2020 GP Report: patients’ experiences of primary care in Brighton and Hove
Today we announce the publication of our review of all GP practices and surgeries across the City. Originally ready for publication just at the time when COVID-19 took hold in the UK, we took advice from Healthwatch England, the City Council and the NHS and temporarily withheld publication of this report to facilitate the virus response.
Now as we enter the restore and recovery phase of the response to COVID-19, we are pleased to share our report and its relevance to this current environment. This report has also been provided to the Health and Wellbeing Board.
Key Recommendations pertinent to the current environment of restore and recovery are:
• Digital / Remote Consultations: Greater use of digital methods to improve making appointments and broadening the range of ways in which consultations are provided.
• Preventative Services: Raising awareness of preventative services, targeting patients who are most likely to need these services.
• Preventative Services: Better patient access to GPs specialising in their condition, particularly where it is long-term, for example mental health issues.
• Primary care system sustainability: Our GP Report presents the context for all of the above, of persistently high numbers of patients per GP coupled with the number of GP practices having decreased since our report in 2018.
Healthwatch Brighton and Hove activity report covering May to June 2020 (published July 2020)
This performance report describes Healthwatch Brighton and Hove activities from May to June 2020. This includes a summary of how we have continued to support patients and local health and social care services during the COVID-19 crisis, and an update on our regular and planned work.
The impact of COVID-19 on Brighton and Hove: a statistical evaluation (published July 2020)
Since the coronavirus was recognised as a global pandemic, and particularly since lockdown was announced in England on 23 March, we have been presented with an ever-increasing amount of data describing the impacts of the virus (COVID-19). But what does this data say about the impacts for our city and its residents? What are transmission rates like in in our city, and how many people have sadly died, directly or indirectly, from the virus? Have certain areas of the city been more affected than others? Which groups have been adversely affected, if any? And what has been the impact on our local hospitals and social care services?
In an attempt to answer these questions, Healthwatch Brighton and Hove has examined a range of published data examining the wider health and societal impacts of the coronavirus (COVID-19).
Patient Led Audits of the Care Environment. A Healthwatch report of the scores achieved
by local Trusts in 2019 (published July 2020)
Welcome to our second report which examines the outcomes from the annual Patient-Led Assessments of the Care Environment programme, or PLACE (see below for more information). Since 2014, Healthwatch Brighton and Hove has supported two of our local Trusts to complete their annual PLACE assessments:
- the Brighton Sussex Universities Hospital Trust (BSUH) and
- the Sussex Partnership Foundation Trust (SPFT).
Following the publication of the 2019 PLACE scores Healthwatch undertook some analysis of the data to gain a better picture of what these revealed about our local hospitals (NB Healthwatch does not produce the raw PLACE data). We describe the outcomes in detail, and Healthwatch hopes that this analysis and commentary will be useful to both BSUH and SPFT and support them in their ongoing programme of work to improve our local hospitals, and wider facilities.
Environmental audits of the Brighton
and Sussex University Hospitals Trust: April 2019- March 2020 (published July 2020)
Since December 2016, Healthwatch Brighton and Hove (Healthwatch) has worked in partnership with Brighton and Sussex University Hospital Trust (BSUH) to conduct monthly visits across the estate. These monthly visits are called Environmental Care Audits (“audits”). This is the third Healthwatch annual report which summarises the findings from these audits, and specifically those undertaken from April 2019 to January 2020. Earlier annual reports from 2017/18 and 2018/19 are available on the Healthwatch website.
Between April 2019 to March 2020:
- Healthwatch volunteers undertook seven audits (Annex A provides more detail).
- We provided BSUH with 129 recommendations to improve the environments of our hospitals.
- We awarded scores based on the NHS 15 steps challenge and all of these were higher than in previous years.
- In December 2020, we added food tastings to our monthly audits. This welcome addition to our work allowed volunteers to sample the variety of food which is available to inpatients.
Healthwatch Brighton and Hove
Annual Report 2020 (published June 2020)
Outpatients’ Booking Systems: an interim Healthwatch report
Working closely with the Clinical Commissioning Group (CCG) and local NHS Trust, Healthwatch Brighton and Hove launched an outpatients’ booking survey in January 2020. With the help of our volunteers we subsequently visited several outpatient departments based at the Royal Sussex County and Princess Royal hospitals to speak with patients. We wanted to understand what aspects of the current booking system were working, and where it fell- down. By March, we had gathered the views of 120 patients. Our plans to analyse the results, publish our report and discuss our findings with providers were halted by the COVID-19 pandemic.
COVID-19 will undoubtedly impact on future outpatient waiting times which are increasing one week every week. In the future, services are likely to face severe disruption and it may take years to restore services to a new normal. As systems look to restore after COVID-19, we will return to our project’s findings and work with our CCG and NHS Trust to determine what the data reveals in terms of where improvements can be made. Patient experiences can also help to deliver on the NHS Long Term Plan for transforming outpatients’ systems, whilst modernising it for the benefit of patients.
In the interim, we have produced this executive summary detailing our work and impact in 2019-2020.
Exploring the views and experiences of young people from BAME backgrounds around local sexual health services
Healthwatch Brighton and Hove worked alongside Young Healthwatch to gather the views and opinions of BAME (Black, Asian, and Minority Ethnic groups) young people, aged 17-25 and living in Brighton and Hove around local sexual health services and STIs (Sexually Transmitted Infections). Young asylum seekers and refugees as well as young people living in the city temporarily to study English were also engaged around this topic.
We found that barriers to accessing sexual health services included:
• Language barriers
• Inadequate services’ promotion and advertising
• Lack of family support
• Issues with privacy and confidentiality
• Peer influence
• Cultural and religious barriers
• But that participants showed a good knowledge of Sexually Transmitted Infections (STIs)
Our main recommendations were:
1. Improve sexual health services’ promotion, information and engagement using social media and ensure that promotional materials represent young people from BAME backgrounds. In addition, prompts and reminders around regular sexual health checks are needed.
2. Deliver targeted training for parents and carers to equip them with the knowledge and skills to best support their young peoples’ sexual health choices.
3. Promotional material should provide information about services’ confidentiality and privacy to reduce fear and stigma of access.
4. Continue to ensure a diverse workforce in sexual health clinics.
5. Increase the provision of bilingual staff and foreign language interpreting services
Sussex Cancer patients have their questions answered
Healthwatch in Sussex responded to patient concerns about cancer services in Sussex. A webinar was coordinated between three local Healthwatch with the help of Sussex Health and Care Partnership. One hundred people across Sussex registered for the event.
Healthwatch in Sussex arranged for cancer patients and their families to hear from three cancer experts.
THIS IS WHAT WE HEARD:
- Cancer screenings are currently limited.
- Endoscopy and colonoscopy tests are available but delayed.
- Patients are urged NOT to hold back from contacting their GP with cancer-related concerns.
- Patients have not been lost in the system but focus on corona virus patients has caused delays.
- Patients SHOULD ATTEND hospital appointments.
- Movement towards managed self-care for cancer patients with contact by telephone with cancer specialists .
- Cancer shielding has lifted slightly with 90% of oncology appointments continuing remotely.
- COVID-19 not as risky to cancer patients undergoing treatment, latest studies show.
- Clinicians fear an influx of referrals once restrictions are lifted.
- New lockdown methods are here to stay (remote contact with patients and PPE used by staff).
- Cancer Support services are still available via Macmillan.
Patient feedback systems for health and social care services: a Healthwatch briefing paper, June 2020
Over the summer of 2019, Healthwatch Brighton and Hove conducted research to gain a better insight into the information that is available to people who are looking to make a complaint, raise a concern or provide feedback about health and social care services. We wanted to understand how easy or difficult it might be for people to find useful information. We had hoped to raise our findings with city leaders last year, but our plans were disrupted by COVID-19. We are still keen to explore this topic further and will determine what we can do after lockdown has ended. In the meantime, we have decided to publish the findings of our review, which includes four annexes.
The role and impact of Healthwatch Brighton and Hove during the coronavirus pandemic: activity report covering January to April 2020
This performance report describes the role Healthwatch Brighton and Hove played in supporting patients and local health and social care services during the COVID-19 crisis. We have focused in this report on our activity from early January to 30 April (2020). We have also included an update on our regular activities and projects.
Stakeholder report, 2020
Healthwatch Brighton and Hove conducts an annual survey of stakeholders in order to understand their awareness of Healthwatch and assess their views on our activities over the previous year.
The survey was conducted from 18th February 2020 to 25th March 2020. We received responses from 47 stakeholders. This is an increase of 88% on last year’s survey, which attracted 25 stakeholders.
Stakeholders told us that:
- 95% (43 stakeholders) say Healthwatch makes a positive impact on health care services.
- 91% (31 stakeholders) say Healthwatch makes a positive impact on social care services.
- 86% (40 stakeholders) say Healthwatch provides insight which positively impacts their organisation.
- 83% (39 stakeholders) say Healthwatch has strong credibility and produces quality work.
- 81% (38 stakeholders) say Healthwatch provides unique patient views that their organisation would otherwise not have access to.
- 77% (36 stakeholders) say Healthwatch has the ability to influence
Healthwatch Brighton and Hove Equality Impact Assessment, 2020
Healthwatch’s core work is to gather patient opinion on health and social care services from across the community and to use this information to recommend improvements. The Equality Impact Assessment (EIA) presents the degree to which the reports published by Healthwatch Brighton and Hove reached out to the ‘protected characteristics groups’ specified in the Equality Act 2010. This EIA uses data from all project reviews published by Healthwatch Brighton and Hove between April 1st 2019 and March 31st 2020. The report includes equalities data on each individual project plus equalities data for all projects combined as a final section.
The individual reports and overall findings show Healthwatch Brighton and Hove is effective in hearing the views from a wide range of people and patients. We are effective at gathering views from people with disabilities; people with varying sexual orientation; people with different religious beliefs; people from Black, Asian and Minority Ethnic (BAME) groups and young people.
Areas that require more engagement are the following:
• Men – all projects show more women being engaged than men
• Younger age groups
• More detailed recording of disability.
COVID-19: Positive comments and feedback received by Healthwatch
The COVID-19 health crisis is understandably drawing public scrutiny and press attention. Local services and providers are facing unprecedented challenges and are adapting quickly to emerging issues. Healthwatch is working closely with partners across the city to ensure that your experiences and concerns are fed into emergency planning arrangements.
At this time, we wanted to share some of the positive comments and feedback that Healthwatch has received. These shine a spotlight on local services, revealing how well some of them have adapted. They also highlight the positive impact that Healthwatch has had.
Healthwatch Brighton and Hove: a forward look at current and planned projects 2020/21
We are pleased to publish a new report which provides information on the projects we are undertaking at present, and those we hope to deliver over the next year and beyond. We will review these and provide further updates as these become available. Should you have any queries then do not please hesitate to get in touch.
*** Reports from 2019 ***
Two Healthwatch reports
Patients’ experiences of Brighton & Hove Hospitals
Today we release two reports on the patient experience and physical environment at Brighton hospitals.
- An annual review of our environmental audits at Sussex University Hospitals NHS Trust (BSUH): Healthwatch BH – Annual Environmental Audit Report 2019
- A historic review of PLACE results 2013-2018 for the Sussex University Hospitals NHS Trust (BSUH) and Sussex Partnership Foundation Trust (SPFT): Healthwatch BH – PLACE 5 Year Results Report 2018
Healthwatch briefing on sexual health – July 2019
Improving local sexual health services and ensuring adequate provision is a priority for Healthwatch in 2019/20. Brighton and Hove has some of the highest rates of sexually transmitted infections in the country and local services face high demand. In response, we undertook research to understand the challenges facing services and providers. This included an examination of national and local funding levels and commissioning of relevant services.
We shared our findings with Health and Wellbeing Board in July.
The evidence used to produce this report shows that:
- Brighton has committed at the international level to ending HIV transmission
- Brighton has very high STI levels, and certain groups are disproportionately affected
- There is high demand for services
- Services are introducing novel ways to cope with demand by improving services
- The current contract for the provision of statutory sexual health services is due for renewal after 31st March 2020.
- Levels of STI diagnoses (not including HIV) are increasing
- Sexual health services are under increasing pressure due to high demand
- Funding levels may not be sufficient to meet current and future demands
- Fragmentation of commissioning may be affecting service provision
Annual Report for 2018-2019
“Smiling Matters – Oral care in care homes” – June 2019
Speaking to residents and staff in care homes across Brighton and Hove, we found:
- 55% of homes have no visiting dentist but 91% of residents are not well enough to visit a dentist surgery.
- 48% of care home staff do not carry out routine oral health checks on admission.
- 37% of care home staff have had no training in oral health.
- 41% of care home staff did not know if their care home had a policy covering oral and dental health.
- Specialist training improves oral health, but the training is not compulsory.
Quarterly Intelligence review – April 2019
Our latest Intelligence review that reviews data and trends and selects the most pressing health issues in Brighton and Hove. These priorities will help inform Healthwatch’s activities in the forthcoming months.
“Online Pharmacy report” – March 2019
In response to concerns about marketing from online pharmacy services, we conducted a survey of people who had received marketing from one of these companies.
We surveyed 91 people in Brighton and Hove and found widespread confusion about marketing received and the credentials of these companies.
“Let’s Get You Home”: Hospital Discharge for older people – February 2019
The experiences of older people being discharged from the Royal Sussex County Hospital, Brighton, from July to September 2018.
Speaking to patients in hospital and at home, we found:
- People wanted to be involved in the arrangements made for leaving hospital and they wanted their family and friends to be involved too.
- People wanted to receive clear written information about what might happen to them on leaving hospital.
- People asked to be fully prepared before returning home and to receive the support they needed at home to live as independently as possible.