established in 2013 with the aim of establishing greater independence and autonomy for the NHS.  What do the changes mean for the NHS? The NHS is not going anywhere. Healthwatch England have explained that the announcement relates to the structure of the NHS; the change means that the “functions [of NHS England] will be taken into the Department of Health and Social Care, with the merger lasting about two years”. The Prime Minister and Health and Social Care Secretary, Wes Streeting, have shared in the news that the motivation behind the change is to bring decisions about the NHS back into government control and empower NHS staff to deliver better care for patients. What does this mean for Healthwatch Somerset? Healthwatch Somerset is your local health and social care champion. We make sure NHS leaders and other decision makers hear your voice and use your feedback to improve health and social care. We’re here to listen to the issues that really matter to local communities and to hear about your experiences of using health and social care services. We’re completely independent and impartial and anything you say is confidential. We also offer information and advice to help you to get the support you need. Our service is free, simple to use and can make a real difference to people in Somerset. The dissolution of NHS England does not change the role we play in ensuring that services put people at the heart of the care they receive. We will continue to champion local people to ensure their voices are heard.  Statement from Healthwatch England Chief Executive, Louise Ansari: "We know people want better access to and experience of care for everyone, in particular those facing health inequalities, including disabled people, carers, and those on low incomes. "During the forthcoming period of change for NHS England, it's important that everything possible is done to ensure that patients’ care is not disrupted and that the progress the NHS has been making in some areas is not reversed. Going forward, any changes in structures need to have improvements in patient access to and experience of care at their heart.” We’re here to help Whether you’d like to share your feedback about NHS and social care services, want to say something to, or about us, or if you’re looking for local signposting support – get in touch. We’re here to help you.

A second opinion is when you choose to request the expertise of another healthcare professional after you've been given a diagnosis or treatment plan. What are the new rules about second opinions and and how can you request one? Do you have a right to a second opinion?   The General Medical Council, which regulates doctors, says doctors ‘must recognise a patient’s right to choose whether to accept your advice, and respect their right – to seek a second opinion’. However, receiving a second opinion on the NHS is not a legal right. More than 140 NHS trusts are also piloting a new initiative called Martha’s Rule , which would give patients the power to formally request an urgent review of hospital patients if their condition deteriorates from a team within the same hospital. Do you need a second opinion?  Before asking for a second opinion, it is worth asking your healthcare professional to go over your diagnosis and explain anything you don’t understand.  If you’re unhappy with your diagnosis or would like to try a different course of treatment, tell them. Your family or carer can also ask for a second opinion on your behalf, but only with your consent.  If they request a second opinion on your behalf, they should have all the information about your illness or condition, and check they understand it well.  Sometimes a consultant may ask a colleague to provide a second opinion.  For example, doctors may ask a colleague about a complicated case, or they may need to refer a patient to a consultant with a sub-specialty interest.   Things to consider  You may need to travel further to attend appointments at a different hospital.   If you have a serious medical condition requiring urgent treatment, you should discuss this with your current healthcare professional and ask whether any delay in starting treatment could affect your wellbeing. Requesting a second opinion should not negatively impact your care or relationship with your GP or any other healthcare professional taking care of you.  You may be able to find a specialist who has particular expertise in your medical condition, especially if it's rare, to give you a second opinion.  How do you get a second opinion?  You need to proactively seek a second opinion, which may involve, for example, asking to see a different GP at your practice, or going back to your GP to be re-referred to a different hospital specialist. If your GP agrees to refer you to a new consultant, they will be told that this is for a second opinion. They will also send your medical records to the new specialist. You will be treated as a new patient referral, and this will mean you need to wait longer for treatment. Considering the pros and cons of seeking a second opinion will help you make well-informed decisions about your treatment and your health.   What is Martha’s Rule?   NHS England is piloting Martha’s Rule , named after Martha Mills, a teenager who died in 2021 after developing sepsis in hospital. She had been admitted with a pancreatic injury after falling off her bike, but her treatment team did not address her family’s concerns about her deteriorating condition. In 2023, a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier, and the government agreed to introduce a nationwide scheme based on initiatives already in place at some hospitals. NHSE said last year that 87 trusts had already implemented an escalation process to help patients or families get a second opinion, and 92 had partly or fully introduced a similar process for staff. In September and October, patients, relatives, carers, and staff made at least 573 calls about deteriorating conditions. Around half of these incidents led to a clinical review, and 14 resulted in patients being urgently transferred to intensive care. The pilots aim to develop a standardised approach to Martha’s Rule, ahead of scaling it up to the remaining trusts in England in the following years. What does Martha's Rule involve?  The three proposed components of Martha’s Rule are: All staff in NHS trusts must have 24/7 access to a rapid review from a critical care outreach team, who they can contact should they have concerns about a patient.  All patients, their families, carers, and advocates must also have access to the same 24/7 rapid review from a critical care outreach team, which they can contact directly, via mechanisms advertised around the hospital, and more widely if they are worried about the patient’s condition. This means that they don’t have to make the request via the medical team currently treating the patient.   The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.  Looking for more information? Further information is available via the NHS website.

You've told us that you've experienced problems registering with a GP. This article explains more about your rights and what to do if you're refused the right to register. GP access is an ongoing issue you tell us about. We want to help you understand your rights when registering with your GP, using  NHS guidelines . Do I need proof of address to register with my GP? NHS guidelines state that you don't need proof of address, immigration status, ID or an NHS number to register with a GP. However, some GP surgeries ask for supporting documentation. They might have a few reasons to do this: It can help the surgery find your medical records or transfer them from another practice. It confirms that you live in the surgery's practice area if they do not accept patients from outside this area. If you don't have a permanent address, you can still register using a temporary address or the address of the GP surgery. Do I need identification to register with my GP? You do not have to provide an ID when registering with a GP, but it does help. Below is a list of documents that you can use as ID:  Passport Birth certificate Biometric residence permit Travel document HC2 certificate ARC card Utility bill What could stop me from being able to register at my GP? A GP must explain why they refuse your request to register in writing. The GP has the right to refuse if:  The practice isn't currently accepting new patients.  The practice only accepts patients living within its practice area.  You have been removed from that surgery before. What to do if you're refused the right to register There could be several reasons a GP may refuse your registration. But they must explain why in writing within 14 days. If you have problems registering with a GP surgery:  Call the NHS England Customer Contact Centre on 0300 311 22 33 Contact Healthwatch Somerset  Here are some ways that you can make a complaint: By  email  (for the attention of the complaints manager in subject line)  By post: NHS England, P.O. Box 16738, Redditch, B97 9PT By phone: 0300 311 2233 (Telephone Interpreter Service available) Further information can be found from your local  Citizens Advice  or  contact Healthwatch Somerset . This information can be made available in alternative formats, such as easy read or large print and may be available in alternative languages upon request. To receive this, contact 0300 311 2233 or send an  email to NHS England . I want to change my GP practice. Do I have to give a reason? No, you don't have to tell your practice why you want to change or your new one why you made that decision.  You'll need to fill in a registration form. A request will then be made to your current GP to transfer your medical records to the new GP surgery.  Read more information  on registering with a practice further away from your residence. Registering as a temporary patient You can register with a GP practice as a temporary patient. You can register as a temporary resident with a GP surgery for up to three months. To register, you must fill out a temporary services form (GMS3) from GP surgeries. After three months, you must reapply to register as a temporary resident or become a permanent patient. Accessing GP care as a student If you become unwell or need other medical treatment when you're at home or not staying near your university GP, you can  contact your nearest practice  to ask for treatment. You can receive emergency treatment for 14 days. After that, you will have to register as a temporary resident or permanent patient. You can also visit an  NHS urgent treatment centre . You don't need an appointment, and you don't need to be registered. They can treat minor injuries or illnesses such as cuts, bruises and rashes. They aren't designed for treating long-term conditions or life-threatening problems. More information Are you an asylum seeker, refugee, homeless or an overseas visitor, whether lawfully in the UK or not?  Find out how to register with a GP surgery .

GP practices very rarely remove patients from their list. If you are removed from a GP practice, you may need to register with a new one. GP practices may apply to remove patients from their list if the relationship between patient and GP has broken down. Your GP will normally explain the problem to you and try to resolve it. They may contact you or they may want to see you. If the problem can’t be resolved, the GP will normally advise you in writing that you may be removed from their list. Patients cannot be removed from a GP’s list because they’ve made a complaint. However, the basis of the complaint may mean that the relationship between patient and GP has already broken down. If a patient has been violent or abusive, or has behaved in a threatening way towards their GP or a member of staff and the police have been involved, they may be removed from their GP’s list immediately without warning. Your GP’s practice leaflet may explain their policy for removing patients from their list. Moving out of your GP’s catchment area You may also be removed from your GP’s list if you move out of the area covered by their practice. If you’re removed from your GP practice’s list, you may need to register with another GP practice. You will be given 30 days in which to make alternative arrangements. Getting a new GP You may choose to register with a different GP practice, but the practice does not have to accept you. This is the same for anyone registering with a GP– it’s not related to your removal from your former practice’s list. It may be because you live outside the practice’s catchment area or because the practice is not accepting new patients at that time. A practice cannot refuse you unless it has reasonable grounds for doing so. These must not relate to race, gender, social class, age, religion, sexual orientation, appearance, disability or a medical condition. It must also give you reasons for its decision in writing. If you’ve been removed from your GP’s list and you haven’t yet registered elsewhere, your local Integrated Care Board, known as ICB, can find you another GP. For more information, see: How do I register with a GP? You can register with a GP surgery using the NHS App. What if I need treatment? If you need emergency treatment or have treatment more than once a week, you can get treatment from your current GP until your condition improves or until a new GP practice accepts you. Patients who have been removed from their GP’s list because of violence are only entitled to emergency treatment if their GP thinks it’s clinically necessary. You can register with a GP surgery using the NHS App. Other family members If you’re removed from your GP’s list, it won’t necessarily affect other members of your family. However, this may depend on why you’ve been removed from the list. For example, if you’ve moved out of your GP’s area, other family members will also need to register with a new GP.

Hospital discharge processes are in place to help you leave hospital safely. Whether you're returning home or, moving onto another care provider here’s what you should expect when it’s time to leave hospital. The current guidance for hospital discharge is set out in the  Hospital discharge service policy and operating model  from the Department of Health and Social Care. What should happen when you arrive at hospital When you arrive at the hospital, you should be given  information explaining the process of leaving the hospital . Changes to hospital discharge policy since the start of the pandemic mean that while you and your loved ones will still receive high-quality care in the hospital, you must be discharged as soon as you no longer require hospital care. For most patients leaving hospital this will mean that, where it is needed, the assessment and organising of ongoing care will take place when they are in their own home. While you are in hospital. staff should discuss with you what kind of care and support you are likely to need after your discharge. Any family or carers who might be supporting you should be involved in these conversations.  What should happen before you leave hospital 1) Explaining the process On the day that you are ready to be discharged from hospital, your health team will discuss this process with you and take you to the discharge lounge. Most people should then expect to be discharged within two hours, although this may take longer if you have more complex requirements for post-discharge care.  2) Hospital lounge and patient transport While you are waiting in the hospital discharge lounge, the discharge co-ordinators should discuss with you your transport home, any medication you might need, and support with immediate practical measures such as shopping and the turning the heating on, if there is no one at home to help you do this. They should also discuss with you whether you are likely to need any longer-term recovery support. 3) Aftercare and ongoing support If you need immediate care or support on the day of your discharge from hospital, this should be arranged by a care coordinator before you leave hospital. If you may need longer-term recovery support, you should be informed that a health professional will visit you in your home or other place of discharge to assess your ongoing healthcare needs after your leave hospital. If you are able to manage your own recovery without significant additional support from the NHS, you should be given information about voluntary or community support services you can contact, and informed that you can request a formal assessment at a later date if your situation changes. If your condition means that you will be discharged to a care home or other place with additional support, you may not be given a choice about where you will go, but you should be supported to move to your preferred long-term care home later. 4) Contact information Before you are discharged, you should be given information about who to contact if you need further health advice or support after leaving hospital. What should happen after discharge – your continuing support needs If you need ongoing recovery support after discharge, you should be visited in your home by a health professional who will arrange this. This could include things like: Whether any changes are needed to make your home safe and comfortable  Ensuring there are people to support you and keep you company  Whether you might need support for daily tasks (e.g. washing, getting dressed, cooking)  Whether a short-term wheelchair loan would be helpful for you Whether you need support taking any medication  This should happen the day you leave hospital or the day after and this support should then be made quickly available. Will I face any costs? Currently, any care and support you receive in your own home will be free for up to six weeks after you leave hospital. During this time, the team caring for you should assess whether you might need longer-term support and if so, support you to determine your eligibility for further funding. Need more information?  Read more on hospital discharge here: NHS - Being discharged from hospital GOV.uk - Hospital discharge information for patients entering hospital Age UK - Leaving hospital

Our report following a visit to Highfield House, a Grade 2 listed house converted to a care home and situated on the High Street, in the centre of Castle Cary. Key findings    The Healthwatch team all reported great first impressions of the home There is a real sense that this is the residents’ home, and staff appear to be like family within that home. The manager and deputy appear very caring and committed to ensuring each resident is happy and healthy The environment felt homely and welcoming, calm and organised Interactions between residents and staff were very personalised; staff know residents well. This was the same for staff interactions with relatives  It was apparent the home sought to get the right staff to fit the ethos and culture of the home Recommendations We would like the home to consider the following recommendations based on our observations and findings from the visit.   We liked that the home had strong links within the local community, including the local coffee shop, primary school and church (who deliver Holy Communion) and would recommend this continues We suggested the home consider a photo board of staff who were on duty that day We like that a resident has been asked to be the Resident Ambassador We really liked the ‘wish board/what matters to me most’ as this reflects the personalised nature of care in the home. Healthwatch would like to use this as an example of good practice to share with other providers   Read our report

In our latest Annual Report, The Value of Listening, we highlight how we've worked throughout the year to understand people’s health and care needs, and to use public feedback to help NHS and social care services improve care in Somerset. The report also outlines our work planned for 2024-25. The year in numbers 2,621 people shared their experiences of health and social care services with us, helping to raise awareness of issues and improve care. 4,325 people came to us for clear advice and information about topics such as mental health and the cost of living crisis. 35 outstanding volunteers supported us last year, giving up 126 days of their time to make care better for their community. We published eight reports about the improvements people would like to see to health and social care services. Next steps Over the next year, we will keep reaching out to every part of society, especially people in the most deprived areas, so that those in power hear their views and experiences. We will also work together with partners and our local Integrated Care System to help develop an NHS culture where, at every level, staff strive to listen and learn from patients to make care better. Our top three priorities are: Care at home Unpaid carers Pharmacies Read the full Healthwatch Somerset Annual Report 2023-24 to find out more about our work during the past year, including findings and recommendations for changes to services. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk   or call 0800 999 1286.