Hampshire County Council Health Overview and Scrutiny Committee Item 5 27 May 2008 Inquiries Received and Action Taken Report of the Chief Executive

Contact: Denise Holden ext. 7338

e-mail: [email protected]

1. Summary and Purpose

1.1. This report provides Members with information about the issues brought to the attention of the Committee and the response to these referrals. It sets out the inquiries received, the source of this inquiry and any action taken. Where appropriate comments have been included and copies of briefings or other information attached.

1.2. The approach adopted provides the route through which Local Involvement Networks (LINks) and other partner organisations (Hampshire district councils, NHS organisations, voluntary and independent sector providers and organisations that are representative of social care service users and carers) can raise issues with the Committee.

1.3. Where inquiries raised with the Committee are already subject to monitoring or other performance management activities the action taken will be focused on the local resolution of inquiries through appropriate sign-posting to the agency best placed to respond.

1.4. Where an issue cannot be satisfactorily resolved between the parties concerned then the Committee can consider options for further action.

1.5. New issues raised with the Committee, and those that are subject to on-going reporting are set out in Table One of this report.

1.6. The recommendations included in this report support the Corporate Strategy aim of maximising wellbeing through the overview and scrutiny of health services in the Hampshire County Council area.

Table One: Inquiries Received and Action Taken

Topic/inquiry	Source	Action Taken	Comment
Fordingbridge Hospital	Committee members	Hampshire PCT will provide an update on the action resulting from the investigation initiated by the PCT and confirm when Ford Ward will reopen. The most recent update is attached at Appendix One.
Recommendation: Members confirm if they are satisfied with the action taken by the PCT.
Progress with the Joint Strategic Needs Assessment	HOSC Members	The Director of Public Health will provide Members with an overview of progress with the development of the JSNA and the key areas for action emerging from this work.
Recommendation: Any additional information requested by Members is provided by the Director of Public Health.
Oak Park Hospital	Chairman/committee members	Members will consider this issue in more detail at their meeting on 22 July.	Linked with the planned `refresh' of the south east capacity plan.
Recommendation: Members refer any specific questions to be addressed on 22 July to the scrutiny office by 31 May 2008.
Access to health services for people who are homeless	Committee members	The options appraisal report considered by the PCT is attached at Appendix Two.
Recommendation: Any further action to be taken is agreed with the PCT
GP engagement with locality commissioning.	Committee member	Following the request at the last meeting the PCT will provide a short presentation outlining the way in which GPs are engaged in the development of locality commissioning.
Recommendation: Members agree any additional information required from the PCT
Mental health services at Andover War Memorial Hospital	HCC members	Members in the Andover area have received numerous enquiries about the future of the Allen Gardiner Unit, based at the AWMH. WEHT have confirmed that they are only the landlord, with services provided via Hampshire Partnership. The PCT and Hampshire Partnership have been asked to clarify the position with regard to the future provision of these services.
Recommendation: Any additional information requested by Members is provided by the PCT or Hampshire Partnership as appropriate.
Winchester and Eastleigh Healthcare NHS Trust	HOSC Members	WEHT has provided a hard copy of the annual plan for 2008/09. Copies are available from the scrutiny office.
Recommendation: WEHT confirms if there are any service changes associated with the implementation of the Plan.
Surrey & Borders NHS Trust	Director for Adult Services	The HOSC is seeking further information on the impact of proposals to reconfigure inpatient adult mental health services by the Trust. Local stakeholders have raised concerns about the way in which the needs of Hampshire residents are being taken into account. Additional information requested from the Trust includes: _ The engagement activities that have taken place to date _ The criteria that will guide the selection of options _ The impact and needs assessment undertaken _ Details of the different services affected.	Surrey HOSC was not aware of these changes. Rushmoor, Hart and East Hants District Council have been asked for their feedback on these proposals
Recommendation: Any additional information required by Members is provided by the Trust together with details of the options for reconfiguring adult mental health services
Changes to GP premises location	Hampshire PCT P&PIF (Andover and Winchester)	The PCT plan for engaging with the practice population is attached at Appendix Three.
Recommendation: Any further action required of the PCT is agreed.
Referrals to the pain clinic- south east Hampshire County Council	Gosport Borough Council	The response from the PCT to Gosport Borough Council was circulated to members- subsequent to members feedback the Chairman raised the following points of clarification with the PCT: _ The number of patients affected and the relationship between in-patient and out-patient activity _ The needs assessment supporting these changes, taking account of travel difficulties _ Details of the current review and supporting engagement activities _ If pain clinics will be provided on an out patient basis in the future _ the current pattern of pain clinic provision across south east Hampshire. The response from the PCT is attached at Appendix Four
Recommendation: Any additional information required by Members is provided at the next meeting.
Local Involvement Networks	Chairman	Members will be provided with a short up-date on progress with the establishment of the transition arrangements for LINks
Recommendation: Any additional information required by members is provide by the HCC LINks lead.
Final Reports from P&PIFs	Hampshire P&PIFs	The final reports received by the HOSC from the P&PIFs in Hampshire are attached at Appendix Five These relate to _ Hampshire PCT P&PIF _ Hampshire PCT P&PIF feedback to Annual Healthcheck _ Basingstoke and North Hampshire P&PIF _ Hampshire Partnership P&PIF _ WEHT P&PIF No other reports have been received.	The P&PIFs were formally disbanded on 31 March 2007- the transition host is ensuring that the issues raised are flagged to the LINK as it is established.
Recommendation: Members note the issues highlighted by the Forums.

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents that disclose exempt or confidential information as defined in the Act.

Appendix One: Fordingbridge Hospital Update

from Katrina Percy, Director of Care Services

Work towards the reopening of Ford ward is reaching its final stage. The investigatory phase of the review into the quality of care provided to inpatients at Fordingbridge Hospital has now concluded. Mindful of our commitment to safely reopen the inpatient beds as swiftly as possible, we asked the independent investigatory team to provide us with their key recommendations ahead of the full report. This has enabled us to take action over the last few months to address the key issues identified by the review, so that when Ford Ward is reopened we can be assured that we are providing the highest quality care and experience for both patients and visitors.

Although the drafting of the report will take a little more time, the PCT will consider the key recommendations and the actions we have already taken to address them later this month. When the Board is assured that all actions have been implemented and it is therefore safe and practicable to re-open the inpatient beds at Fordingbridge we will do so.

Since the Ward was temporarily closed in October, we have worked very hard to make sure the environment is of a high quality, providing safe comfortable surroundings for patients, visitors and staff.

This has included a ward refurbishment which includes amongst other more routine improvements, upgrading the call bell systems so patients and staff can seek assistance swiftly from any part of the ward, improved information with clear signage, and painting the doors a special shade of blue, which is recognisable to visually impaired people as the exit.

Once our Board has given careful consideration to our progress against the action plan I hope to be able to announce a date for the reopening of the ward, but it's essential that we have the right amount of staff, qualified to the appropriate level, and the best possible environment for patients before we do so.

Appendix Two: HAMPSHIRE PRIMARY CARE TRUST.

BRIEFING NOTE OF THE PROVISION OF HEALTHCARE SERVICES FOR THE HOMELESS POPULATION IN WINCHESTER.

1. INTRODUCTION

1.1. This paper provides sets out options for future provision of healthcare services for the homeless population in Winchester. The paper summarises the background, key issues and next steps.

2. BACKGROUND

2.1. The Homeless Healthcare team was established under 3^rd wave PCT PMS in 2001 to provide healthcare to an unregistered homeless population in Winchester. Although it provides general healthcare, the key health needs relate to mental health, drug and alcohol abuse, sexual health, contraception and hepB/C immunisations. There is a needle exchange provided by Nexus.

2.2. The service currently operates from the Trinity centre in Winchester, and includes walk-in service and one weekly clinic. There is no night or out-of-hours service specific to this population. The Trinity facility is acknowledged as no longer being fit for purpose. This has resulted in Trinity Winchester currently building a new centre in Winchester.

2.3. The clinical team supporting the provision of health care to the homeless population in Winchester has been subject to significant changes over the course of the last seven years. At various times it has consisted of a GP, a practice nurse, a Community Psychiatric Nurse [CPN], a mental health worker and sexual health nurse. Currently, only the GP is located on site and works two mornings a week. There is currently no CPN, sexual health nurse or practice nurse provision. Recruitment to vacancies within the team has been put on hold until the future of the service has been decided.

2.4. The service currently provides approximately 967 contacts per month. There are computer records for 750 male and 217 female attendees. Of these, approximately 31% are drug dependant and 32% alcohol related problems and 30% mental health problems. 7% have a combination of all of these. There are currently no under 15's under active treatment. 102 minor injuries were treated in 06/07.

2.5. Those becoming pregnant or ill with long term conditions are recommended to register with a GP practice as there is currently a challenge being experienced by the GP working at the Centre in referring clients through to secondary care at Winchester and Eastleigh Healthcare NHS. This is current being investigated.

3. OPTIONS FOR FUTURE PROVISION

3.1. The PCT is currently considering an options appraisal for the future provision of healthcare services for the homeless population in Winchester. A decision on the way forward will be taken on 28 May 2008. The options for the future provision of this service are summarised in the table below:

	OPTION	PATIENT FOCUS	PREMISES	FINANCE	RISKS	BENEFITS
A	No Change	The current service does not provide sufficient access for patients.	The current premises are about to close so this is not viable.	No change	The current facilities are no longer fit for purpose	None
b	Homeless Healthcare team is disbanded	No specific service with specialist skills relative to these patients. Chaotic lifestyles of this group of people mean they are unlikely to register with a GP therefore attendances at A&E likely to increase. Links with needle exchange, mental health and other community workers will be lost.	n/a	Cost of increased attendance at A&E would be covered by current budget in the short term. Long term there will be increased costs of later stage interventions.	Reduced community support for people with drug, alcohol, mental health problems. short tem treatments by A&E not necessarily beneficial for longer term health maintenance / improvement. Reduced preventative interventions	None
c	Service continues to be managed by the PCT, employing salaried GP's and support staff to maintain service as part of PCT Care services and provided in the new Trinity building.	This would be least disruptive to patients	The appropriateness of the facilities in the new Trinity site would need to determined.	The costs of the facilities in the new building have not been discussed with Trinity.	Recruitment to current vacancies in team would reduce current lone worker risks	Improved healthcare provision for a disadvantaged community provided out of premises fit for purpose.
d	The PCT will retender for the provision of the service. This could be either an Alternative Provider of Medical Services or a local PMS/GMS provider	Engagement with service users would be required in the development of a tender specification.	This could be new Trinity building, local GP practice or other premises that meet HCC standards.	Minimal risk, managed by provider	No tenders may be submitted - need contingency plan TUPE considerations	Service stability for term of contract. Financial stability for term of contract Only providers that meet standards/ requirements able to tender for contract so improved care for patients

4. NEXT STEPS

4.1. The PCT will consider each of these options at its meeting on 28 May 2008. Clearly options A & B appear to be unsustainable, which leaves the PCT with the decision whether to tender for the provision of the service or manage the service in-house. Subsequent to this decision will be the consideration as to whether the service will use the new Trinity site as the base for care provision or whether an alternative location is used. Clearly, service user engagement will be integral to either to the development of a tender specification or the design of any in-house service.

Appendix Three

Friarsgate Surgery

Engagement Plan - Latest update 14 May 08

Friarsgate Surgery

Engagement Plan - Latest update 14 May 08

Contacts

Deborah Upham Head of stakeholder relations Hampshire PCT

Kate Luker Practice manager Friarsgate Surgery

Manda Copage Head of primary care performance and improvement Hampshire PCT

Amanda Glenn Hampshire PCT

Jane Brooks Community Engagement Co-ordinator working with HPCT

Brief description of activity	Date	Who is involved?	What are the expected outcomes?	How will these outcomes be fed into the engagement exercise?	Update	Contact name
Information on notice boards in the surgery, frequently updated	Summer 05 - ongoing	Surgery patients	Involving patients in options and appraisal, raising awareness and gathering views, ensuring needs are considered	Views will be taken into account and potential issues investigated and considered	Ongoing	KL
Information in newsletters	Summer 05 - stopped - plan to re-start late spring 08	Surgery patients	Involving patients in options and appraisal, raising awareness and gathering views, ensuring needs are considered	Views will be taken into account and potential issues investigated and considered	Re-start late spring 08	KL
Stakeholder event (evidence not available)	Summer 05	Patients, public, stakeholders - approx 40 people attended	Raising awareness and gathering views	Views will be recorded and taken into consideration (evidence not available)	Done
Survey of 50 patients at the surgery	October 07	Patients	Raising awareness and gathering views	Views will be recorded and taken into consideration. Results shared with PPI Forum	Done	AG/DU
Discussion at PPI Forum Network Meetings (Winchester & Andover)	January - March 08	PPI Forum members	Raising awareness and gathering views	Views will be recorded, taken into consideration and fed into engagement plan and report	Done	DU
Press release to Hampshire Chronicle	January 08	Local print and broadcast media, members of the public as readers	Response to readers' letters, general awareness spreading	Encourage patients and public to share views on move	Done	KL
Set-up dedicated email address: [email protected]	January 08	All stakeholders	Additional way for stakeholders to feed into engagement process	Views will be recorded and taken into consideration	Done	KL
Active group with volunteers to help with relocation plan	January 08 onwards (first meeting April 08; then monthly)	All volunteers	Group of active volunteers for close involvement with relocation plan	Active involvement in relocation plan	Ongoing	KL
Meeting between HPCT Director of Corporate Affairs and Chair of Winchester and Andover PPIF Network	March 08	Richard Samuel and Martin Wade	Future engagement activity to be agreed	Views will be recorded and fed into engagement plan and report	Done	DU
Update to Hampshire Overview and Scrutiny Committee	25 March 08 then 27 May 08	Local Authority Members	Formal update of engagement activities further to issues raised by PPI Forum	Views will be recorded and fed into engagement plan and report	Done On going	DU DU/JB
Update in Hampshire PCT's stakeholder newsletter	Bi-monthly from April 08	Range of internal and external stakeholders	Raising awareness and gathering views	Views will be recorded and taken into consideration	Ongoing	DU/JB
Letters about relocation sent to 10% of patients	April 08	10% of patients	Raising awareness and gathering views	Views will be recorded and taken into consideration	Done	KL
Dedicated website for relocation involvement and updates	Late spring 08; once lease signed	All stakeholders	Raising awareness and gathering views	Views will be recorded and taken into consideration		KL
Dedicated relocation notice board and suggestion box in the surgery	Late spring 08; once lease signed	All patients and staff	Raising awareness and gathering views	Views will be recorded and taken into consideration		KL
Liaise with PPSA help to send letters to all patients	May 08; once lease signed	PCT comms team	Surgery receives help to send letters to all patients	Action will be recorded and fed into engagement plan and report		RS/DU /JB
PCT help to deal with responses from letters to patients	May 08	PCT comms team	Surgery receives help managing responses to letters to patients	Views will be recorded and taken into consideration		RS/DU /JB
Letter to all patients (head of household) with an update on relocation plans and ways to get involved	Late spring 08; once lease signed	All patients	Raising awareness and gathering views	Views will be recorded and taken into consideration		DU/JB
Staff briefing	Staff aware through whole practice meetings		Raising awareness of relocation and other future plans and gathering views	Buy-in from staff, views expressed and taken into consideration	ongoing	KL
Update event to be arranged	September 08	All patients and stakeholders	Raising awareness of relocation and other future plans and gathering views	Views will be recorded and taken into consideration		KL
Press release following stakeholder event	September 08	Local print and broadcast media, members of the public as readers	Raising awareness and gathering views	Views will be recorded and fed into Project Team		KL

Appendix Four: Gosport Pain Clinic- Response from Hampshire PCT to the HOSC queries

· The Pain Department which was based at Queen Alexandra Hospital, moved temporarily (in 2000)  to Haslar whilst a refurbishment programme was going on and moved to the Chronic Pain Unit at St Mary's in 2002. At this time some clinics were still run in RHH but these moved in November 2005. There have been no pain clinics run in RHH since 2005.

· The decision to move the clinics to St Mary's was taken by The Chronic Pain Taskforce which was set up in 2004  and had members of Portsmouth City PCT, East Hamposhire PCT and Fareham and Gosport PCTs. The move of the remaining clinics was discussed and agreed within this forum.

· Discussions are ongoing regarding provision of outpatients in the redeveloped Gosport WMH. A range of key outpatient services will be provided at GWMH and this will be more comprehensive than what is at RHH. The Futures Group which has representation form the local councils will be involved in this process.

· You also requested some data regarding current provision for Gosport patients, I will share this information as soon as I have received it from PHT.

· In summary The Chronic Pain Department moved the St Marys in 2002 and the remaining clinics moved in 2005 to provide centralised provision of services. Currently there is no change to provision for chronic pain patients. PHT have though committed to provide more outpatient services in localities and chronic pain will be considered in that process.

Appendix Five

HAMPSHIRE PRIMARY CARE PATIENT AND PUBLIC INVOLVEMENT FORUM

ANNUAL REPORT

This final annual report covers the period 1 April 2007 - 31 March 2008.

Forum Support Organisation: Help and Care

CPPIH Regional Centre: Guildford

Current Forum members:

	Frank Rust. Chairman Suzanne Adams Ian Barcroft John Boast Jane Brooks Jean Buckle David Burgess Joy Deadman Helen Durnford Colin Fisher Patricia Garrett Colin Godfrey Eileen Grinter Patricia Gulliford John Gunner Martin Cox .Vice Chairman Julie Hawksworth Audrey Howe George Howe Judith Howse Penny Maggs Martin Nonhebel Gordon Peake Guy Phelps Jean Pushman Christopher Riley Paule Ripley Mike Roberts Sheila Rowland Derek Rumsey Leslie Simmons Colin Slatter Tom Smith Brian Stillwell Sally Stoodley Joan Street Julie Sutherland Michael Tyrer Sonia Vincent Colin Wade Miranda Whitehead Ted Winfield Cecilia Young John Young

Our thanks to former Members who took part in the work of the Forum over the last year.

Due to the size of the PCT, the Forum continued to operate as local networks with responsibility for their own workplans.

FORUM MEETINGS. There have been 5 meetings of the full Forum; these were all held in public. ETVS and New Forest Networks have held 4 informal meetings and 9 in public; SE Hants Network has held 11 meetings in public; Basingstoke and Alton Network has held 11 meetings in public; Fareham and Gosport Network has held 11 informal and 5 in public; Winchester and Andover Network has held 9 in public; Rushmoor and Hart Network has held 10 meetings in public.

MONITORING

Item 1

· Activity Name

Community Hospital Services in the New Forest

· Description

Members of the New Forest Network made an unannounced visit to Fordingbridge Hospital on 7^th August 2007.

· Patient & Public Involvement

The visiting members spoke to staff and patients before, during and after the visit.

· Result

A report was submitted to the PCT.

The members' findings were also included in an external review of services at the hospital, the outcome of which is due in the Spring.

Item 2

· Activity Name

Community Hospitals

· Description

The proposed development of the Fareham Community Hospital has occupied the attention of the Network members.

· Result

The PCT plans are monitored to ensure that the plans are responsive to local needs

Item 3

· Activity Name

Community Hospitals

· Description

Work with stakeholders, patients and the public in developing services at Alton Community Hospital and the Chase Hospital, Bordon.

· Patient & Public Involvement

Ensuring local peoples views sought and taken into account when developing community services.

· Result

A range of services identified by local people will be developed to address the needs of the communities served by these two hospitals

Item 4

· Activity Name

Community Hospitals

· Description

Work with stakeholders, patients and the public in developing services at Fleet Community Hospital

· Patient & Public Involvement

Ensuring local services targeted to the local community;

· Result

Continued focus on the needs of the local population.

Item 5

· Activity Name

Community Hospitals

· Description

Issues around the provision of Pain Clinic Services in Community Hospitals - specifically Alton Community Hospital and the Chase Hospital Bordon.

· Patient & Public Involvement

Survey of patients and the public in respect of access to these clinics

· Result

Interim arrangements put in place locally pending recruitment of pain clinic consultants.

Item 6

· Activity Name

Dentistry Services

· Description

Members of the Forum have been active in monitoring access to NHS dental services across the County.

· Patient & Public Involvement

Surveys have been carried with both patients and dentists out across Hampshire. Information was sought from local CABs

· Result

A Forum member now sits on the PCT Dental Commissioning Group.

Results of the surveys have been shared with the PCT in order to inform their commissioning plans.

Item 7

· Activity Name

Maternity Services

· Description

Members have been involved in consultations on Maternity Services and are monitoring the provision of relocated services in West Hampshire.

A member sits one of the Maternity Services Liaison Committees, ensuring the patients' voice is heard.

· Patient & Public Involvement

Members have attended consultations to gauge public feeling.

Item 8

· Activity Name

Maternity Services

· Description

With regard to the delayed proposals for Maternity services in the South East - the relevant networks were impressed by the inventiveness of the consultation process.

Item 9

· Activity Name

Audiology Services

· Description

Resulting from work carried out by the Forum, audiology waiting times have reduced in parts of the New Forest; members continued to monitor this success.

· Result

Waiting times have remained at a more acceptable level.

Item 10

· Activity Name

Phlebotomy services

· Description

This area of service remains of concern in some areas and the relevant network has suggested a number of improvements.

Item 11

· Activity Name

Contraceptive and Sexual Health Services in North Hampshire

· Description

Work with the PCT to establish the need for expanded CASH services in the North Hampshire area;

· Patient & Public Involvement

Views of patients and the public sought by Network Members by means of surveys.

· Result

Expansion of clinic into two areas immediately with further expansion to follow.

Item 12

· Activity Name

Practice Based Commissioning

· Description

Members have been nominated as "liaison" members with the PBC clusters.

Engagement with the clusters is happening in varying degrees across the County.

· Patient & Public Involvement

The role of the Forum is to test the adequacy of the PBC clusters' efforts to engage and consult patients and the public and to advise and work with commissioners on the level of engagement required.

· Result

Improved understanding of PPI by Primary Care staff and enhanced relationships between staff and the Forum.

Item 13

· Activity Name

GP Practices

· Description

Monitoring the development of Aldershot Centre for Health Work with stakeholders, patients and the public in establishing this new facility

· Patient & Public Involvement

Ensuring local peoples views sought and taken into account when developing community services.

· Result

Continued focus on the needs of the local population.

Item 14

· Activity Name

GP Practices

· Description

Involvement in the proposed expansion/relocation of two GP surgeries in North Hampshire (based in Fleet and Basingstoke).

· Patient & Public Involvement

Discussions with patients as to best consultation methods; engagement with local populations to ascertain preferences for `new' surgeries; development of consultation and engagement strategies with relevant practices;

· Result

Ongoing

Item 15

· Activity Name

Friarsgate Surgery

· Description

The concerns expressed last year on this matter have not been allayed. The Network has tried with little success to raise with Hampshire PCT - the lack of patient involvement in the decision to move the surgery away from the centre of the city with the probable inconvenience to patients, especially older people, who use public transport.

Item 16

· Activity Name

Other Involvement Monitoring

· Description

W & A Network has monitored the patient involvement undertaken by other surgeries who are proposing changes to the way in which services are delivered.

· Patient & Public Involvement

Surgery visits

· Result

The Network noted that surgery involved promptly with the local population that was affected but there was a lack of clear standards of how to proceed when the responses were received.

Item 17

· Activity Name

Hospital Discharge

· Description

The Networks plan to monitor the adequacy of discharge arrangements for patients leaving the Portsmouth Hospitals was superseded when the hospital trust and the PCT undertook a similar study

Item 18

· Activity Name

Discharge notes and test results

· Description

A survey was carried out into the manner in which patients discharge notes and test results were communicated from Hospitals to GPs. The findings of the survey indicated that results were not communicated in a timely manner, nor were they always meaningful; this was of concern to members.

· Patient & Public Involvement

As part of the initial fact finding exercise patients experience taken into account.

· Result

Results of the initial survey were shared with the PCT, encouraging communication between the PCT commissioners and the CEOs of the Hospital Trusts. A follow up survey was carried out in Jan/Feb which does not evidence substantial improvements, results shared with the PCT a response is expected by 12^th March.

Item 19

· Activity Name

Brendoncare, Chandler's Ford.

· Description

Members took part in informal visits to a private facility from which NHS services are provided.

· Patient & Public Involvement

Speaking with staff and patients during the visit

· Result

Members were impressed with the service and facility and reported this to the PCT.

Item 20

· Activity Name

Tamerine Steering Group

· Description

The Forum has been represented on the steering group looking at the future of the Tamerine Respite Centre in Denmead and has advised centre users opposed to its closure.

Item 21

· Activity Name

West of Waterlooville developments.

· Description

The Forum has monitored the progress of the development to the west of Waterlooville, attending public and council meetings and talking to the medical practice involved.

Item 22

· Activity Name

Hayling Island Pharmacy provision

· Description

Poor pharmacy service is noted in this locality

· Result

The Forum has taken up the issue of poor pharmacy services on Hayling Island with the providers.

Item 23

· Activity Name

Building safety

· Description

W & A Network monitored the PCT's internal processes for ensuring that Trust Buildings are safe and properly maintained.

.

Item 24

· Activity Name

Out of Hours services

· Description

Issues around access to primary care services out of hours identified through surveys; information requested from the respective OOHS providers

· Patient & Public Involvement;

Through surveys and questionnaires.

· Result

Ongoing

.

Item 24

· Activity Name

Transport issues

· Description

Issues around access to health services through public transport identified, particularly in the North East of the area where all secondary services and many primary care services are delivered across the county border.

· Patient & Public Involvement

Discussions with patients and the public at meetings; issues identified during surveys and questionnaires.

· Result

Ongoing

OTHER WORK WITH NHS

Item 1

· Activity Name

Annual Health Check

· Description

Contribution to Health check process

Item 2

· Activity Name

PALS/Customer Services

· Description

Monitoring of PALS/Complaints data to inform the Forum workplan

· Result

Insufficient data available

Item 3

· Activity Name

NHS Next Stage Review

· Description

Attendance at two National Events and participation in video clip for SHA to encourage feedback.

· Patient & Public Involvement

Ensuring patient views from South Central SHA area recorded as part of the review.

· Result

Observations of the event fed back to the SHA

Item 4

· Activity Name

Community Hospital Stakeholder Groups

· Description

Attendance by members on local stakeholder groups centred around Community Hospitals.

· Patient & Public Involvement

Advising on appropriate stakeholders to be included in these reference groups and ensuring patients are represented.

Evaluating how the hospitals can best be utilized within the scope of PBC.

· Result

Improved scope of patients and public represented.

Item 5

· Activity Name

Commissioning and Strategy

· Description

Forum Chair attends the Board meetings with speaking rights

The Forum has membership on the following PCT Boards/Committees:

PCT Leadership Team

Care Services Board

Governance and Health Assurance

Dental Commissioning

Medical and Pharmaceutical Commissioning

Area Professional Advisory Committees

· Patient & Public Involvement

The remit of members on the above is to test the adequacy of the Trust's engagement with the public at all levels.

· Result

Heightened awareness of the PPI Forum's activities and improved understanding by the PCT of the need for PPI.

Item 6

· Activity Name

Department of Health consultations

· Description

Comments have been made to inform a number of consultations to ensure that the needs of the local population were highlighted.

Item 7

· Activity Name

West Sussex reorganisation

· Description

Together with the Portsmouth Forums the networks participated in the consultations over the redesign of services in the West Sussex PCT to ensure that possible adverse effects on the Hampshire Health economy were addressed.

Item 8

· Activity Name

NHS Direct Deliberative Panel

· Description

Members participated in this committee

PARTNERSHIP WITH NON NHS SERVICES

Item 1

· Activity Name

Hampshire County Council

· Description

Forum Chair attends the Health Overview and Scrutiny meetings with speaking rights.

All networks are encouraged to communicate issues of relevance to the Forum Chair so that he can be well informed for OSC meetings.

· Result

Improved Communication between OSC and PPI Forum

Item 2

· Activity Name

Hampshire LINK

· Description

Input into arrangements for the Hampshire LINk. Member sits on the steering group. Members have met with the project manager to discuss transitional arrangements and future plans.

Item 3

· Activity Name

Transportation issues

· Description

Network members contributed to the review of transportation arrangements in the local area and attended the council review to give evidence

Item 4

· Activity Name

Red Cross

· Description

· The Network is supporting the Red Cross to find a suitable site for its local depot.

Item 5

· Activity Name

Air Ambulance

· Description

W & A Network sought assurance that this charitable service would receive funding from the PCT and remain an effective service in Hampshire.

Item 6

· Activity Name

Year of Care

· Description

Forum members were involved in helping design this innovative care model which is being run by the University of Southampton, with Winchester and Eastleigh Healthcare Trust and Winchester and Andover area of Hampshire PCT. The project aimed to improve well-being of patients with long term conditions who would be required to "co-produce" their health living. Prescriptions would include time at the gym or swimming if necessary. Forum members advised on the care pathways which would provide for better health outcomes and the avoidance of hospitalisation.

Item 7

· Activity Name

Royal College of General Practitioners Committee

· Description

Forum Members attended these meetings and offered a patient perspective to their discussions.

Item 8

· Activity Name

HCC Access to Healthcare Pilot

· Description

A member sits on this group which is looking at an area from Lymington to Hythe in respect of transport access to secondary care.

· Patient & Public Involvement

Liaison with volunteer hospital car groups.

· Result

Work in progress.

Item 9

· Activity Name

New Forest Older Persons Focus Group

· Description

A member sits on this group which looks at health, social care and community issues. Membership includes the public and a wide range of statutory bodies.

· Patient & Public Involvement

Feedback from public membership of the group including volunteers from health related groups.

· Result

Informing the work of the Forum and improving inter-agency information sharing.

JOINT FORUM WORKING:

Item 1

· Activity Name

SHA meetings

· Description

This Forum initiated joint meetings with all Forums within the SHA area, the final meeting was held on 5^th Feb. The SHA has offered to continue to facilitate similar meetings in the LINks arrangements

· Result

Communication between PPI Forums within South Central SHA, sharing of information, ideas and best practice. This work will be ongoing into new PPI arrangements.

Item 2

· Activity Name

Hampshire Ambulance PPI Forum

· Description

Attendance at Ambulance Forum meetings for the sharing of information

· Result

Continuity of relationship between Forums, improved knowledge of the service.

Item 3

· Activity Name

SW Hants OOHS

· Description

Members of this Forum held regular meetings with members from Southampton City PCT PPI Forum, WEHT PPI Forum and Hampshire Partnership PPI Forum ensuring the needs of the public were met by the service.

Ongoing monitoring of the service and communicating views from the patient perspective to the service provider.

· Patient & Public Involvement

The views of the public were sought at regular Forum meetings, attendance at events etc.

· Result

PPIF inclusion as observer on the tender process for new provider

Item 4

· Activity Name

SHA PPI

· Description

Hampshire Primary Care PPI Forum has taken the lead on meaningful engagement with the SHA in relation to communication and consultation. This piece of work to continue under the auspice of the LINk (if it is on the LINk workplan)

· Result

Widening of the SHA's engagement processes

Item 5

· Activity Name

Work with Hospital Forums

· Description

Links formed with Hospital Forums for Bournemouth & Christchurch, SUHT, Poole and Salisbury

Joint hospital monitoring visits carried out.

Links with Hospital Forum for Winchester and Eastleigh Healthcare Trust and joint information stands were held.

Joint engagement work with Basingstoke and North Hampshire PPI Forum, including street surveys and information events.

Links between Rushmoor and Hart Local Network Group and Frimley park Hospital PPI Forum.

· Patient & Public Involvement

Patients' views sought as part of the visit;

Engagement with patients and the public by means of surveys and questionnaires;

Exchange of information, identification of common issues and trends and sharing of good practice.

· Result

Members opinions informed the report to the Trust.

Establishing regular pattern of engagement with patients and the public; feeding back issues identified to the Trusts; identifying areas of good practice.

INVOLVING THE PUBLIC

Item 1

· Activity Name

Listening to patients' views and experiences of the NHS;

· Description

Stands at various public events including Eastleigh BC Roadshows;

3 day engagement event at Lymington Hospital;

Undertaking regular street surveys of patients and the public; identifying areas of concern and of good practice.

· Patient & Public Involvement

Speaking with patients, carers and friends, using questionnaires to gather opinions.

· Result

The collated information used as a basis for the workplan, information fed back to the PCT to inform their strategy and improve services at local level. Information relating to services in Hospitals passed to the appropriate Forums.

Item 2

· Activity Name

Attendance at public meetings.

.Description

Members attended meetings organised by NHS Trusts to gauge the public view on NHS consultations.

· Patient & Public Involvement

Meeting with members of the public at the events

· Result

Enabled informed comment by the Forum on the adequacy of the NHS consultations.

Item 3

· Activity Name

Presentations given to carers groups, parish and town councils

· Description

Talks on PPI given to local groups to raise awareness of the PPI agenda, latterly with a focus on new arrangements for LINks

· Patient & Public Involvement

Engaging further with local people.

· Result

Improved understanding of PPI by the Public and enthusiasm for involvement in new arrangements.

Item 4

· Activity Name

. Meetings held in Public

· Description

Open agenda item for input from members of the public at Forum Meetings

· Patient & Public Involvement

Views of patients and public sought at meetings

· Result

Informed workplan, PCT staff attendance at meetings ensured a "direct voice" into the Trust

Item 5

· Activity Name

Open meetings

· Description

Forum meetings held with speakers on health related topics

· Patient & Public Involvement

Enable patients and public to feed their views directly to the NHS via the staff member giving the presentation

· Result

NHS heard the views of the patients "face to face"

Item 6

· Activity Name

GP Patient Group

· Description

Following a request from a GP practice manager, a Forum member is actively involved in developing a GP Practice Patient Group on the Waterside (NF);

Members in the North East Hampshire area are involved with GP patients groups and with Practice Managers groups;

· Patient & Public Involvement

Encouraging patients to be involved with plans for services locally;

Acting as the conduit for information between patients and GP Practices;

· Result

Development of patient group to enable involvement in PBC plans;

Ensuring patient interest informs future plans.

DEVELOPING THE FORUM

Item 1

· Activity Name

PPI Forum member training

· Description

Members continued to receive training from Cppih on Forum related subjects.

Training and workshops on PBC attended by members allocated to PBC clusters.

Training sessions and workshops on the subject of LINks attended by members

· Result

Members better equipped to carry out their workplan.

Improved understanding of PBC

Enabled members to have a voice in the future PPI arrangements (LINks workshops)

FURTHER COMMENTS

Hampshire PCT is the largest PCT in the country serving approximately 1.25 million people over a geographical area of 367,860 hectares. In addition to the local population, Hampshire receives approx 4.43 million overnight visitors 1plus an unknown number of day visitors.

DECLARATION

On behalf of the Hampshire Primary Care Patient and Public Involvement Forum, I confirm that the above is an accurate record of our recent activity.

Signed:

Name: Frank Rust

Date: 17^th March 2008

Annual Health Check 2007 - 2008. Hampshire Primary Care Patient and Public Involvement Forum Commentary
First Domain - Safety Domain Outcome Patient safety is enhanced by the use of health care processes, working practices and systemic activities that prevent or reduce the risk of harm to patients
C4 Healthcare organisations keep patients, staff and visitors safe by having systems to ensure that a) the risk of health care acquired infection to patients is reduced, with particular emphasis on high standards of hygiene and cleanliness, achieving year-on-year reductions in MRSA; b) all risks associated with the acquisition and use of medical devices are minimised; c) all reusable medical devices are properly decontaminated prior to use and that the risks associated with decontamination facilities and processes are well managed; d) medicines are handled safely and securely; and e) the prevention, segregation, handling, transport and disposal of waste is properly managed so as to minimise the risks to the health and safety of staff, patients, the public and the safety of the environment	C4b) Infection controls procedures at local Community Hospitals in the North East Hampshire area observed to be robust and in line with local priorities. Use made of local media in highlighting the issue of HAI and public health issues resulting. (Evidence: Local media adverts during February 2008)
Second Domain - Clinical and Cost Effectiveness Domain Outcome Patients achieve health care benefits that meet their individual needs through health care decisions and services based on what assessed research evidence has shown provides effective clinical outcomes
C5 Healthcare organisations ensure that a) they conform to NICE technology appraisals and, where it is available, take into account nationally agreed guidance when planning and delivering treatment and care; b) clinical care and treatment are carried out under supervision and leadership; c) clinicians continuously update skills and techniques relevant to their clinical work; and d) clinicians participate in regular clinical audit and reviews of clinical services.	C5b) Members of the Forum carried out an unannounced visit to Fordingbridge Hospital on 7th August 2007 and reported that they were impressed with improvements which have lead to a significant improvement in patient care since their previous visits in September and October 2006. C5c) Members carrying out an unannounced visit to Fordingbridge Hospital on 7th August 2007 noted that revised training arrangements had removed previous areas of concern regarding "mouth care" for patients.
Third Domain - Governance Domain Outcome Managerial and clinical leadership and accountability, as well as the organisation's culture, systems and working practices ensure that probity, quality assurance, quality improvement and patient safety are central components of all the activities of the health care organisation
C11 Healthcare organisations ensure that staff concerned with all aspects of the provision of health care a) are appropriately recruited, trained and qualified for the work they undertake; b) participate in mandatory training programmes; and c) participate in further professional and occupational development commensurate with their work throughout their working lives.	C11a) Network Members in the North East of the area, through a series of meetings with the Community Hospital Matron, established that suitable staff recruitment and retention programmes were in progress to address staff shortages in the Community Hospitals but there is concern at the very lengthy appointment process. (Network meeting notes: 16th November 2007)
Fourth Domain - Patient Focus Domain Outcome Healthcare is provided in partnership with patients, their carers and relatives, respecting their diverse needs, preferences and choices, and in partnership with other (especially social care ) whose services impact on patient well-being.
C13 Healthcare organisations have systems in place to ensure that a) staff treat patients, their relatives and carers with dignity and respect; b) appropriate consent is obtained when required for all contacts with patients and for the use of any patient confidential information; and c) staff treat patient information confidentially, except where authorised by legislation to the contrary	C13a) `Street' surveys in Alton, Bordon, Basingstoke and Fleet by local Network members evidenced a generally high satisfaction level; however, a small number of respondents expressed concerns. (Survey reports for Alton and Bordon April 2007, Basingstoke July 2007and Fleet March 2008)
C14 Healthcare organisations have systems in place to ensure that patients, their relatives and carers a) have suitable and accessible information about, and clear access to, procedures to register formal complaints and feedback on the quality of services; b) are not discriminated against when complaints are made; and c) are assured that organisations act appropriately on any concerns and, where appropriate, make changes to ensure improvements in service delivery	C14 a) 75% of Hampshire residents surveyed on access to NHS dentistry said they do not know how to make a complaint with regard dental services. (Cppih survey July/Aug 07) Members from the F&G Network are dissatisfied with contacts from Trust staff especially the PALS Service from which little useful information is forthcoming. The reorganisation and restructuring following reorganisation of Hampshire PCTs has also caused the loss of existing networks of contacts within the Trust that have provided information in the past. North Hampshire Members had received regular Customer Care reports until August 2007. Once the PCT had established its new structures, these reports ceased with the subsequent loss of contact referred to above.
C15 Where food is provided, healthcare organisations have systems in place to ensure that a) patients are provided with a choice and that it is prepared safely and provides a balanced diet; and b) patients' individual nutritional, personal and clinical dietary requirements are met, including any necessary help with feeding and access to food 24 hours a day.	C15a) Street surveys undertaken in Alton and Bordon demonstrated a particularly high level of satisfaction with food and meals provided at the two Community Hospitals in the area. (Survey reports - April 2007)
Fifth Domain - Accessible and Responsive Care Domain Outcome Patients receive services as promptly as possible, have choice in access to services and treatments, and do not experience unnecessary delay at any stage of service delivery or of the care pathway
C17 The views of patients, their carers and others are sought and taken into account in designing, planning, delivering and improving health care services.	C17) Forum members liaising with Practice Based Commissioners find that the level of engagement with patients when designing services is variable across the County, the commissioners have lacked guidance on this. The concerns of W & A Network regarding the involvement of Patients and the public on the rumoured move of Friarsgate Surgery from the Centre of Winchester have not been addressed by Hampshire PCT. A number of letters were not responded to, and only recently information concerning a small survey of 50 people was shared with the network. The practice has over 20,000 patients on its list. The Network is concerned that the PCT's difficulties over commercial sensitivity, on this occasion, has overshadowed its obligation to engage with patients, prior to deciding to relocate the surgery, which will be of great inconvenience to those patients who rely on public transport. Other Involvement Monitoring W & A Network members have monitored the patient involvement undertaken by other surgeries who are proposing changes to the way in which services are delivered. The Network noted that surgery involved promptly with the local population that was affected but there was a lack of clear standards of how to proceed when the responses were received. W & A Network have noted that in comparison to the contacts with Trust staff made by other areas, the Winchester and Andover area is very badly served. PALS contacts and information is very poor and local awareness of the PALS service is low. Similarly with Forum member membership on PBC locality groups, the WANT has still not met with the appropriate locality manager. It seems that the manager for one of the clusters has still not been appointed. SE Hants Members were impressed by the efficient organisation of the Consultation on Maternity Services in South East Hampshire. Pre-consultation ensure that appropriate options were proposed, and a wide range of relevant views was obtained, leading to a conclusion that was widely welcomed.
C18 Healthcare organisations enable all members of the population to access services equally and offer choice in access to services and treatment equitably.	C18) The availability and equability of NHS dental services within Hampshire is of concern to members of the Forum. Members have carried out research into the availability of the service and base their findings on: · Commission for Patient and Public Involvement (Cppih) Survey carried out across Hampshire in July and August 2007. · Information received from Hampshire Citizens Advice Bureaux · Alton Town Partnership Survey · Comments received direct from members of the public · Local questionnaire and enquiries made by the Basingstoke and Deane Network · Information received from the PCT Results of the Cppih and Romsey CAB surveys both indicate that a high percentage of patients currently not registered with a dentist say this is because they are unable to locate a NHS dentist locally. Patients are quoted as saying "I am disabled and have to travel by bus (5 miles), and then walk which is very hard for me" "I have to pay train or taxi fares and take my children with me because I have no childminder", "Unable to travel far at my age (80) so don't go"2 When surveyed, a high proportion of patients (Cppih survey 87%) stated the reason they attend as private patients is due to the fact that they can not find a dentist accepting NHS patients or that their own dentist has withdrawn from the NHS system. SE Hants - The PCT has failed to move effectively to address the issue of inadequate access to NHS dentistry in several parts of the county. It has identified the problem - highlighted in several surveys, notably by PPI Forums and Citizens Advice- but action has been dilatory. Significant new commissions are not expected until well into 2008-9 with the result that the PCT has failed to spend its dentistry budget to date. East Hampshire is a particular blackspot with patients unable to get appropriate advice about what action to take while awaiting the provision of new services. F&G - There was a lack of clear overall strategy apparent in the reorganisation of Maternity Services in SE Hants. Changes were made in a piecemeal fashion and the problem was further compounded by lack of clear communication to service users and the public. Transport is a major problem given the rural nature of the area. The PCT formed a transport group to address the issues however the group has yet to meet.
C19 Healthcare organisations ensure that patients with emergency health needs are able to access care promptly and within nationally agreed timescales, and all patients are able to access services within national expectations on access to services.	C19) Approximately half of Hampshire patients surveyed said they do not know how to access emergency dental treatment outside of normal surgery hours.(Cppih survey July/Aug 07)
Sixth Domain - Care Environment and Amenities Domain Outcome Care is provided in environments that promote patient and staff well-being and respect for patients' needs and preferences in that they are designed for the effective and safe delivery of treatment, care or a specific function, provide as much privacy as possible, are well maintained and are cleaned to optimise health outcomes for patients.
C20 Healthcare services are provided in environments which promote effective care and optimise health outcomes by being a) a safe and secure environment which protects patients, staff, visitors and their property, and the physical assets of the organisation; and b) supportive of patient privacy and confidentiality	C20) As a result of a 3 day engagement event held in July 07 at Lymington New Forest Hospital, members are pleased to report that patients were complimentary of the care received and facilities provided at this site.
C21 Healthcare services are provided in environments which promote effective care and optimise health outcomes by being well designed and well maintained with cleanliness levels in clinical and non-clinical areas that meet the national specification for clean NHS premises	C21) Members carried out an informal visits to Brendoncare Chandler's Ford (a private facility from which NHS services are provided), the final of which was on 12th April 2007. Members were impressed with the service and facilities, having a pleasant atmosphere and friendly staff.
Seventh Domain - Public Health Domain Outcome Programmes and services are designed and delivered in collaboration with all relevant and communities to promote, protect and improve the health of the population served and reduce health inequalities between different population groups and areas
C22 Healthcare organisations promote, protect and demonstrably improve the health of the community served, and narrow health inequalities by a) co-operating with each other and with local authorities and other organisations; b) ensuring that the local Director of Public Health's Annual Report informs their policies and practices; and c) making an appropriate and effective contribution to local partnership arrangements including Local Strategic Partnerships and Crime and Disorder Reduction Partnerships	Access to Dentistry services is extremely poor for patients in parts of the County. Members believe insufficient action has been directed to resolving this problem
Additional Comments from the Forum The Forum notes that in areas where there were good communications with the staff of the PCT this had been lost with the reorganisation of the PCT. The rebuilding of good communications has been hindered by the large size of the PCT and by the slowness in appointing staff within the PCT to intermediate managerial positions. It would foster the involvement of patients and the public if Trust documents were simplified and shortened.

	C4b) Infection controls procedures at local Community Hospitals in the North East Hampshire area observed to be robust and in line with local priorities. Use made of local media in highlighting the issue of HAI and public health issues resulting. (Evidence: Local media adverts during February 2008)
	C5b) Members of the Forum carried out an unannounced visit to Fordingbridge Hospital on 7th August 2007 and reported that they were impressed with improvements which have lead to a significant improvement in patient care since their previous visits in September and October 2006. C5c) Members carrying out an unannounced visit to Fordingbridge Hospital on 7th August 2007 noted that revised training arrangements had removed previous areas of concern regarding "mouth care" for patients.
	C11a) Network Members in the North East of the area, through a series of meetings with the Community Hospital Matron, established that suitable staff recruitment and retention programmes were in progress to address staff shortages in the Community Hospitals but there is concern at the very lengthy appointment process. (Network meeting notes: 16th November 2007)
	C13a) `Street' surveys in Alton, Bordon, Basingstoke and Fleet by local Network members evidenced a generally high satisfaction level; however, a small number of respondents expressed concerns. (Survey reports for Alton and Bordon April 2007, Basingstoke July 2007and Fleet March 2008)
	C14 a) 75% of Hampshire residents surveyed on access to NHS dentistry said they do not know how to make a complaint with regard dental services. (Cppih survey July/Aug 07) Members from the F&G Network are dissatisfied with contacts from Trust staff especially the PALS Service from which little useful information is forthcoming. The reorganisation and restructuring following reorganisation of Hampshire PCTs has also caused the loss of existing networks of contacts within the Trust that have provided information in the past. North Hampshire Members had received regular Customer Care reports until August 2007. Once the PCT had established its new structures, these reports ceased with the subsequent loss of contact referred to above.
	C15a) Street surveys undertaken in Alton and Bordon demonstrated a particularly high level of satisfaction with food and meals provided at the two Community Hospitals in the area. (Survey reports - April 2007)
	C17) Forum members liaising with Practice Based Commissioners find that the level of engagement with patients when designing services is variable across the County, the commissioners have lacked guidance on this. The concerns of W & A Network regarding the involvement of Patients and the public on the rumoured move of Friarsgate Surgery from the Centre of Winchester have not been addressed by Hampshire PCT. A number of letters were not responded to, and only recently information concerning a small survey of 50 people was shared with the network. The practice has over 20,000 patients on its list. The Network is concerned that the PCT's difficulties over commercial sensitivity, on this occasion, has overshadowed its obligation to engage with patients, prior to deciding to relocate the surgery, which will be of great inconvenience to those patients who rely on public transport. Other Involvement Monitoring W & A Network members have monitored the patient involvement undertaken by other surgeries who are proposing changes to the way in which services are delivered. The Network noted that surgery involved promptly with the local population that was affected but there was a lack of clear standards of how to proceed when the responses were received. W & A Network have noted that in comparison to the contacts with Trust staff made by other areas, the Winchester and Andover area is very badly served. PALS contacts and information is very poor and local awareness of the PALS service is low. Similarly with Forum member membership on PBC locality groups, the WANT has still not met with the appropriate locality manager. It seems that the manager for one of the clusters has still not been appointed. SE Hants Members were impressed by the efficient organisation of the Consultation on Maternity Services in South East Hampshire. Pre-consultation ensure that appropriate options were proposed, and a wide range of relevant views was obtained, leading to a conclusion that was widely welcomed.
	C18) The availability and equability of NHS dental services within Hampshire is of concern to members of the Forum. Members have carried out research into the availability of the service and base their findings on: · Commission for Patient and Public Involvement (Cppih) Survey carried out across Hampshire in July and August 2007. · Information received from Hampshire Citizens Advice Bureaux · Alton Town Partnership Survey · Comments received direct from members of the public · Local questionnaire and enquiries made by the Basingstoke and Deane Network · Information received from the PCT Results of the Cppih and Romsey CAB surveys both indicate that a high percentage of patients currently not registered with a dentist say this is because they are unable to locate a NHS dentist locally. Patients are quoted as saying "I am disabled and have to travel by bus (5 miles), and then walk which is very hard for me" "I have to pay train or taxi fares and take my children with me because I have no childminder", "Unable to travel far at my age (80) so don't go"3 When surveyed, a high proportion of patients (Cppih survey 87%) stated the reason they attend as private patients is due to the fact that they can not find a dentist accepting NHS patients or that their own dentist has withdrawn from the NHS system. SE Hants - The PCT has failed to move effectively to address the issue of inadequate access to NHS dentistry in several parts of the county. It has identified the problem - highlighted in several surveys, notably by PPI Forums and Citizens Advice- but action has been dilatory. Significant new commissions are not expected until well into 2008-9 with the result that the PCT has failed to spend its dentistry budget to date. East Hampshire is a particular blackspot with patients unable to get appropriate advice about what action to take while awaiting the provision of new services. F&G - There was a lack of clear overall strategy apparent in the reorganisation of Maternity Services in SE Hants. Changes were made in a piecemeal fashion and the problem was further compounded by lack of clear communication to service users and the public. Transport is a major problem given the rural nature of the area. The PCT formed a transport group to address the issues however the group has yet to meet.
	C19) Approximately half of Hampshire patients surveyed said they do not know how to access emergency dental treatment outside of normal surgery hours.(Cppih survey July/Aug 07)
	C20) As a result of a 3 day engagement event held in July 07 at Lymington New Forest Hospital, members are pleased to report that patients were complimentary of the care received and facilities provided at this site.
	C21) Members carried out an informal visits to Brendoncare Chandler's Ford (a private facility from which NHS services are provided), the final of which was on 12th April 2007. Members were impressed with the service and facilities, having a pleasant atmosphere and friendly staff.
Seventh Domain - Public Health Domain Outcome Programmes and services are designed and delivered in collaboration with all relevant and communities to promote, protect and improve the health of the population served and reduce health inequalities between different population groups and areas
C22 Healthcare organisations promote, protect and demonstrably improve the health of the community served, and narrow health inequalities by a) co-operating with each other and with local authorities and other organisations; b) ensuring that the local Director of Public Health's Annual Report informs their policies and practices; and c) making an appropriate and effective contribution to local partnership arrangements including Local Strategic Partnerships and Crime and Disorder Reduction Partnerships	Access to Dentistry services is extremely poor for patients in parts of the County. Members believe insufficient action has been directed to resolving this problem
Additional Comments from the Forum The Forum notes that in areas where there were good communications with the staff of the PCT this had been lost with the reorganisation of the PCT. The rebuilding of good communications has been hindered by the large size of the PCT and by the slowness in appointing staff within the PCT to intermediate managerial positions. It would foster the involvement of patients and the public if Trust documents were simplified and shortened.

Commission for Patient and Public Involvement in Health

PATIENT AND PUBLIC INVOLVEMENT FORUM ANNUAL REPORT 1 April 2007 - 31 March 2008,

Forum Name...BASINGSTOKE AND NORTH HAMPSHIRE FOUNDATION

TRUST

Forum Support Organisation HELP AND CARE

CPPIH Regional Centre: SOUTHERN REGION

Current Forum members:

[Please list the names of the Forum members, identifying the Chair and Deputy Chair(s) if applicable. In those circumstances where it has been agreed with the CPPIH that a Forum Member's name can be withheld, please note the number of names withheld]

Gordon Summers, Chairman;

Gill Tomlins, Vice-Chair;

Ann Blairman;

John Blairman;

Joy Deadman;

Ann Jeffery;

Elizabeth Tunnah;

Colin Godfrey, Hampshire PCT PPIF Representative;

OUR THANKS TO FORMER MEMBERS WHO TOOK PART IN THE WORK OF THE FORUM OVER THE LAST YEAR.

Meetings

Type of meeting	Number held
Meetings held in public	12
Informal	4
Public Meetings	1

Forum work

Achievements

Please categorise each Impact.

Car Parking Issues Patient Advice and Liaison (PALS) reports and Complaints reports had highlighted patients and visitors concerns around the Car Park facilities. Basingstoke and North Hampshire NHS Foundation Trust (BNHFT) Patient and Public Involvement Forum (PPI Forum) had discussed these issues and decided to undertake a survey of the Car Park facilities prior to determining whether any further Forum involvement was required. It was agreed that a series of 3 visits would take place. As a result of recommendations made by the Forum, the following changes were implemented: 1. Car Park attendants carry more change to assist patients and visitors; 2. Signs are displayed advising that Car Park Attendants will assist in the purchase of the ticket; 3. Consideration is being given to the proposal that Car Park Attendants hold temporary and dated `disabled' badges to give to patients who do not hold a Blue Badge but who have clear mobility problems; 4. More publicity is given to the proportion of the car parking charges received by the Trust and what this is used for; 5. Issues around the dropping off of elderly, vulnerable or less mobile patients have been addressed.

Patient Focus

ACTIVITY 2007-08

Activity Name	Description	Patient & Public Involvement	Result
Monitoring/ review of NHS Services. Monitoring of PALS/Complaints: Visits to ward areas and departments; Patient Surveys;	The Forum received regular PALS, Complaints and Governance reports; Forum Members undertook regular surveys of patients to identify areas of concern and areas of good practice. The Forum engaged in an ongoing programme of visits to ward areas to assess standards of care; Forum Members undertook regular patient surveys;	Discussion with patients and the public during visits and surveys; Discussions with patients and the public during visits; Gathering patient experience;	Identification of issues of concern and trends in complaints. Identification of good practice; Identification of issues for patients and of areas of good practice; Results brought back to the Trust for discussion and identification of issues of concerns and areas of good practice;
Other work relating to NHS services. Survey of Pain Clinic Services (with local Members of Hampshire PCT PPI Forum)	Identification of Pain Clinic services within the Trust and community based;	Contact with patients and the public and discussions around access to Pain Clinic services;	Issues brought to Trust and discussed, ensuring equity of service across the health community;
Working in partnership with non- NHS services. Healthcare Commission Standards for Better Health	The Forum commented on the Trust's performance against certain Core Standards.	From contact with patients and the public, the Forum was able to assess the Trusts compliance with certain core standards.	Forum Statement on Trusts performance shared with the Healthcare Commission and the Trust.
Involving the public/ community. The Forum worked with other local North Hampshire Forum members to develop a patient and public involvement and engagement strategy	Regular Street surveys of patients and the public to assess the patient experience; Promotional activities (such as stands in local hospitals and health care sites) undertaken;	Members of the public and patients engaged and involved; Recruitment activities undertaken at these events.	Continuing engagement process.
Developing the Forum - training, promotion and recruitment. Regular joint North Hampshire Forum meetings held to encourage sharing of issues and good practice;	Sharing of areas of commonality, issues of concern and development of good practice.		Networking between Forum Members.

Further comments/ significant issues

The Forum would like to record it's thanks to all Board, Staff and Public Members of the Basingstoke and North Hampshire NHS Foundation Trust for continuing to support the principles of Patient and Public Involvement. The Forum recognises that the Trust places patients at the forefront of service delivery and applauds the Trust's commitment to its public.

DECLARATION

On behalf of the BASINGSTOKE AND NORTH HAMPSHIRE FOUNDATION TRUST PATIENT AND PUBLIC INVOLVEMENT FORUM, I confirm that the above is an accurate record of our recent activity and future work plans.

Signed: Gordon Summers

Name: GORDON SUMMERS

Date: 10^th March 2008

PATIENT AND PUBLIC INVOLVEMENT FORUM

(HAMPSHIRE PARTNERSHIP NHS TRUST)

REPORT

Report of activities of the Forum

2004 - 2008

Help and Care

Forum Support Organisation

Wessex House

Upper Market Street

Eastleigh

SO50 9FD

Patient and Public Involvement Forum

(Hampshire Partnership)

REPORT ON ACTIVITIES OF THE FORUM 2004 - 2008

Introduction

At the end of March 2008, the life of the Patient and Public Involvement Forums ended. The PPI Forums were set up under the provisions of the Health and Social Care Act 2001 which imposed legal obligations on all NHS Trusts to involve patients and the public in the decisions about their health services. The monitoring of the level of involvement by the NHS Trusts, of service users, patients, carers and the public in this decision-making will now pass to the new Local Involvement Network or LINk. In Hampshire there will be three LINks, one for each local authority which commissions social care, Hampshire, Southampton and Portsmouth.

Presently there is little clarity about how these bodies will function or be organised. On the positive side however, the remit of the new structure will include social care as well as health. As health and social care services work more closely together and the boundaries between them become more blurred, it is helpful that the LINk should now monitor across the two service areas. Questions and concerns have been raised by the public at the Forum's meetings in public which could not be addressed since they were concerned more with social care and therefore not within the Forum's remit of healthcare.

The Forum is working with Hampshire County Council and Southampton City Council to offer their comments, input and expertise to ensure that the LINks will be an effective voice in articulating the needs of the public.

This report summarises the Forum's work over the four years of its existence. It gives a flavour of the range of its activities and provides a formal record. More importantly, for its successor bodies, either LINks or Councils of Governors attached to the NHS Foundation Trusts, it sets down tasks which the Forum would have worked on in the future had its existence not been so arbitrarily terminated. The Forum sincerely hopes that this identified unfinished business will be pursued energetically.

Background

The first meeting in public of the Forum took place on 25^th February 2004 and the last on 6^th March 2008. Initially there were some problems to surmount; the major difficulties were its small membership and the task of finding a way in this new area, a difficulty that was experienced by the Forum support organisation. Nevertheless in these early days there were some noteworthy emphases. One was the decision to encourage increased levels of service user and carer involvement within the Trust and the determination to hold public meetings and annual general meetings to which members of the public were invited, to participate in the discussions and to raise issues that the Forum might need to take under review.

Since its inception the Forum has organised 28 meetings in public. At these meetings, senior members of the Trust staff including both the Chair of the Trust Board and the Chief Executive attended to give presentations to the Forum and the attendees on a variety of topics. Attendees had the opportunity to comment on the presentations and to ask questions. These meetings were very successful in allowing the views of the public to be expressed. The public were also enabled to contribute by sending in their views or comments in writing.

Such meetings have been central to the Forum's work and recent sessions have seen invited groups focussing in depth on particular areas of care. Our work has been summarised under the following headings:

· Working with the Trust structures

· Visiting Trust facilities

· Taking part in consultations

· Engagement with the public

· Projects

· Philosophy of Care

Working with the Trust

Trust Board

An early action was to participate and represent the needs of patients and the public at Trust committees. Trust board meetings were monitored by Forum members who had the opportunity to address the Board at those meetings.

Service User and Carer Involvement

The Forum has continued its involvement in the Trust's Service User and Carer Committee and Steering Groups. The Committee has received regular update reports from each directorate on their individual Service User and Carer Involvement Objectives. It has also looked at user and carer involvement in staff recruitment, training, clinical audit, exit surveys, Choice agenda, User and Carer Consultant Roles, Better Information Group and payment for service users.

Forum members also sat on a number of other key committees, including Clinical Governance and Risk and the Older People's Reference Group. Forum members have participated and monitored the Trust's Clinical Governance events which focus on sharing good practice across the Trust

Through the Forum's involvement in this work, Forum members have exerted pressure to ensure that senior staff in all units recognise the need to take explicit account of the experiences and views of all users and carers not just a few chosen representative voices. At the Forum's AGM in 2007, the Trust's Consumer Advisor gave a presentation on the work of the User Carer Steering Group noting its successes and some of the difficulties it had experienced. Following this, the Forum representative on the Steering Group highlighted the failure of the Trust to effectively promulgate good practice in service user and carer involvement across all its service areas and in particular, the distinct absence from the Steering Group, of some localities. The Forum is happy to report some improvement in locality involvement in the work of the service user and carer involvement steering group.

The Forum have been regularly working closely with the Trust on Service User and Carer Involvement, initially in the Service User and Carer Reference Group and latterly on the Service User and Carer Steering Group. This group has been instrumental in:

· establishing a Key Performance Indicator for service user and carer involvement in staff recruitment and selection

· writing a User and Carer Involvement Strategy

· ensuring Locality Managers are more visible, accessible and engaged with Service User and Carer networks

· looking at the payment of service users and carers

This group have also established regular innovative service user and carer Engagement Events across the County looking at:

· the Care Planning Process

· physical health and wellbeing

· service user and carer involvement in commissioning services

· personalised budgets

· Foundation Trust Status

Visiting by Forum Members

Starting in 2005, the Forum undertook a series of visits to Trust sites. Visits were announced to the Trust and two or more members undertook the visits and monitored the site. Service users and staff (the Forum does represent the views of staff as well) were invited to discuss any matter that was of concern. These visits were undertaken for a variety of reasons. When it was thought necessary, unannounced visits were undertaken. A report of the visit was prepared and agreed along with any recommendations from the visit and presented to the Trust for comment and action.

Visits were undertaken to the following sites: (brief summary of report attached)

Melbury Lodge, Stefan Oliveri Unit Aug 2005

This revealed that when the original Unit was extended to incorporate Ann Ward, not enough thought was given to the differing uses of the two wards. Joining the two wards together resulted in problems, both in the security of the patients in Ann Ward, and in the freedom of movement of the patients in Charlotte Ward and for the staff themselves.

East Southampton Day services June 2005 (following expression of public concern)

The visit highlighted some problems with many of the good facilities. The Forum conducted a follow up visit in May 2007 when many improvements to the use of facilities and the ambience had been implemented.

Parklands Hospital 16 May 2005

The concerns of staff with regard to the services and staffing were noted

Ravenswood House two visits in Feb 2006

As a result of the visit, some improvements were made.

Woodhaven 2nd February 2006

Some minor improvements were recommended that would improve the patient experience

The Meadows 20 December 06

The need for a significant environmental upgrade of this unit was highlighted in the report. The Forum has recently heard (March 2008) that substantial funds have been allotted for this work.

Linden and Minstead Ward, Western Hospital Southampton 16th May 2007

Improvements in the staffing caused by the move of the OPMH Community Team to the same site were noted. Patients had better access to social workers in this way.

Foxmead Unit at Tatchbury Mount 10 July 2007

As a result of the visit, again some minor improvements were recommended that would improve the patient experience

Department of Psychiatry (DoP), Southampton

As part of a programme of visits to the adult mental health units in Hampshire, a visit was made to the DoP in April 2005. The visit raised serious concerns about conditions within the unit. At the same time there was negative publicity about the DoP on national radio. The Forum raised these concerns and other visits were undertaken. The Chief Executive of the Trust attended a meeting with a number of members of the public present and their views and concerns were expressed. Some significant changes were made to address these concerns in the short term. The Chief Executive ensured that changes took place, that the environment was greatly improved and that issues about staff morale were also addressed.

The process of improvement was monitored extensively by the Forum in a variety of ways and a further visit was undertaken in July 2006. Further recommendations for improvements were made as an outcome from the visit. Forum members reported:

"we were impressed with the effort and investment that has been channelled into DOP since our visits last year. Senior staff are grasping key issues, the environment has been much improved and a new spirit is evident"

However significant concerns were still expressed about Mayflower ward (the Psychiatric Intensive Care Unit). On the visit the unit presented a drab and institutional appearance, it was poorly decorated and space was not used well. Forum members detected tensions among patients and staff and urged strongly that ameliorative action be taken swiftly - even though a totally new unit is currently being planned. Forum members suggested practical ways in which this amelioration could be achieved. It is understand that the environment of this ward has now received investment and attention.

A number of visits were undertaken with other Forums where there was an issue of mutual concern, e.g. a visit with Portsmouth City PPIF to St James Adult Mental Health Unit, Milton House, Portsmouth, and compilation of joint report on implementation of recommendations and some of the visits to Accident and Emergency departments (see below)

PEAT visits - January - March 2006, Jan 2007 and March 2008

Members participated in the Patient Environment Action Team (PEAT) visits which are made to Trust sites by the Trust staff to check the ward environment.

Apart from detailed comments on individual visits, the Forum drew the following conclusions from their visits:

· they felt there was a questionable "rounding up" of scores - where one part of a ward or unit scored low, the tendency was to set the overall scores to a total which represented the general standard observed and which "played down" less acceptable areas.

· they have had difficulty in obtaining information about follow up actions on areas that received low grades. After a considerable delay this information appeared. (March 2008)

· the inspection process reveals and identifies a much wider range of issues than simply the environment. It is important that these are not lost sight of.

Consultations

The Forum participated in a number of consultations from various sources on both local and national level. The Forum commented on the proposals where these would have an impact on service users in their area of concern. e.g. Hampshire County Council's "Access to Therapy Services for Children in School and Pre-school" and the "Review of Eligibility Criteria", and the joint Hampshire County Council and Hampshire PCT "Older People's Mental Health Strategy". The Forum monitored the engagement events that were undertaken with reference to services for older people in the Southampton area, "Getting the Balance Right"

Forum members were very involved in the consultation on the Trust's modernisation of adult mental health services "Moving Ahead" in 2005. Forum members attended each consultation event raising the profile of the Forum and taking account of service user and carer concerns and responses to the consultation.

Engagement with the Public

There have been a series of seminar/workshops which the Forum has undertaken and which have been an important focus for users and carers in scrutinising specific area of service.

These have included:

People with Learning Disabilities

Act Up Event July 2007

The Forum hosted an innovative event for people with learning difficulties to comment on their experiences in getting medical care. A theatre group offered a series of scenarios about how people with learning disabilities are treated well and badly by the medical professionals, both at the doctors' surgery and in the hospital. Following these presentations the attendees gave their comments on good and poor treatment.

The event was filmed and a short DVD was prepared which has been presented to the Hampshire Partnership Trust as an educational resource to be shown to staff to demonstrate the better way to relate to patients with learning disabilities. It highlighted in particular issues of human dignity and respect and noted the comments of the attendees.

Autism and Aspergers Syndrome

Mind the Gap November 2007

The Forum identified the difficulties experienced by children or young adults with learning disabilities who pass from the care of children's services to that of Adult services. This problem is particularly acute for children with Autism Spectrum Disorders or Aspergers. To add a further layer of confusion, there are a number of services involved. These include Hampshire County Council's Children's services and its Adult Services as well as Children and Adult Services from Hampshire PCT and Hampshire Partnership Trust. Voluntary services are also involved.

The Forum hosted a meeting of professionals from all of these relevant areas, together with parents of children who are affected. In a seminar format, a solution to this difficulty was sought. e.g. The issue of the different criteria used for assessment of children compared with adult services was highlighted. The Forum drew the attention of participants to EIP (Early Intervention in Psychosis Teams) which are in place to help the transition difficulties experienced by young people who have experienced a psychotic episode, as a model for a service which could address the issue of transition.

A full report was sent to the Trust and to Adult Services Directorate, Hampshire County Council and the PCT. This issue is recognised but remains unresolved.

Mental Health Services for Older People

The Forum has sponsored three events in this area over the past year:

· In July 2006 the Forum hosted a social afternoon at Littleton focused around a cricket match. A good number of users and carers and Trust staff joined in the informal proceedings. Good contacts were made and useful information exchanged.

· In December 2007 the Forum organised a session when older people with dementia and their carers met with senior Trust staff. An open question and answer session enabled the service users and carers to identify the short comings of the services that are provided. A report was drawn up outlining the major concerns of the attendees and shared with the Trust.

· In March 2008 a further event was held. The panel of staff included two Directors of Nursing from Hampshire's acute hospital Trusts. The large number of attendees were able to raise the issues of most concern to them especially about the care of the people with dementia who go into acute hospital and to highlight the lack of specialised knowledge that can often be detrimental to the health of those with dementia. Another issue that was mentioned by the carers was the limited range of interventional services which were able to assist the carer when the service user was in the community. The need was shown to be very acute especially at night and over the weekend. There was also discussion of early news of a proposal to reduce bed numbers in either Andover or Winchester.

Detailed descriptions of inadequate care and/or services are to be followed up by the health care professionals present but three significant gaps in the current service were identified;

a) The need for a 24 hour crisis service in the community

b) A significant increase in the psychiatric liaison service for the older patients in the acute hospitals

c) The development of a programme for `expert carers'

The Forum deprecated the cuts in the service budget which were made last year and oppose any further cuts in the budget which it is understood, are currently being considered.

The key elements of these two events have been communicated formally to the Trust.

Again the future development of this service catering for a rapidly growing population of the elderly needs close attention from our successor bodies.

Projects

Locally Based Hospital Unit (LBHU) re-provision for people with learning disabilities

The Forum have monitored the process of the re-provision of accommodation for those in LBHUs in line with national directives. The involvement of two authorities, County and NHS has proved time consuming and the work in the South West of Hampshire started slowly. The Forum ensured that the issue was addressed and that the service users were fully involved in the decision and that their needs were addressed. The Forum undertook a series of visits to these units and discussed progress with staff and the users. The Forum have noted that the proposed timetable for the re-provision in the South West is now in place and should soon be completed but formal monitoring remains necessary..

A recent concern is that there has been little done to address the issue of re-provision in the South East. This has been for a variety of reasons outside the Trust's control but there is little time before the deadline is reached in 2010. The Forum is attempting to engage those involved to respond to the urgency of the issue and make much faster progress than they managed in the South West. This too needs monitoring.

Accident and Emergency

A series of comparative visits to the Accident and Emergency facilities in the four main Hampshire hospitals with A&E departments was undertaken in 2007. Facilities and services at these departments for treating attendees who have mental health problems were examined carefully through interviews with the staff and a review of the facilities. Input from service users was also sought.

A report was prepared with a series of recommendations which have been distributed to the chief executives of the relevant acute NHS Trusts and to the Chief Executive of Hampshire Partnership Trust. This area which represents the overlap of the acute and mental health services can be neglected. We found a number of deficiencies which need attention to be rectified. Again this is an area where monitoring and follow up is required.

Community Services

The Trust now has a complicated network of community services in place and the Forum is particularly concerned to establish that these are both comprehensive and effective. The Director of Adult Services for mental health shared with the Forum her views on assessing the efficient working of the service. The Forum was particularly concerned that such an assessment should not be based on `inputs' (caseload, referrals, etc) but should evaluate the real experience of users and carers. This is a complex area and will require considerable attention. The Forum would see it as a significant priority for the future.

Philosophy of Care

Both nationally and locally (Hampshire County Council), an ever increasing emphasis is being placed on the `consumer' as the focus of care. The process of tailoring care and treatment services to meet the needs of individuals - rather than grouping `patients' together in diagnostic categories or as geographical companions - is a constant theme in public pronouncements.

For a county-wide specialist Trust such as HPT, this represents a major challenge. Its services are organised in clinical groupings with age and diagnosis as the key criterion. Those services are complex in arrangement and administration, often operating over widespread `patches' and, always, subject to budgetary restraints. While many practitioners wish to put the user's needs at the centre of the care contract, all too often the prevailing patterns of services militate against this. The Forum has seen this recently in its examination of services for the older patients, in the transition problems for patients with autism and Aspergers from child to adult services and in difficulties in obtaining specialist care for mentally ill patients in A & E Departments.

If this much trumpeted reorientation is to be anything more that windy rhetoric, HPT - and the other Trusts - are facing a reappraisal and redefinition of the relationship between themselves as providers and the users and carers as their customers (in a real sense). Decision making and resource allocation will need to be focused to a truly local level. Real choice for users and carers will have major repercussions for care professionals and their managers.

How the Trust approaches this new agenda should be at the centre of its deliberations over the immediate future - and should be the focus of a crucial, and critical, dialogues with the new LINks body.

Conclusion

The HPT Forum would like to take this opportunity to highlight that the voice of people living with a learning disability or experiencing mental health difficulties or a dementia may well get lost amongst the comments, needs and views of other service users better able to make their voices heard. Representing some of the most vulnerable members of society, the Forum strongly urges the new LINk's in Hampshire to ensure that HPT service users and carers views and comments are specifically elicited and that the absence of any dissenting views from this client group does not necessarily represent positive feedback about services.

As a final comment, the Forum notes that the decision to end Forums was taken just as members were developing their knowledge and expertise in this area. The processes for involving patients and the public have now been re-designed. It is to be hoped that the new LINks will prove effective in dealing with issues that cross the health and social care divide, and thereby offer greater opportunities to ensure that these services are responsive to people's needs.

With regard to mental health services there are significant facets of work that require close public scrutiny and the Forum earnestly recommends to its successor bodies this report which summarises our involvement and our unfinished business which must form part of their inheritance

The attached Appendix gives a brief summary of outstanding issues

Ongoing work that requires action by the LINk interim group

Unit or Issue involved	Action required	Who involved
Philosophy of care	Discussion should take place about the reorientation of care to place users and carers first and to ensure that real choice is offered in a consistent and meaningful way.	Hampshire Partnership Trust, Hampshire Primary Care Trust and Hampshire County Council.
LBHUs in South West Hampshire	Monitor any delays to the scheduled progress on re-providing this service	Hampshire Partnership Trust and Hampshire County Council
LBHUs in South East Hampshire	There is a need to ensure that real progress takes place. Some pressure needs to be maintained on those who are involved.	Hampshire Partnership Trust and Hampshire County Council
Mind the Gap - transition problems for young people crossing to the care of adult services	This matter needs to be followed vigorously	Hampshire Primary Care Trust and Hampshire County Council
A&E report	Consideration of recommendation and monitoring of the results and responses that stem from the report	Acute Hospital Trusts, Hampshire Partnership Trust and Primary Care Trust
OPMH services - proposals to re-provide services at the Andover site.	The Trust must consult in a way that offer real alternatives and allows the comments and views of the service users and carers to be meaningfully expressed and their comments taken into account.	Hampshire Partnership Trust
OPMHS - Care in the community	The adequacy of the supportiveness of the services provided to the carers and the services users must be assured and specific proposals from the Forum seminars	Hampshire Partnership Trust
Community Services	There is a need to review the effectiveness of the services that are provided and evaluate the experience of users and carers	Hampshire Partnership Trust
Hospital units	Visits by informed outsiders should continue to monitor standards.	Hampshire Partnership Trust

March 2008 ck

Commission for Patient and Public Involvement in Health

PATIENT AND PUBLIC INVOLVEMENT FORUM ANNUAL REPORT - 2007/2008

1 April 2007 - 31 March 2008

Forum Name: Winchester & Eastleigh Healthcare

Forum Support Organisation: Help and Care

CPPIH Regional Centre: Guildford

CURRENT FORUM MEMBERS:

Please list the names of the Forum members, identifying the Chair and Deputy Chair(s) if applicable, one member per line. [In those exceptional circumstances where it has been agreed with the CPPIH that a Forum Member's name can be withheld please note the number of names withheld]

Shirley Kenneally Chair

Jean Pushman Vice Chair

Alexander Gourlay Vice Chair

Dennis Pearce

Marjory French

Paul Harrison

Roger Langridge

Our thanks to former members who have resigned in this year

Lawrence Hanney

ACHIEVEMENTS OF THE FORUM -

Please give two or three specific examples of the impact the Forum have had this year on health. Please also categorise each impact in terms of the health issue it relates.

Achievements (describe the outcome and how it was achieved by the Forum )		Please categorise each Impact.
Andover War Memorial Hospital Having a Forum Member on the Trust's Project Board helped to keep the development plans in the public arena and raised its status by keeping the issues in the forefront at Forum Meetings in Public in Andover. In addition, it helped raise the profile of transport problems for local people travelling to Winchester from Andover.	· People of Andover have been engaged and a more acceptable plan is being pursued. · Some general anaesthetics have returned to Andover · Patient services locally have improved. · A bus service is to be laid on between Andover and Winchester
Impact 2 Working with Minority Ethnic Groups Meetings were held with local BME groups identifying some of the distinct needs within the NHS of this growing population and passing this information on to WEHT for action.	· Confirmation that chapel is available to all faiths, Korans are available in the chapel and on wards and a link created with the Hospital Chaplain. · Confirmation that Trust recognises the need for female doctors for female patients in some cultures (which is not always possible in emergency situations). · Working towards improved access to literature in other languages. · Improvements in meeting the needs of a hard to reach group.
Impact 3 Visiting Programme Visiting wards and departments that have become subject to changes	· Kept Trust aware of the views of patients and visitors and the effects of said changes on patient care · Forum Members became better informed.

ACTIVITY 2007 - 08

Please summarise the key activities of the Forum in the period 1 April 2007 to 31 March 2008. Include any results of that activity. Please also include any arrangements you have made to obtain the views of patients and the public

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Monitoring/Review of NHS Services Formal and informal visits to RHCH and AWMH	Visits to wards and units were made in accordance with an agreed visiting schedule. Visiting reports are prepared containing recommendations for improvement which are then sent to the Chief Executive of the Trust.	The visiting schedule is approved at meetings in public, comments from members of the public influence the choice of units visited. In addition to monitoring the facilities, visits involve discussion with patients, relatives and staff to identify complaints and compliments. Complainants are signposted appropriately Visiting reports with patients' comments, with formal responses from the Trust and follow up action or recommendations were taken at meetings in public and are in the public domain. Experiences from visits were used when talking to groups out in the community.	Improved understanding by Forum members of the services being provided who are able to raise more informed questions and concerns when representing the views of patients and the public at key committees they attend. Members also feel better able to address the public when seeking their views. Recommendations on the visiting reports are taken on board by the Managing Director of Nursing. Subsequent visits are set to follow up on what action has been taken.

Activity Name ( e.g's Appendix B)	Description		Patient & Public Involvement	Result
Attending key committees and working parties		Members of the Forum represent it at the following meetings of the Trust: · WEHT Trust Board · Andover War Memorial Hospital Service and Site Reconfiguration Project Board · WEHT Single Equality Committee (formerly Disability Discrimination Act (DDA) Steering Group) · Integrated Healthcare Governance (including NCRS and computer systems) · Patient Environment Action Group (PEAG) · WEHT Patient & Public Involvement & Complaints Committee · Coronary Heart Disease Local Implementation Team · National Standards of Cleanliness Group	Written reports were made by Members for the Forum and made available at meetings in public. Issues identified by members on these key committees can be drawn to the public's attention at the Forum's meetings in public and to the attention of the Trust e.g. Members noted the loss of focus on the issue of DDA within the Trust and were able to raise the significance of this group and its issues within the Trust. Attendance has enabled the Forum to be up to date on the plans to reconfigure the AWMH and hear the views of local users who also sit on the Project Board. Forum members have also participated in patient experience groups to offer advice and comments on the design of service from a patient perspective.	Members are better informed about issues affecting the Trust and local health services. The DDA has regained status, an appropriate Executive has taken the lead and intranet web as a training tool for staff has been prioritised as urgent. The guest speakers at meetings in public have enabled local people to be given updated information of concern to them. Members have been invited to comment on the development of Trust policy and strategy documents

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Keeping a watching brief to see how the Trust is carrying out its Section 11 duties	Forum members have an extensive network of information that is useful in identifying where there might be failures in the engagement and involvement processes of the Trust.	Comments received from patients and the public during visits to the units of the hospital highlight issues of concern. Comments are also sought from local groups with whom the Forum has contact	The Forum is pleased to note that the Trust's concern to balance the budget of the Trust has not hampered the Trust's involvement with patients and the public.
	Trust Foundation Status bid	The Forum has monitored the development and plans of the Trust to seek Foundation status in the near future	The Forum has offered comments in the development of this initiative.

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Other work relating to NHS services	The Forum members have become involved with a range of other NHS services when cross boundary issues have been involved. Similarly the Forum has progressed issues of concern to other groups, with the WEHT. A joint visit was undertaken to the A&E department with the PPI Forum (Hampshire Partnership) to view the provision for patients with a mental illness who attend the service.	Relevant groups have been involved to find solutions to the problems that have been identified by other Forums and NHS Trusts Comments that are agreed at meetings in public are made available generally	The Forum has been able to develop a growing network of collaborators and has offered its help to other groups in a similar way
	National resources and reviews	The Forum has monitored the reviews and reports of national regulatory bodies to discover areas for review and monitoring	Improved services for patients.

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Work in partnership with non - NHS services	Work with Hampshire County Council regarding the proposals that have an impact on health matters eg Criteria for care in adult services and transportation The Forum has reflected the opinions and views of the patient and public across a wide range of consultations some of a national nature which have an impact on the quality of life and on the quality of health provision.	The Forum voiced its concern alongside the comments of other groups at a meeting organised by Community Action Hampshire. Views and comments are obtained from meetings in public and engagement with the public during hospital visits	HCC's withdrawal of its proposal to provide care only for those in "critical" need and not those in "substantial" need was welcomed, because of the affect it could have had on patients being discharged to their own home. Voluntary sector has set up a committee to work in partnership with HCC. These non- NHS organisations are able to make decisions that are both more informed and more reflective of the views of the patient and the public.

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Involving the public/ community A programme of giving talks has continued	The Forum has always sought to engage with and discover the views of local people. Regular meetings in public have been held with talks that address health matters of topical interest such as infection control The Forum has continued its engagement with BME groups in the area and has been able to relay to the Trust some of the special needs of these groups and feedback to them The Forum recorded all comments made at these meetings in public and other community engagement events that have been undertaken. The comments received have led to the monitoring of the Trust services. Comments are relayed to the Trust.	More involved groups are the result of these discussions. Reporting comments gathered to Trust management and following up to see whether any action has taken place. Questionnaires to understand the views of patients and the public were completed The Forum engaged with the public at community events at Colden Common, Botley and Eastleigh. Together with the local network group of Hampshire Primary Care Forum an information stand was held in a shopping area in the Andover area and comments were received from members of the public which were progressed appropriately.	We recognise that meeting with the public is an important aspect of our work. Views and concerns expressed by members of the public have been followed up where appropriate and have informed the Forum's Work Plan with its visiting schedule. The new Chief executive has invited the Forum to feedback any specific problems in some detail so that he might undertake to identify problem areas and find solutions Increased public awareness of the Forum and its role. Forum members are able to address common questions that concern the public. Views gathered are passed to the Trust Board which appears to have taken an interest and action taken when appropriate.

Activity Name ( e.g's Appendix B)	Description	Patient & Public Involvement	Result
Developing the Forum - training, promotion and recruitment	In addition to the training from the Commission. Members have attended training from other providers eg Healthcare Commission. Members have also been able to attend seminars with a health focus and also respond to consultations on health related issues	Members were able to introduce the views of patients and the public at an early stage in these discussions	More effective members, more engaged communities and more involved decisions

MEETINGS

[Please list the number of meetings the Forum has held either informal, meetings in public or public meetings].

Meetings	Number Held
Meetings held in public	7
Informal	5

DEVELOPMENT FUND

As you will be aware all Forums were able to submit proposals to access the Development Fund in support if the Forums work plan. If you have used this funding please describe how this has helped you to take forward your work plan.

Funding	What was achieved by using the funding
None was requested.

DECLARATION

On behalf of the Winchester & Eastleigh Healthcare PPI Forum, I confirm that the above is an accurate record of our recent activity and future work plans.

Signed: .....................................................................................

Name: Shirley Kenneally Date 20 March 2008

PPI FORUM FOR WEHT

Suggested issues to be taken forward by the Patient User Group to be discussed and agreed at its MiP on 20 March 2007

Issue	Action required
Lack of patient committee representation	There are presently no Trust committees that allow or facilitate the voice of patients and the public being heard.
Feeding policy	Copy of letter to Trust from RM
Outstanding responses to visiting reports.	Copies of letters to Trust from RM
Arrange visit to Victoria Ward	Note visit previously arranged did not take place.
Visits to be paid as and when issues are identified as with PPI Forum	Take note from complaints, media and reports from key committees and from issues brought to members' attention.
Staffing levels on wards	Review currently being undertaken referred to by Juliet Beal.
Policy on tackling problems with dementia /mentally ill and learning disabled patients.	Noting action referred to in Trust Board papers/action plan and comments by Juliet Beal at Hampshire Partnership PPIF Mtg. As above
Ethnic minority issues	SK to meet with Winchester Muslim Women's Group to follow up issues previously pursued.
Other issues taken up with the Trust?
Staff training	The Figure is 14 % of staff attend the training
The Therapy department is being shrunk to accommodate other depts. to enable closure of Butterfield Wing.	We thought forcing the Wheelchair Service to move into Therapy from its previous old house offsite in the grounds of Hilliers (house had been donated by Lady Hillier) was a bad move because it was already a crowded department with other disadvantages for Wheelchair Service ("old" members will remember the arguments) then they ought to see what is happening there now. I know we need to reduce the footprint but we still need to walk