Annual report 2019-2020 - healthwatchtowerhamlets.co.uk · care system so health outcomes meet your...

Annual report 2019-20

Guided by you

Contents

Executive Summary 3

Message from our Co Chair 4

Our priorities 5

About us 6

Highlights from our year 8

How we’ve made a difference 10

What would you do 11

Making your voice heard 13

Urgent Care 15

Sexual Health 17

Young Influencers 19

Helping you find the answers 20

Our volunteers 24

Our finances 27

Our plans for next year 29

Thank you 31

Contact us 32

Guided by you | Healthwatch Tower Hamlets 2

Over 7,000 local people shared their experience of health and social care services. We used these to complete 17 reports; making 127 recommendations for service improvement across maternity, children's, adults and older peoples services.

We fed the resident voice into the NHS LongtermPlan and supported the development of resident designed outcomes to measure local health and care providers.


We prioritised work into understanding why accessing healthcare can be so difficult for local people and how it could be improved. Our work on digital access has been used extensively to inform new ways of working as Covid has drastically changed face to face consultations.

We continue to provide advice on how these changes may impact on different groups within our community.

We have provided the only source of real time feedback from local residents of their experience Covid 19. We will continue to use this information to improve service design now and in the future.

You can find all of our reports here https://www.healthwatchtowerhamlets.co.uk/our-work/documents/

Sexual health

What next?

Urgent Care

Executive Summary Community insights

Our user insights on sexual health led to improvements in information, administration privacy, test result access and the Gynaecology Ward lay out at the Royal London.

Our Young Influencers helped co-design a mental health in schools programme and a dedicated young peoples GP service.

Young people

https://www.healthwatchtowerhamlets.co.uk/our-work/documents/

Message from our chair

Because of our work with GPs and the hospital to increase and

improve access by phone and video we think we are in a better

position in Tower Hamlets to adapt to new approaches to care.

We will be asking local people what the impact of these

changes are for them.

The professionals we work with have told us that we matter

and are making a difference to society. By personal experience

and observation, I think that we are a valued, effective and

relevant organisation which empowers the patients and the

public, through feedback, to have a direct impact and, thus,

change the care system for the better; a system which only

exists to serve the needs of the community.

By collecting the evidence and people's stories, we can show in

a clear and understandable way, a picture of how the

community is using the services that are provided to promote

their health and well-being. We all know the problems of living

in a deprived inner-city area but by working together we will

find answers for the difficult times that lie ahead.

I commend the report to you and hope our work will stand the

test of difficult times to come.

Thank you for supporting us.

David Burbidge

Healthwatch Co Chair


Listening to the voice of local people is even more important in this crisis if we are not going to leave people behind.

This year the world

turned upside down due

to a virus that caused

chaos, fear and death.

The response was, first

we must protect the

capacity of our health

care system, then search

out the virus and

eradicate it.

Our priorities


The ‘What would you do?’ report was really good because it set out the

principles that Healthwatch has always been good at which is not about

people coming to Healthwatch but Healthwatch going out to where people

are .’ Somen Banerjee Director of Public Health

Improving sexual health services by understanding users’ experiences.

Supporting young people to design health and care services to meet their needs.

What would you do – gathering local insights to influence neighbourhood, local, regional and national wellbeing improvement plans.

Making your voice heard by feeding your insights across the health and care system so health outcomes meet your needs.

Last year 3,594 people told us about the improvements that they would like to

see health and social care services make in 2019-20. These were our five

priorities for the year based on what you told us.

Improving urgent access to GP and A&E services.

About us

Here to make care betterThe network’s collaborative effort around the NHS Long Term Plan shows the power of the Healthwatch network in giving people who may find it hardest to be heard a chance to speak up.

The #WhatWouldYouDo campaign saw a national movement, engaging with people all over the country to see how the Long Term Plan should be implemented locally. Thanks to the thousands of views shared with Healthwatch, we were also able to highlight the issue of patient transport not being included in the NHS Long Term Plan review – sparking a national review of patient transport from NHS England.

We simply could not do this without the dedicated work and efforts from our staff and volunteers and, of course, we couldn’t have done it without you. Whether it’s working with your local Healthwatch to raise awareness of local issues, or sharing your views and experiences, I’d like to thank you all. It’s important that services continue to listen, so please do keep talking to your local Healthwatch. Let’s strive to make the NHS and social care services the best that they can be.


I’ve now been Chair of Healthwatch England for over a year and I’m extremely proud to see it go from strength to strength, highlighting the importance of listening to people’s views to decision makers at a national and local level. Sir Robert Francis, Healthwatch

England Chair

Our vision is simple That local people shape health and social care support to better meet their needs and the needs of their community.

Our aim To be the voice of local people within health and social care.

Our approach People’s views come first – especially those who find it hardest to be heard. We will identify problems and priorities based on community insights and work collaboratively and constructively with health and care partners to actively seek solutions.

How we find out what matters to youPeople are at the heart of everything we do. Our staff and volunteers identify what matters most to people by: • Visiting services to talk to users and see how they work• Running surveys and focus groups • Going out in the community and working with

other organisations


Find out more about us and the work we do

Website: www.healthwatchtowerhamlets.co.uk

Twitter: @HWTowerhamlets

Facebook: htps://www.facebook.co/Healthwatch-Tower-

Hamlets-436763663344717/


Highlights fromour yearFind out about our resources and the way we have engaged and

supported more people in 2019-20.

287 volunteershelping to carry out our work. In total, they gave up 1,080 number of hours.

We employed

5 staff60% of who were full time equivalent, which is a 10% increase from the previous year.

We received

£179,716 in funding from our local authority in 2019-20, this was the same asthe previous year.


Health and care that works for you

7,200 people shared their health and social care experience with us, almost 50% more than last year.

5,191 people accessed Healthwatch advice and information online or contacted us with questions about local support, five times more than last year.

20,057 people engaged with us through our website, 13,025 people engaged with us through social media, and 1,053 people engaged with us at community events.

We published

17 reports about the improvements people would like to see made in health and social care and, from this, we made 127 recommendations. You can find all of our reports here https://www.healthwatchtowerhamlets.co.uk/our-work/documents/

Reaching out

Making a difference to care

Providing support

https://www.healthwatchtowerhamlets.co.uk/our-work/documents/

How we’ve made a difference


What would you do

People told us they:

prefer to walk to stay healthy.

would like more services under the same roof as their GP.

would consider using an app to access their GP.

can find it difficult to get the information they need when they need it particularly when they are having mental health or chronic illness episodes.


Healthwatch did a fantastic job of pulling together a comprehensive analysis of the issues which mattered to local residents. There was a depth and breadth to this analysis which is not always the case in patient experience research which was very helpful. Insights from this work fed directly into the co-development of the Tower Hamlets Together Out of Hospital strategy.Dr Simon Munk, Consultants, Carnal Farrar

The NHS wanted patients to help them develop a Long Term Plan and Tower

Hamlets Health and Wellbeing Board wanted to know what would improve local

people’s wellbeing.

We talked to over six hundred people at local markets about what they would do to

improve their health and the health of their local community.


The ‘What would you do?’ report was really good because it set out the principles that Healthwatch has always been good at which is not about people coming to Healthwatch but Healthwatch going out to where people are - and that’s why they get really good engagement. They got over 300 people which means that when Healthwatch say something it’s got a weight behind it.Somen Banerjee, Director of Public Health

The What would you do ideas have led to:

better mental health, substance misuse, early years, homeless, young peoples and health and housing services.

a set of service measures for service providers designed by residents to meet their priorities.

better informed local, regional and national NHS planning with a focus on digital access and inequalities.

a greater focus on air pollution and active transport policies.

increased digital service access for those who want it.

Because we are able to better inform health and care providers of local needs and the outcomes that are important to residents, people are better supported to stay as healthy as possible and receive services that are more joined up at a local level.

Our reports have been considered by the Health and Wellbeing Board and the Tower Hamlets Together Partnership life course boards and help set the strategy and priorities for local health and care services. They are heavily referred to in NHS and Council plans and have established us as the key voice of local residents in terms of health and wellbeing in the Borough.

What next

We’re gathering the experience

of residents experience of Covid

19 to help the health and care

system respond to Covid,

support recovery planning and

inform the new normal.

Making your voice heard

Guided by you | Healthwatch Tower Hamlets

Our community insights system provides

the only local source of patient and user

experience data across all aspects of

health and care. With over 30,000

comments from a wide range of sources

including: surveys; case studies;

interviews; social media; and online, it

has allowed us to build a comprehensive

picture of user experience, identify gaps

and measure whether outcomes are being

achieved over time. It includes wider

health and wellbeing issues such as

housing and employment and can

be analysed according to demographics,

provider and conditions.

Our insights have helped improve:

GP access through understanding

demand for phone triage and online

services.

Hospital Outpatients by identifying

the need for better admin and

information.

understanding of the risks and

concerns of older people and how to

tackle them.

13

Healthwatch data is crucial to our GP quality improvement programme. It allows patient experience to be measured over time, across the care journey with reference to life course, demographics and equality groups. It is the only source of patient experience data we have immediate access to and enables us to have patient improvement as a key aspect of continual test and change. This offers a crucial narrative to inform our wider quantitative feedback, and is without doubt one of the sources of data we most value and trust. Virginia Patania Tower Hamlets CCG Board Member, WEL Board Member, GP Care Group Board member

To design good health and care services you need to know what it feels like to receive the service and how users think they could be improved. You especially need to hear from people who would not normally speak out. We’ve been working hard to bring a range of residents’ insights together in one place so that nobody designs services without community insights.

Local people’s feedback on GP services during the Covid

pandemic.


We are now recognised across the

Borough as the lead agency for the

provision of resident and patient centred

intelligence on health and wellbeing.

Local peoples’ views are included in the

needs’ assessments and plans developed

by Public Health, THT, CCG, WEL. They

feed into a broad range of strategies

across the Council including childrens,

transport, air pollution, liveable streets,

and physical activity and sport. They have

informed better health programmes for

young people, homeless and substance

misusers, local neighbourhoods, sexual

health, mental health, and women’s

services.

Healthwatch Co Chair and staff presenting at the Health and Wellbeing Board

Healthwatch have helped us form our Joint Strategic Needs Assessments (JSNA) that talk about what’s going on with specific health issues. Joanne Starkie Head of Strategy and Policy – Health, Adults and Community Services

What next

Greater community insights’ sharing

with partners feeding in their own

insights, accessing the insights data

themselves and agreeing where there

are gaps and working together to fill

them would greatly improve community

led design.

We have the most comprehensive set of

insights of people’s experience of Covid

19 and we will continue to feed the

voice of local people into the recovery

planning to ensure our health system is

the best it can be in the future.

We would like to:

see our evidence used to support

greater resident representation across

decision making bodies and stronger

community voice in the co-design and

production of services.

be able to work more effectively with

our neighbouring Healthwatch to

provide joined up community insights

at a regional level.

offer to manager other organisations’

community insights data.

Urgent care


From working on our GP access report we understood that people were struggling to

get appointments within what they felt was a reasonable timeframe. We wanted to

know more about what impact this was having on other parts of the urgent care system.

Their reports were balanced and gave praise where it was due while ensuring that the areas of poor patient experience were clearly set out with practical recommendations on how to improve them. Chris Banks, Chief ExecutiveTower Hamlets GP Care Group CIC

We tracked how people ended up in A&E and where

they were eventually seen.

We interviewed 197 patients at the

Royal London A&E and Urgent

Treatment Centre (UTC) and

analysed 283 comments

from websites our outreach

and Barts Complaints and

Compliments.

We learnt that:

Many patients appear to seek advice from a GP or 111 before accessing urgent care services.

Two thirds of patients seen in UTC and nearly a quarter seen in A&E would’ve preferred to have been seen at their GP surgery.

Over half of those seen in the UTC felt that they could have been seen in a Minor Injuries Unit.

Patients who accessed urgent care services feel well-supported in receiving the care they need. They trust that they are being treated by competent medical professionals, and believe they receive a high standard of medical care.

Patients are unhappy with the length of time they have to spend in A&E; while opinion of waiting times in the UTC is mixed.


Communication with medical

professionals can be poor in both

settings and, as a result, patients may

feel a lack of involvement in their

care.

A few A&E service users commented

upon insufficient staffing levels,

nurses being rushed or lacking

empathy and patients not receiving

pain relief when they needed it. Many

of the patients who gave negative

feedback related this to a belief that

staff are overworked and under too

much pressure.

We recommended that they:

Improve access to urgent GP-based

care including telephone and online

consultations.

Integrate minor injuries units into GP

hubs rather than referring or

signposting patients to the UTC.

Improve triage in GP surgeries.

Consider a single point of access e-

triage mechanism allowing patients

to book same-day GP appointments,

hub appointments or signpost

towards appropriate urgent care

services.

What impact did it have?

Our insights on patient flow enabled the

hospital and GPs to act quickly in the

Covid pandemic to increase phone triage

and online appointments. They had a

better understanding of what did and

didn’t work for particular patient groups

in relation to digital access. This may

also help prevent patients going to

alternative services such as GP at Hand

and prevent crucial resources being lost

to the Tower Hamlets care system.

We asked people where they would’ve liked to have been seen and based on their preferences

we mapped how an urgent care system might be managed..

Sexual Health


We spoke to 66 sexual health service

users and 72 gynaecology patients

identifying 382 comments.

We visited;

Sylvia Pankhurst Centre at Mile End

Hospital

St. Andrews Sexual Health Satellite

Gynaecology Outpatients, Emergency,

and Inpatient Ward

Ambrose King Centre

Sexual health recommendations:

Clarify services available from GP

versus Barts Health satellite clinics and

simplify the online booking system.

Inform and encourage patients to use

satellite clinics.

Make the termination process clear.

Undertake cervical screening alongside

contraception services.

Improve telephone services at

Ambrose King.

Develop a text-based system for test

results not requiring follow-up and

appointment reminders and locations.

Hospital gynaecology

recommendations:

Improve administration processes both

with patients and between

professionals and departments

Be clear who patients can ask for

information about their diagnosis,

condition and treatment.

Change the policy of using Ward 8C

for overflow and the emergency

gynaecology recovery and consultation

rooms for outlier beds.

Sexual health services were difficult to understand and navigate and we wanted to gather community insights to help re-design a more integrated service.


Avoid moving patients at night, if they

must be moved, limit the amount of

noise and disruption caused.

Ensure patients understand food

choices and they receive the food

they ordered.

Consider a Royal London Hospital App

providing patients information on how

wards function, food menus, link to

NHS information, entertainment,

library services etc. Volunteers to

support less digitally confident.

What difference did it make?

• They updated the East London sexual

health website with accurate

information.

• They plan to move to a centralised

call function with dedicated staff to

answer patient calls.

They introduced Inform Patient kiosks

and online registration to improve

patient confidentiality and give

patients the choice to self-book

in. Some reception areas are now

separate from the waiting areas.

Patients can now get results sent by

text message with an average three

day turnaround.

They opened eleven beds as winter

surge beds to reduce the need for

patients to be placed on Ward 8C and

protect day surgery and Emergency

Gynaecology.

Ward 8C is being remodelled as a

gynaecology and female abdominal

surgery ward to reduce the variance

in specialities cared for and to assist

in improving the quality of care for

patients and staff.

Healthwatch have been instrumental in getting us where we are with the commissioning of sexual health services. We have invested a lot of money and time improving the physical building of the sexual health services with a greater knowledge of what patients want. Chris Lovett, Deputy Director, Public Health.

Services for young people were being designed without their input and therefore were not necessarily catering to their particular needs. But it’s not easy to gain or retain their interest in the co-design process.


We developed the Young Influencers –

a group of young people who are

incentivised (through shopping

vouchers, work experience, training

and feedback on impact) and

supported to gather and represent the

views of young people. The young

people develop their own priorities and

run their own social media based

engagement programme.

In the past 12 months they have

worked with:

The Community Mental Health

Team to co-produce a mental

health in schools trailblazer

programme.

Healthy London Partnership and

the Born Well Growing Well THT

Board to co-produce an innovative

Young People’s Primary Care Hub.

Presented insights to Children and

Young People’s Board, THT Born

Well, Growing Well Partnership

Board and the Tower Hamlets

Together Board.

Their research has supported the

establishment of a young person

primary care hub in Tower Hamlets.

Young Influencers

What next

Young Influencers form a part of

every new health programme in the

borough – a sounding board for the

design and implementation of each

project, using our broad reach to

young people across the borough.

I’ve always aspired to be a doctor, so I’m finding being a young influencer and helping people I this stressful time a very valuable privilege. Mehrab

What young people thought should go in a Youth Hub

Helping you find the answers

Guided by you | Healthwatch [Insert local Healthwatch name] 20

Finding the right service can be worrying and stressful. Healthwatch

plays an important role in helping people to get the information they

need to take control of their health and care and find services that will

provide them with the right support.

This year we helped 184 people to get the advice and information they needed either by phone, email, or face to face in the office. Over twenty thousand people visited our website which provides signposting and information through an A-Z directory of services including feedback from other users.

Here are some of the areas that people asked about.


20%

21%

14%2%

34%

3%5%

Information Advocacy and ComplaintsHospitalMental HealthCommunity SupportGPs and Primary CareCommunity HealthcareSocial Care

Helping people to navigate care when life is difficult

Much of our advice and information work

has been dedicated to supporting people

with complicated lives who find it difficult

to navigate complex health and care

systems. They often suffer from mental

health, substance misuse and housing

problems and find it difficult to manage

their health alongside housing,

employment, benefits and caring for

others. It can be incredibly difficult and

often results in the breakdown of

relationships with the people who are

trying to help them. We plug them into the

right parts of the system and help them to

understand who to go to for help for all

aspects of their care.

It can also be difficult to navigate health

care if English is not your first language.

We worked with the Chinese Vietnamese

community through the Community of

Refugees from Vietnam, East London to

help their large membership better

understand how health and social care

services work and brought together a

range of service providers to meet with

them to understand what they do.


Community of Refugees from Vietnam, East London organised an event with nearly 90 first generation Vietnamese and Chinese Vietnamese people.


Contact us to get the information you need

If you have a query about a health or social care service, or need help with where you can go to access further support, get in touch. Don’t struggle alone. Healthwatch is here for you.


Telephone: 020 8223 8922Freephone: 0800 145 5343Email: [email protected]

GP Access

Richard had been in a dispute with his and

his mother’s GP Practice and following an

argument with a receptionist he was

removed from the practice. As a result of

not having a GP he wasn’t taking his

regular medications. Richard was upset

and frustrated about the lack of

communication from the system back to

him and called frequently angry and in

tears. We helped both him and his mother

register with another GP practice and put

them in contact with social services to

assess his mother’s care needs.

Mental Health Advice

We noticed a number of people were

phoning up to ask for information about

mental health services they could go to

for support whilst waiting for their follow

up appointment. We wanted to make it

easier for people to find this information

so created an easy flow chart on the

website to help people get the information

they need. Over 5,000 people have

viewed the mental health information on

our website during the year.

http://www.healthwatchtowerhamlets.co.uk/

mailto:[email protected]

Volunteers



At Healthwatch Tower Hamlets we are supported by over 70 volunteers to help us find out what people think is working, and what people would like to improve, to services in their communities.

This year our volunteers:

helped us to gather insights from over 600 local residents face to face at local street markets and the Idea Stores.

ran regular outreach stalls at the Royal London Hospital to gather patients views.

provided signposting and information at service providers and community events to make sure they are providing people with the right support.

helped support our day-to-day running.

listened to people’s experiences to help us know which areas we need to focus on.

Volunteer with us

Are you feeling inspired? We are always on the lookout for new volunteers. If you are interested in volunteering, please get in touch at Healthwatch Tower Hamlets.


Telephone: 0800 145 5343

Email: [email protected]

Women’s birth control

Thanks to a group of volunteers, women’s

contraception services in Tower Hamlets

are being designed with service users’

needs in mind.

Local university students went to talk to

Bangladeshi mothers about their

contraception needs at a series of school

coffee mornings. Through our sexual

health work we’d become concerned that

women were using termination because

they were not accessing effective

contraception advice.

Mothers gain a lot of their contraception

advice from talking to fiends and family.

They often find that the choices offered to

them at the GP are limited and there is

not much time to discuss side effects.

As mothers said post birth was a good

time to discuss birth control, we

suggested more information could be

provided by midwives and health visitors

who may have more time to discuss the

options. This may also be possible at the

baby clinics at GP Practices. This is now

happening.


Stephanie, Board member

I got involved with Healthwatch Tower

Hamlets when I retired and I wanted to

stay involved in improving the health of

my local community. Being on the Board

gives me the opportunity to use my skills

in a way that directly benefits local people

while at the same time stretching my own

learning and understanding.

Amrin, community researcher

Having the chance to directly interact with

residents to seek out how to help them

meet their needs is empowering. The

support offered by the Healthwatch Tower

Hamlets team is great, my individuality is

valued and encouraged when supporting

the community, and when raising

awareness about Healthwatch and its

services.

Afzal, Young influencer

I’ve been volunteering at Healthwatch

since August 2019 and have met many

new faces and made new friends.

Healthwatch exposed me and other young

influencers to a few problems in the

community that we were not aware of. It’s

been great to add some of our ideas to

help make sure that young people in

Tower Hamlets have positive experiences.

Our volunteersWe could not do what we do without the support of our amazing volunteers. Meet some of the team and hear what they get up to.

Having Healthwatch in our meetings and

people who use services has really

helped to change conversations and

roots them in reality. We might be

talking in quite technical terms and

Healthwatch helps us to think what does

that really mean for people on the

ground who need the support. Amy

Gibbs – Chair of Tower Hamlets

Together

Finances


We are funded by our local authority under the Health and Social Care

Act (2012). In 2019-20 we received £179,694.


36.0%

18.0%

18.0%

8.5%

10.5%

Delivering priority projcets

Building community insights

Engaging local residents

Signposting

Bringing about change

£179,694 Total expenditure

Each of the figures above includes an appropriate share of the charities overheads and office running costs.

All income received but not spent has been carried forward.

Our plans fornext year



We have built a strong evidence base of community insights that have allowed our local health and wellbeing partners to respond more rapidly and effectively to the Covid pandemic.

We’ve completed two reports on

community insights of Covid together

with more specific reports on: mental

health; GPs; hospitals; outpatients, and

digital access as well as reports on

vulnerable and Black, Asian and Minority

Ethnic groups.

We’ve presented our insights at the

Borough Pandemic Committee, the

Health and Wellbeing Board, Tower

Hamlets Together Board; Primary Care

Co-Commissioning Committee and the

Safe Guarding Adults Board and our

reports have been circulated and used

widely by partners.

Thank youThank you to everyone that has helped us put the voice of local people at the heart of decision making particularly:

All of the local people who shared their views and experience with us.

Our hard working Board Members.

All of our amazing staff and volunteers.

the voluntary organisations that have contributed to our work including Tower

Hamlets CVS and Almost Anyhow.

Thank you

Dianne Barham

Healthwatch Tower Hamlets CEO


Continue to speak authoritatively as the voice of local people on Covid 19 aiding a better recovery and informing long-term improvements.

Improve our Covid signposting and information and our feedback function by building strong links to Tower Hamlets Together directory of services.

Better understand the needs of mental health users in terms of faith, culture and community and their experience of Covid 19 to improve services.

Support our Young Influencers to understand the wider impact of Covid 19 on young people and how they can be helped to cope.

What nextWe want to:

Contact usHealthwatch Tower HamletsWheelchair CentreMile End Hospital275 Bancroft RoadLondon E1 4DG

Office number: 020 8223 8922Freephone number: 0800 145 5343

Email: [email protected]: www.healthwatchtowerhamlets.co.ukTweet us: @HWTowerhamletsLike us on Facebook: htps://www.facebook.co/Healthwatch-Tower-Hamlets-436763663344717/


We confirm that we are using the Healthwatch Trademark (which covers the logo and Healthwatch brand) when undertaking work on our statutory activities as covered by the licence agreement.

If you need this in an alternative format please contact us.

Company: 8786829Charity: 1158809© Copyright Healthwatch Tower Hamlets 2020

mailto:[email protected]

http://www.healthwatchtowerhamlets.co.uk/

Healthwatch Tower HamletsWheel ChaircentreMile End Hospital 275 Bancroft RoadLondonE1 3AG

www.healthwatchtowerhamlets.co.uk

t: 0800 145 5343

e: [email protected]

@HWTowerhamlets

Facebook.com/Healthwatch-Tower-Hamlets

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