Below are some examples of how we have previously engaged with the public, patients and carers.
The Armed Forces Covenant is a promise by the nation ensuring that those who serve or who have served in the armed forces, and their families, are treated fairly.
The Northamptonshire Armed Forces Covenant Partnership, which includes Nene CCG, commissioned Healthwatch Northamptonshire to find out more about the health and social care needs of the Armed Forces community. This includes people serving as regulars or reservists, volunteers, ex-forces members (veterans) and family members of past and present service personnel.
More than 450 people took part in the survey in 2018 and a report on the findings has been published.
The report recommendations call for a greater awareness of the Armed Forces Covenant amongst health professionals in the county, more timely access to suitable mental health support, and further preparation for civilian life when people leave the armed forces.
The survey data is now being formally analysed by the University of Northampton. However, the Northamptonshire Armed Forces Covenant Partnership is responding to the report recommendations, as outlined below.
- Awareness of the Covenant. All partners on the Covenant Board, including Nene CCG, are working hard on awareness and training, although it is recognised that this commitment needs to be extended more widely. Keeping the issue high on the agenda will help to ensure that our Armed Forces community do not slip through the net. Active work has only begun in the last two years, with the aim of embedding it throughout mainstream NHS services.
- Mental Health. NHS England, through Ministry of Defence funding, have commissioned a new national Veterans Mental Health service. This is fully supported by Nene CCG and the local Covenant Partnership Board. It will help serving personal through transition into civilian life, in addition to our current veteran population, with specific and timely support for all types of mental health issues.
- Transition into Civilian Life. Nene CCG and other partners are committed to working with the transition team within the Ministry of Defence, so that individuals can be directed to the support available. We recognise the importance of ensuring that those being medically discharged or who leave early for some other reason do not slip through the net.
The CCG undertakes a programme of tailored engagement activity with our Armed Forces community. This includes working with partners such as the British Legion and SSAFA charities, attending events like Armed Forces Day and veteran tea dances, and arranging focus groups. Nene CCG has been awarded the Ministry of Defence’s Silver Award, as an employer committed to the Armed Forces Covenant.
Nearly 10,000 Northamptonshire children are estimated to have a mental health issue. Half of all mental health problems experienced by individuals begin by the age of 14, and these can continue into adulthood if not addressed. Poor mental health can also lead to poor physical health.
In Spring 2018, Young Healthwatch Northamptonshire was asked by the Northamptonshire Health and Care Partnership, which includes Nene CCG, to gather young people’s views on local mental health services.
To do this they devised a survey to ask young people across the county about their emotional wellbeing and access to services – specifically their frustrations and what services they would like to support them.
749 young people aged 11-19 responded, including 45 who identified as being a ‘young person in care’ and 71 who said they looked after someone with an illness or disability (carers). The resulting report produced some key recommendations:
- The development of a self-help service to enable young people to access support when needed – co-designed with young people to ensure it meets their needs
- More, or more specialised, mental health support in schools and colleges to enable young people to access support in an environment that suits them
- An assessment of the waiting times for wellbeing services for young people (especially Child and Adolescent Mental Health Services), and finding ways to improve them
- Continuing to ensure that the voice of young people is heard in decision-making, and in the design of youth mental health and emotional wellbeing services
The main themes identified in the survey are addressed in Northamptonshire’s refreshed Children and Young People’s Local Transformation Plan for mental health services, of which Nene CCG is partner.
The plan outlines the intention to strengthen how CAMHS supports other services with an Early Intervention Model, which aims to contribute to the creation of mentally healthy communities in Northamptonshire. This is in line with the aspirations and recommendations of the national Five Year Forward View for Mental Health and Future in Mind.
There will be a range of direct work undertaken with children, families and carers, plus indirect interventions to reduce stigma, build resilience, increase knowledge and improve understanding and early identification of mental health difficulties.
These interventions will take place in the different settings in which children find themselves:
- For young children, this includes Children's Centres and primary schools
- For older children, this includes secondary schools, GP practices, online or through virtual communities and platforms
- For those with additional needs, the ‘communities’ might include Children's Services, Youth Offending Teams or schools specialising in addressing social, emotional and mental health needs
This year to support our local Winter Campaign Nene CCG had the opportunity to do something slightly different.
The project, funded by NHS England was inspired by the following account from a local member of the community:
‘I have been entitled to the flu jab for a while now but I have never taken up the opportunity to have it, I didn’t feel like I needed it. This year things have changed, I have a granddaughter who was born prematurely and as a result has a lung condition.
For the first time this year, I will be having my flu jab, not just for my own health but also to protect my granddaughter’s health. #ImDoingItFor my Granddaughter’
- Mr A, a very proud Granddad
Working with the local Northamptonshire Singing 4 Breathing choir and Chris Startup a local music professional, the Clinical Commissioning Groups produced a promotional video using a song written by Chris and performed by the choir specifically for the project.
The local Signing 4 Breathing choir was set up by James Wyatt an Occupational therapist from Northampton to help people diagnosed with Chronic Obstructive Pulmonary Disease (COPD). COPD causes long-term damage to the lungs and people with the condition often experience chronic breathlessness. Singing 4 breathing has made a profound difference to local residents’ health thanks to the natural lung exercise singing can bring.
Flu can be dangerous for the most vulnerable members of our community. The aim of the campaign was to encourage those members of the community that were entitled to the flu vaccination to have it for themselves or to have it for members of the community like Mr. A’s granddaughter who features at the end of the video.
The choir, who were all eligible for a free jab due to respiratory conditions, became advocates for the flu jab and accompanied CCG staff on the annual Winter Campaign roadshow to perform live at venues around the county whilst encouraging uptake.
People with a learning disability often have poorer physical and mental health than other people but this does not need to be the case. Nene and Corby CCGs engage with people with learning disabilities in a number of ways to improve the care they receive and their health.
Quality Checker Service
Quality Checkers work with local providers to improve the experience of healthcare and support for people with learning disabilities All Quality Checkers have a learning disability and experience of using local services. They actively engage with people with learning disabilities and will then advise us how NHS services could be made better for people with learning disabilities.
As a result of the service:
- People are meaningfully engaged in sharing their experiences of the support received
- Services receive feedback on the support they deliver and recommendations are made on how it can be improved
- Commissioners are advised of any gaps in services they need to consider
Longer Lives for People with Learning Disabilities Events
In February 2019, Corby and Nene CCGs organised two special events to educate and inform people with learning disabilities, their families, carers and support workers about health problems that are often missed or ignored. The aim was to help patients who are unwell to get the right help more quickly. You can find out more about these events by watching the short film below:
The Northamptonshire CCGs (Corby and Nene) are working to align local maternity services to the recommendations outlined in the NHS England Better Births report, to deliver improvements by 2021.
We needed to understand what our local mums, dads, partners and families felt worked well and what needed to improve. To do this, the CCGs appointed Healthwatch Northamptonshire to liaise with parents who had used maternity services in Northamptonshire. The key areas of focus were continuity of care, safety and the provision of clear and consistent information to support informed choices. A survey of more than 500 parents covered a pregnant women’s journey before, during and after giving birth. Mums were also asked about:
- The support they received relating to perinatal mental health conditions
- How local maternity services support breastfeeding
- How services support stop smoking and healthy eating during pregnancy.
The Healthwatch report formed the foundations for developing the Northamptonshire Local Maternity System transformation plan.
Partnership has been central to this process. The CCGs worked with Northamptonshire Healthcare Foundation Trust, Northampton General Hospital and Kettering General Hospital to run two local Whose Shoes? workshops in 2018.
These events were well attended by both parents of young children and clinicians working in maternity services, such as midwives and heads of midwifery services. They were facilitated through a fun interactive board game, to cover key questions and encourage debate in a relaxed environment.
Feedback was gathered from those who attended. 100% of service users who attended were supportive, while clinicians said the workshops had influenced their thoughts on doing things differently in future.
Recruitment for the Northamptonshire Maternity Voices Partnership (MVP) was also promoted at the workshops. The MVP is a local volunteer group made up of mums who have used maternity services in Northamptonshire. Their role is viewed as critical to developing a genuine change in the services.
Through this ongoing forum we can enable women and their families from all backgrounds, ages and ethnicities to share their views with us, and work with us to co-produce services and plan and monitor service improvements.
In 2018 Nene CCG ratified changes to the local acute care pathway for stroke patients, under proposals developed through the Northamptonshire Health and Care Partnership:
- All hyper-acute and acute stroke services to be based at Northampton General Hospital (NGH)
- All acute rehabilitation to be in Northampton, rather than split between NGH and Kettering General Hospital (KGH)
- KGH to continue providing outpatient follow-up care and treatment for Transient Ischemic Attack (very minor strokes)
- 12 community stroke beds at Isebrook Hospital, with the Community Stroke Team continuing to provide home-base care and rehabilitation across the county
The changes were implemented to ensure everyone in Northamptonshire has access to the same high quality standards of care, improve the sustainability of services, and bring care closer to patients’ homes when it is safer and more effective to do so.
The views of patients, carers and other key stakeholders (such as GPs and HealthWatch) were sought through an extensive programme of engagement lasting several months. This included input from public representatives in Nene CCG’s governance structure. The engagement confirmed general support for the changes before they were formally considered and adopted.
The high-quality hospital care people receive in Northamptonshire after suffering a stroke is already showing evidence of getting even better after this new way working was introduced earlier this year. More information can be found on the Northamptonshire Care and Partnership website.
Informed by input from mums, Corby and Nene CCGs worked with Northamptonshire Healthcare NHS Foundation Trust (NHFT) to bid for funding to develop a community specialist perinatal mental health service for women at risk of, or experiencing, severe mental health conditions during pregnancy and the first year following delivery.
The bid was successful. As part of the service design, women who have experienced severe mental illness during their pregnancy or following the birth of their child are involved to ensure the service has a "Think Family" approach, with the best interests of women and her infant at the heart of the service.
Working together, the CCGs and NHFT have recruited a multidisciplinary team to deliver a comprehensive Perinatal Mental Health Service for hundreds of women by:
- Intervening earlier at pre-conception, during pregnancy and up to 1 year following delivery
- Delivering on-going training of professionals from across children’s’ and maternity services
- Improving the experience, pathways and processes for mothers, their families and professionals
In December 2018 mothers posted the following feedback about the Northamptonshire service on iWantGreatCare:
- "Amazing experience where I feel comfortable and safe to discuss any issues I am experiencing. Also to meet people who are going through something similar to me makes me feel ‘normal’ and less isolated."
- "The whole team are fantastic a breath of fresh air and helped me see light at the end of the tunnel"
- "The care I have received has been outstanding, from all the professionals along my journey. Rebecca has supported me weekly and has been there at the end of the phone if I've needed her. Throughout, I have been treated with complete respect and dignity and involved in all decisions about my care. I was concerned that I was now in a 'system' but Rebecca has answered all my questions."