The new Pharmacy First scheme enables your local pharmacy to treat some common conditions with prescription-only medicines, without you visiting your GP. Find out everything you need to know. This can include prescribing and supplying antibiotics and antivirals where clinically appropriate. What conditions can be treated at my pharmacy?  Your local pharmacy can now supply prescription-only treatment, if they believe you need it, for the following conditions:  Sinusitis (for patients aged 12 years and over only) Sore throat (aged 5+) Earache (aged 1 year-17) Infected insect bite (aged 1 year+) Impetigo (aged 18 years+) Shingles (aged 18 years+) Uncomplicated urinary tract infections (women aged 16 to 64) How does it work?  If you are feeling unwell with any of these conditions, you can go to your local participating pharmacy and ask for a private consultation with the pharmacist. You may also be referred by a GP practice if they don’t have any appointments and believe your pharmacy can help. The 111 helpline service may also refer you. Pharmacists can also offer this service on-the-spot if you go in asking generally for help. Pharmacists may offer a virtual consultation by phone or video call, or in person in a private room in the pharmacy. They will ask questions, may perform an examination and must get your consent to access your medical records. The pharmacist will be able to recommend the best course of action based on your clinical needs. This might include issuing prescriptions for antibiotics or antivirals where necessary or advising you on over-the-counter treatments that could help. What are the benefits of the scheme?  There are many benefits to the new scheme, helping to make care easier and more accessible. These benefits include: Participating pharmacies must offer the service during all their opening hours including any late nights or weekends. It may be quicker to see your pharmacist than waiting for an appointment with your GP. Pharmacy First – along with expanded Blood Pressure Check  and Oral Contraception services at pharmacies – could free up to 10 million GP appointments a year. How can my pharmacist supply a prescription-only medicine if they are not a doctor? Pharmacists must follow a strict NHS protocol (called a ‘patient group direction’) covering their own required knowledge and skills the types of patients covered. This means that the supply of prescription-only medicines will be limited in all cases by age groups, and in one case, by gender. Will I have to pay for my advice or medication?  The appointment and advice from a pharmacist are free to access. If you are recommended an over-the-counter medication, you will pay the costs of buying this. If you are supplied with a prescription-only medication, usual prescription charges would apply unless you qualify for free prescriptions. If you regularly require medication and are not exempt from prescription charges, you may be able to save money through a prescription prepayment certificate (PPC). Find out what help you can get to pay for your prescriptions How do I know if my local pharmacy is participating? Most pharmacies have agreed in principle to deliver the new service but may launch at different times, from 31 January 2024 onwards. They may need to train staff, upgrade IT and install a private consultation room. Can I get oral contraception without a prescription?   From December 2023, some pharmacies will be able to start women on oral contraception (also known as ‘the Pill') for the first time, or re-start them after a break, without the person needing to see their GP first. This is an extension of the existing oral contraception service that let women go to pharmacies for repeat prescriptions, that had been initiated first by a GP. The pharmacist will offer a confidential consultation to discuss your current medication and ensure it is the best option for your needs. Oral contraception is free on the NHS, and you will not be charged any prescription charges. To find a local pharmacy offering this service – check out the NHS website Can I still see my GP?  You can still choose to visit your GP if you prefer. Pharmacy First simply offers an alternative route for getting treatment for these specific conditions.

We created a survey that could be accessed online and completed at engagement events. The survey ran from 11 June to 31 August 2018. It asked for the views of local people who had used the service within the last three years. Key findings 90% of people felt they were treated with compassion, dignity and respect when they have used the NHS 111 service. Two thirds of people felt that the NHS 111 service did not meet their needs. This was often because the service could not solve their issue then and there. In other cases, it was because they were unhappy with the outcome of the call. Where a person felt that the NHS 111 service had not meet their needs, people identified which other service had. A lot of people told us that the NHS 111 service was their gateway to other services, especially at night and weekends. This could either be because they were referred to it or, that they decided to access an alternative service. Despite the NHS 111 service not meeting the needs of some people, a high proportion of the sample would rate their experience of using the service as very good or good, often describing the service as helpful, professional and providing advice. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

We are calling on local people to make sure their voice is heard and reflected in proposals being drawn up by Somerset NHS health and care services, for changes to community-based services and non-emergency care. We are the county’s independent health and care champion.  We make sure that, wherever possible, local people’s views are at the heart of decisions made about health and care services in the county. We have been involved in the development of the public engagement programme,  Fit for my future , that was launched today by Somerset health and care services, to seek local people’s views about how to improve services in the county. Chair of Healthwatch Somerset, Judith Goodchild, welcomed the county’s commitment to public engagement, while emphasising the value of listening and learning from people’s experiences.  She said:  “Changes to health and care services must reflect the views and experiences of the wide range of people who use and provide those services.  This is essential to truly understand people’s needs and to develop plans that will bring about positive change.  Healthwatch Somerset wants as many people as possible to speak up now and share their views about how to improve community-based services and non-urgent care.  We will be raising awareness of this important opportunity to help shape the future of these services in our county.” People can share their views until 12 April 2020, either at events organised by the Fit for my future team in community hospitals and libraries, or via a survey completed online or at GPs surgeries.  To find out more about the health and care services that are being reviewed and about the different ways to get involved contact Somerset’s Fit for my future team online:  fitformyfuture.org.uk , call 01935 384119 or email  somccg.fitformyfuture@nhs.net .  Alternatively, contact us  on 01278 264405. Following the public engagement programme, there will be a formal consultation about the different ways that Somerset could deliver community health and care services in the future.

Healthwatch Somerset Annual Report 2018-19: A review of our work over the past year and its impact, plus our work planned for 2019-20. Message from our Chair About us Highlights of the year How we’ve made a difference Helping you find the answers Our volunteers Our finances Our plans for next year Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

We have been talking to local people about their experiences and views of the Health Visiting Service in Somerset. This report tells you what people said when we spoke to them about the service. Key findings Two thirds of people were satisfied, or extremely satisfied with the level of support they received from the Health Visiting Service. Most people would like to access information about the health and development of their child/ children from the Health Visiting Service. This was closely followed by their GP surgery. A meaningful number of people reported that key contact points were missed or delayed (10%) and that ongoing communication with families did not meet people’s expectations (7%). Breastfeeding support was mentioned most frequently as being a helpful source of support offered by the Service. People would like to see more drop-in clinics and groups that are both accessible and flexible to meet the needs of families. 21% of people told us that they would like to access information about the health and development of their child at local groups. Lack of communication was a big issue for many respondents. They felt that the Health Visiting Service did not keep track of families or keep in touch. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Healthwatch Somerset Annual Report 2019-20: A review of our work over the past year and its impact, plus our work planned for 2020-21. Message from our Chair About us Our priorities Highlights from our year How we’ve made a difference Helping you find the answers Our volunteers Our finances Our plans for next year About Healthwatch Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

By Tanya Camberwell, Healthwatch Somerset Engagement Officer Imagine my surprise when in the third week of July, I received a letter that I wasn’t expecting, and from the outside, appeared to be from NHS England.  I was being asked to participate in a COVID-19 testing national study to help measure the frequency of cases.  The test would only show if I had COVID-19 at the time of my swab, this is an antigen test so would not show if I had previously contracted the virus. The study is being conducted by the Imperial College London and Ipsos MORI, (an independent research organisation), on behalf of the Department for Health and Social Care. How I got involved To participate I had to register and agree that I was willing to take part; I chose to sign up online but there was also the option to register over the phone.  It was a straightforward process that took me less than five minutes, I had a unique code to register with and was asked a few general questions. Taking the test The test kit and instructions were delivered to me the following week, the kit included: one swab, a swab container, collection labels, a biohazard bag, a collection box (flat packed but really easy to assemble), a security seal for the box, and instruction booklet (pictured right). The test needs to be done on the day of the collection, so the very first step was to book a collection date.  Once again, I did this online and selected a day suitable for me from a choice of dates, (these did include a Saturday collection too).  It was not possible to book a time slot for the collection, but the instructions advised I would be contacted with given slot on the chosen day of collection. The booklet that came with the test gave clear and simple instructions about when and how to take the test on the day of your booked collection.  There is also the option to watch a video online about how to take the test correctly.  The instructions would not have suited people with sight or reading difficulties and were only written in English, however I did not investigate if there were any other formats available and there is a helpline telephone number that maybe able to assist with these needs. The test must be performed before 08:00am, (which is the earliest collection time), then it must be bagged, boxed, and stored in the fridge until it is collected.  The trickiest, and slightly uncomfortable, part of the whole process was the throat swab which couldn’t touch any other part of your mouth or teeth and was a bit scratchy.  I had to swab both sides of the back of my throat where my tonsils are for about 10 seconds and then swab both nostrils (about 2.5cm up) for the same length of time.  As you must use the same swab for both areas it is really important to do your throat first… The swab has a break off point, this is so it fits in the container and the sample is not contaminated by the end that is held in your fingers.  I then put my unique identifying label on the container and put the container in the biohazard bag which also had to be labelled.  The final step was to put the bag in the, now assembled, box then seal that with the security seal and add the final unique box label. The whole process took a lot longer to explain than it did to perform including the final step of completing the online survey which consisted of questions about my weight, height, age, and so on.  There is the option of ‘prefer not to say’ for each question and measurements did not need to be exact.  This type of information is important for research to help identify any trends in different groups of people such as location, ethnography, and social determinants of health. Test collection Just after 8am on the day of my collection I received a text message that gave me a time slot of two hours for the collection of my test.  The courier arrived within the timeframe and was wearing PPE, they kept a two-metre distance and I had to place my sealed box in the container provided.  They were polite and courteous, and I wasn’t required to sign or touch anything that they were handling. Receiving the results Three days later I received a text and email with my test results, I had tested negative and this was confirmed with a letter though the post a few days later. Making a difference Taking part in this study has been interesting and I feel like I have contributed to a wider cause.  A little bit of my time and insignificant tickle on my throat is the least I can do to help, it is nothing compared to the difficulties key workers, unpaid carers, and some family members have faced during such challenging times.  I have even signed up to take part in further research, so who knows I may get a chance to do a bit more in future.

We gathered the views of those currently using the District Nursing Service. We wanted to know what the current strengths and weaknesses were in the delivery of the service to patients in Somerset. Recommendations It is clear throughout the experiences we gathered that the current service provided by Somerset District Nurses is very well received by patients, their carers, and family members. Maintaining and building on this level of service should be at the heart of any proposed changes to the DNS. Increasing the hours of service, so that routine visits can take place during weekends and evenings where appropriate, would be beneficial for both service users and staff. Consideration into the suitability of the appointment day/time must be given on an individual basis to maintain equal access for all. The data suggests that, at present, any move to digital appointments would need to be sympathetic of those who are digitally excluded, such as those who do not have an internet connection or a device for accessing the internet. Investigate the possibility of introducing a time slot system such as AM or PM where capacity allows, this would be especially useful for patients with memory loss or mental confusion. Improving continuity of care by providing a consistent nurse, or group of nurses, for long term service users and those with cognitive impairment, should be given significant consideration. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

In our recent survey, patients who are waiting for planned surgery in Somerset reported a lack of communication from hospitals and many felt their health and wellbeing had deteriorated while waiting for treatment. Earlier in the year, Somerset’s NHS leaders asked us to help them understand how people are being affected by waiting for surgery to inform their ongoing work to improve support for patients. We ran an online public survey from July to September 2021 and carried out phone interviews with patients from Musgrove Park and Yeovil District Hospitals who responded to an invitation to take part.  Seventy-two people provided feedback about their experience of waiting for treatment. At the end of March 2021, a total of 6,382 people in Somerset were waiting for planned surgery, which is a 62.1% increase compared to March 2020, just before the start of the Covid-19 pandemic.  Despite the backlogs and other challenges faced by the NHS, there were 2,568 completed surgeries in Somerset during March 2021.  Nationally there are 5.7 million people waiting for hospital care. Key survey findings 48 of the 72 patients who responded (65%) said they had been waiting over 40 weeks for surgery and many did not know how much longer they would have to wait.  (The NHS performance standard is a maximum 18 weeks waiting time from referral to treatment.) A common theme among those who completed the survey was a lack or absence of communication by specialists with patients who were waiting. Many survey respondents reported that while waiting they felt they had experienced a deterioration in their condition, reduced mobility, and mood changes, which impacted on their daily lives. 35 of the 46 people who commented said they had to rely on family and/or friends to help them manage their daily tasks. We shared detailed findings with Somerset NHS Clinical Commissioning Group, Somerset NHS Foundation Trust and Yeovil District Hospital, and made several recommendations on how to improve support for patients while they wait for treatment. Healthwatch Somerset recommendations for change and improvement Improve communication: Specialists and their teams should communicate frequently with all patients waiting for treatment and provide them with information about plans for their care. Patients should be given an up to date ‘package’ of information, including FAQs, advice and contact details for a wide range of useful health and community care services and support groups. Provide more support to meet individual patients’ needs: Patients should be treated as individuals with specific needs. Specialist treatment teams should work with GPs to check on patients’ health and wellbeing regularly and systematically, to quickly identify potential issues and provide timely intervention, treatment, and support. Patients who are unpaid carers should be identified and additional supported should be provided to help them manage their own health and wellbeing, which also affects those they care for. In our new report,   The impact of waiting for NHS surgery in Somerset , we suggest practical solutions to help services achieve these improvements and presents patients’ experiences and feedback.  The report also includes a response to our recommendations from Somerset Clinical Commissioning Group and a joint response from Somerset NHS Foundation Trust and Yeovil District Hospital. Gillian Keniston-Goble, Healthwatch Somerset Manager said : “Measures are being put in place by the NHS to tackle the backlog, but long waiting lists look set to continue for some time due to increased unprecedented demand on services.  There is particular concern for people who experience long waits as this increases the potential for patients to develop additional issues with their physical health and emotional wellbeing.  Although long waits are not the norm, we heard from many people waiting longer than the NHS maximum wait of 18 weeks from referral to treatment.  While waiting lists are inevitable, it is clear from our research in Somerset, and from national  Healthwatch England research , that what matters is how waiting lists are managed – patients need more information and better support while they wait, to prevent deterioration in their health and wellbeing.” NHS Somerset Clinical Commissioning Group (CCG)  thanked Healthwatch Somerset for providing “valuable insight into the impact that long waiting times can have on our patients within the system.”  They continued: “The CCG and health and care partners recognise that waiting for planned care can be an anxious time for patients.  Alongside our recovery plan programme, we have been working together to develop our preventative programmes to help support people as they wait for treatment… the survey has already had a significant impact on the improvement work that is being carried out by our Acute Trusts and the CCG will continue to work with all providers in supporting further improvements for the benefit of our patients.” Somerset NHS Foundation Trust and Yeovil District Hospital Foundation Trust , welcomed the Healthwatch Somerset research, commenting: “While the increases in the length of time patients are waiting for their planned surgery have been unavoidable, it is important that we remember the very real impact these waits have on each patient individually and we welcome the Healthwatch report in providing this snapshot of people’s experiences and the recommendations on how to improve our communications with these patients. “Reducing these waits is a key priority and we would like to thank all our staff who are working exceptionally hard to implement practical steps to make a difference in these extraordinary times.  We acknowledge the importance of communicating well with our patients and, since the report was concluded, we have taken a number of steps for those waiting the longest, with plans to develop this further, while balancing the demands on our services.  We are committed to working in partnership with patients and their families.” Sybil, age 86, from West Somerset: 17-month wait for hip surgery Sybil, a former nurse, is 86 and lives alone in West Somerset.  She has always been active and drives to see her friends and to the shops.  Driving allows her to maintain independence and to provide help to others – in fact, she is the go-to person for her friends who ask for lifts for things like shopping and appointments. She had a lower leg amputated in 2008 and was waiting for a hip replacement surgery on her ‘good’ leg.  After her first X-ray, Sybil was referred in October 2019, to Musgrove Park Hospital in Taunton.  She saw the surgeon in February 2020 but then, the COVID-19 pandemic began and so did the delays in treatment. Sybil wasn’t told when the surgery would take place or provided with support.  She phoned the hospital admissions line and the surgeons office every two weeks to check on progress and to remind them she was in pain.  She eventually had surgery in March 2021, 17 months after being referred for treatment. Sybil said: “The waiting time was dreadful.  I was in constant pain and at times thought I couldn’t go on any longer.  I felt suicidal in December 2020.  Due to my amputated leg, I use mobility aids to get around, but I developed a shoulder injury that was so painful I couldn’t move.  I had lost a lot of my independence and had to turn to painkillers to ease my pain while waiting for surgery.” Sybil’s outcome is good.  She said: “When the day finally came, I felt extremely well looked after by the NHS.  The surgery went very well too.  I have now regained my independence and joy of life.  You wouldn’t even know there had been anything wrong with that hip.”

A new public survey has been launched to find out more about local people’s experiences of using the NHS 111 service in the region. 111 is the NHS non-emergency number. When you call 111 you speak to a highly trained telephone adviser, supported by healthcare professionals (nurses or paramedics). They ask you a series of questions to assess your symptoms which allows them to direct you to the best medical care for your needs. NHS 111 is available 24 hours a day, 365 days a year, with calls free from landlines and mobile phones. NHS 111 is also available as an online service:  111.nhs.uk . Devon Doctors is the lead provider for urgent care in the region, offering 24/7 access to urgent care services including NHS 111 and Out-of-hours services in the South West. We are the local consumer champion for health and social care services, and will once again be independently collating public feedback from anyone who has recently used the NHS 111 service in the Somerset, Devon, Plymouth and Torbay areas. In Winter 2020/21 local Healthwatch in Somerset, Devon, Plymouth and Torbay conducted a similar public survey and published a  report  which showed that the accuracy and quality of the service people received was not consistent, despite many people rating their experience highly. At the time, Devon Doctors supported recommendations made in the report, and said it would help shape an improvement plan to address public concerns. Local Healthwatch have joined forces again to launch a follow up survey to see if improvements have been made, and to ensure that the people using the NHS 111 service have their say on the way it is delivered to them. All responses will be anonymous, and the information provided will be used to inform a new joint Healthwatch report which will be shared with NHS 111 and the health and social care regulator, the Care Quality Commission (CQC). The Healthwatch online survey runs from 13 September to 24 October 2021. It only takes a few minutes to complete. [Survey closed] Members of the public can also speak to their local Healthwatch directly to share their experience of NHS 111 or receive support completing the survey. For Healthwatch Somerset call Freephone 0800 999 1286, or for Healthwatch Devon, Plymouth and Torbay call Freephone 0800 520 0640. Judith Goodchild, Chair of the Healthwatch Somerset Board, said: “Understanding people’s experiences of using vital health and care services such as NHS 111, allows us to highlight where there are areas for improvement as well as areas of strength. By sharing this insight with those responsible for commissioning and delivering services, we can drive positive change and improve standards of care. Your feedback really will make a difference to the quality of the local NHS 111 service and to people’s lives, so do please share your views with us by completing our survey or contacting your local Healthwatch.” A spokesperson for the Care Quality Commission (CQC) commented: “Local Healthwatch in Somerset, Devon, Plymouth, and Torbay are working in partnership with CQC to invite members of the public to tell us what they think of the services provided by Devon Doctors. Their views and experiences will help CQC inspectors decide what to look at when they inspect the services provided by in the future. People are being encouraged to tell the team about their experiences of services provided by Devon Doctors in the past year and to say where they would like to see improvements made in the future.”

People who use NHS 111 in Devon and Somerset have reported ongoing concerns about the quality of the service, with the most common complaints being about long waiting times and difficulty getting through on the phone. This is a follow up to the original report published January 2021. Recommendations Recommendations that require NHS England action Reducing waiting times for arranged call-backs and inbound calls. Improvements to the call-handling procedures and staff training surrounding these processes. Review the pre-recorded messages and frontline options for patients before they are connected to a call operator. Recommendations that may be actionable locally Ensure that training is consistent for all staff so that delivery of the assessment and conclusions are of the same standard for all patients. Improve procedures surrounding calls relating to patients with mental health problems to ensure they are handled with empathy and diverted to the correct support. Consider the viability/benefits of a call-logging system that provides a point of reference, so that if patients need to call back, a record of their previous call is easy for the call operator to access and review. Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.

Healthwatch Somerset Annual Report 2021-22: A review of our work over the past year and its impact, plus our work planned for 2022-23. Message from our Chair About us Highlights from our year Listening to your experiences Advice and information Volunteers Finances and future priorities Statutory statements Read our report If you need this report in a different format, please email  info@healthwatchsomerset.co.uk  or call 0800 999 1286.