You said, we did


Our engagement must always be meaningful.  We must be able to evidence how the involvement of patients and the public has led to real improvements in services and the health of local people. When planning our engagement, we always consider what impact people can have.  This section of our website is dedicated to feeding back to patients on the outcome of their involvement.  This is not the only way we feedback; we also have direct contact such as revisiting groups, emailing or calling people who have attended focus groups.

Here are just a few examples of how patient and public involvement has made a difference.

You said

When designing the Wilson Health and Wellbeing Campus, you need to go to people, rather than expecting them to come to you.

We did

Reached out to voluntary and community groups in the Mitcham and surrounding areas to seek thein feedback mon the development.

You said

The term "MSK" is not always understood by patients but is on the self-referral cards and letters. There is confusion by patients and GPs as to what the service offers.

We did

Self-Referral cards and posters are being reviewed to ensure that the language used is helpful for patients and to explain what the service can offer. These are being developed alongside the CCG with patient involvement.

You said

There is limited awareness of mental health services in Merton.

We did

Invested in the service to increase capacity and ran a campaign to promote the service. The campaign reached more than 30,000 people through Facebook advertising. 

‘You said we did’ feedback 

Commissioning intentions 2018/19

Connect Care – musculoskeletal services

Connect Care took on board feedback from PEG members (during their May 2018 session) and made significant changes to their service. The below table gives an outline of the breadth of feedback and the action taken.

You saidWe Did
The Physiotherapy Waiting Room chairs at the Nelson Health Centre are low and a challenge to stand up from

Connect Care have ordered chairs for the waiting area to replace the current seating

Exercises are like those given by the GP which are given over the phone by physiotherapists.  The exercise sheets given are basic and unclear.

Connect Care have recently invested in a new patient facing exercise and education software.

This allows patients to access videos of exercises and educational resources online or via an app on their mobile phoneswww.physitrack.com

Patients now receive these minutes after their consultations (phone or face to face).

It is unclear whether more appointments can be booked and it is difficult to book face to face appointment via physio line.

 

Would prefer 1:1 face to face physiotherapy rather than groups.

  • Clinicians have recently had training on communication to help improve their explanation to the patients during Physio line assessments.
  • Connect Care are reviewing letters and patient information to ensure this is 100% clear.
  • A patient opt-in process has been introduced which allows patients to call and make an appointment within 28 days of their last appointment
  • Patient choice means people can choose home exercise, 1:1 physio sessions, the groups or sign posting to local gyms/ exercise classes.
The term MSK is not always understood by patients but is on the self-referral cards and letters. There is confusion by patients and GPs as to what the service offers.
  • The self-referral cards and posters are being reviewed to ensure that the language used is helpful for patients and to explain what service they can offer. These are being developed alongside the CCG, with patient involvement.
  • Patient information leaflets have been updated. The leaflets aim to explain the service and has been shared with all Merton GP practices. They are available at clinics and will be on the Connect website.
  • Patient feedback will be sought on the self-Referral cards, posters and Patient Information Leaflets before they are finalised and sent to GP practices.
  • Self-referral cards will be available in large print and possibly braille
  • Connect Care will be visiting GP practices on a regular basis to update GPs, answer any queries and obtain feedback on the service.
Complaints cards for patients to take away was suggested
  • We have developed complaint cards which are available at our clinical sites for patients to take.
  • Posters are available in all clinics and there is information and links on the Connect Website which gives detail on how patients can raise concerns and complaints
  • Patients who log a formal complaint will be invited to attend their service user groups within our response letter
How does Connect Care consider disabilities within their policies?
  • The patient access policy and patient privacy and dignity policy ensures fair and equitable access for all patients.
  • Connect are currently working with the CCG to review the access to the service and what changes and improvements can be made in line with the Equality Act (2010)
There is poor access for patients with Learning Disabilities (LD). It is suggested that Connect Care contacts the learning disability specialist for Merton.
  • There are plans to change the access policy for patients into the service to incorporate self-referral.
  • Connect Care have met with the learning disability Physiotherapist to discuss ways to improve links between the two services.
  • Clinicians attended a training session, led by the learning disability service to increasing the awareness of the service and how physiotherapists can refer to this service
  • Merton Vision led a training session with staff in August 2018 which was extremely useful. The training focused on communication skills and strategies to support patients within the service
Access to the Physiotherapy service is poor for patients with communication difficulties.
  • This is a service development project for 2018/19 which will be looking at improving the access to the physiotherapy service for all patients.
  • Review of the self-referral process including inclusion and exclusion criteria is in progress. This will include options for patients who previously required a GP referral to refer directly into the service.
  • Redesign of patient literature such as self-referral cards and Information Leaflets to ensure they are clear and informative. larger print, braille and other languages are being investigated.
  • Connect Health's website will have patient information available in different languages and audio and there is consideration of the use of interpreting services
The patients suggested that there was a gap in the service for patients who required long term physiotherapy input and suggested that we run classes for these patients on a permanent basis
  • As with all long-term health conditions healthcare professionals focus on supporting patients to self-manage their conditions as quickly as possible. If patients need further support, they can self-refer to the service. This means support can provided at the right time as and when required.

 

Wilson design brief feedback


Please click here to view the community feedback report.

Merton Autism Strategy


Following the Merton Autism Strategy engagement activities, Information was used to update and finalise the Autism Strategy and action plan which was published in August 2018. "You said, we did" information is included below.

You saidWe did
There is a need to strengthen accountability for the actions proposed and clarify those actions which are priorities. The phrase 'long-term goal' was ambiguous.

The full action plan, which includes specific actions required to deliver our aims will be published. This includes timescales for delivery and the team's responsible for each action.

We have separated the 'how will we get there' sections into action which will be delivered in the first year, and those which will delivered within 5 years.

The theme on training and raising awareness of autism is the most important themeTraining and raising awareness has been moved to theme 1
Diagnosis takes too long and the current pathway is not NICE compliant

All comments relating to the diagnostic pathway for 0-18 year olds have been fed back to our colleagues who are re-designing the pathway.

The action plan now includes:

  • Develop 5 Year milestones plan for achieving NICE guidelines compliance.
There is a lack of post-diagnostic support for adults following a diagnosis of autism

The action plan now includes :

  • Engage staff and clients of adult services to explore options for post-diagnostic support
Increasing autism-friendly social activities is a priorityLondon Borough of Merton are supporting the voluntary sector to seek funding to support this action
Increasing life-skills training for young people with autism is a priority.

The action plan now includes: 

  • Work with schools, libraries and adult education to explore their potential for providing more life skills training for young people with autism e.g. interview training, extended work experience opportunities, financial management training and cooking classes.
There is a lack of parenting programmes available, particularly for those with children over the age of 8.As part of the development of the CYP 0-19 assessment, diagnosis and support pathway, we will work with partners to identify resources to increase the availability of parenting programmes on offer in the borough-particularly for those with children over 8 years old.
Autism awareness training should be mandatory for all London Borough of Merton staff

We are exploring how best to deliver autism awareness training to all council staff as part of mandatory induction training.

The action plan includes;

  • Work towards all NHS and Merton Council staff undertaking autism awareness training as part of general induction and equality training.

 

Community Ophthalmology


Following the focus groups in Merton and Wandsworth in October 2018, feedback has been shared with commissioners to update the service specification. Specific changes because of patient feedback have included:

  • The inclusion of Domiciliary Care for housebound patients
  • The Minor Eye Conditions, Cataracts and Glaucoma service will also be available on weekends to improve accessibility
  • Appropriate service user representation will be part of the procurement, to provide feedback, input and support with selecting a new provider
  • There will be training and accreditation for those providing the service so that they can give appropriate signposting and advice, even if they are not able to treat the patient themselves.

Improving Access to Psychological Therapies


Feedback received has informed the updated service specification. Specific updates have included making sure:

  • The new providers establish a service user group
  • Carers' support and Carers' assessments are included
  • There is partnership working with the voluntary sector
  • There is consistency across all three service specifications, for example the number of days from receipt of referral when patients will be contacted
  • There is a description of a single point of access/referral-assessment hub

During the process of evaluating bids for a new provider, the Chair of the Merton Mental Health Forum and the Chair of the Patient Engagement Group were involved in assessing bids and ultimately selecting the new provider.

In response to feedback about lack of awareness around the current services and waiting times, the CCG has invested to increase the size of the Merton IAPT service through expanding the capacity of the existing service and introducing two new ones. The CCG has urgently promoted the range of services available to the people of Merton to increase uptake.

The new services are:

  • Ieso Digital Health - one-to-one online therapy. Patients can self-refer online or over the phone.
  • Big White Wall - CBT and Counselling sessions - delivered by typing, audio only or via secure webcam. Available via GP referral

As a result of the awareness raising campaign, we reached more than 30,000 people through Facebook advertising, which resulted in 734 clicks through to information about the service. We also distributed 4000 leaflets and are awaiting statistics about the impact the campaign has had on referral rates to the service.