Our Approach to Involving People and Communities starts with the principle, ‘Be accountable to our people and communities’ Accountability means that we are expected to uphold our commitment to involve, justify our actions or decisions and be responsible for them. This principle is one which is upheld by the ICB Board Members. As Director of Communications and Involvement I attend the Integrated Care Board (ICB) meetings and I think its really important that as the Board Members are making decisions, they are focussed on who we are here to serve.
So, I committed the ICB involvement team to capturing some reflective views from the many people and groups they talk to each month. We will now play these into the Board room at the start of each meeting to set the scene for discussions which will follow.
To get us started we kept it simple, asking Black Country people what they thought we did well as a local NHS and what we needed to improve.
I have come to expect local people to be really open, and they did not disappoint. Not everyone wanted to be on camera, which I totally understand, but they did talk to us and we played our first ‘Feet on the Street’ production to the September Board.
The table below summarises what people said, including the response from the Board Members.
|What we heard||
What we did / will do
|Long wait times for elective procedures||
We are currently reaching the target of having no one waiting over 104 weeks in the Black Country for elective care, however, we will make a continued effort to restore services and tackle waiting times. We will also continue to carry on the work that we are doing to address the issues related to staying well while waiting for a procedure.
We know that for those that are waiting for a procedure, it is important that they are given an indication of how long they might expect to wait, know how to raise questions about their procedure and receive timely information about how to stay healthy and manage their condition while waiting for their procedure. Evidence is clear that people who improve their health before elective procedures (even slightly) can have much better outcomes and recovery.
|Lack of access to interpretation services||We will understand what contracts are in place and ask providers to ensure their staff are aware of the services available to give timely access to interpreters, for those who need them.|
|Lack of digital access||
There is currently work happening to reduce the digital inequalities and to give people access to knowledge and advice to tackle this.
|Lack of access to GP appointments||
From Saturday 1 October, people in the Black Country will be able to book an appointment with their GP practice on evenings and weekends. Appointments will now be available between 6.30pm and 8.00pm Monday to Friday, and between 9.00am and 5.00pm on Saturdays.
This would not have been possible without the groups who supported us to have conversations with local people. I want to say thank you to those who have hosted us on a co-location days, and an even bigger thank you to those who took the time to express their views.
You can watch the Feet on the Street here
Look out for the next one in November.
Director of Communications and Involvement, NHS Black Country ICB
We visited West Bromwich YMCA in September alongside Just Straight Talk, a voluntary sector organisation who support vulnerable adults with a range of needs. Just Straight Talk invited individual service users to come and talk to us about their experiences with using the NHS.
Service users were very generous with their time and we heard some thought provoking stories, including:
- Mark, who was recently diagnosed with Parkinson’s disease and has become isolated due to regular falls and mobility challenges.
- Nathaniel, who lives with a number of health conditions including epilepsy and lymphoma, and has had difficulty accessing the support he needs.
- Terry, who shared his mixed experiences with mental health services.
- Mario, who is unable to work due to health issues and said he often has to go without food or heating in order to pay his rent.
Much of the feedback we received on the day was around access, including difficulty getting a GP appointment or repeat prescription, as well as long waits to see a specialist or get an assessment. People who have multiple or complex health needs told us they feel like “everything is a battle”, that they do not always feel taken seriously and sometimes even feel discriminated against. They agreed that better communication from professionals and easier access to advice would make a big difference to their experience.
Following this feedback, we invited Just Straight Talk to attend the Sandwell Health and Care Partnership board meeting on 15 November, when leaders from health and care organisations from across the borough were able to hear Mario's story directly and reflect on his experiences.
On 23 September, we had the pleasure of meeting the LGBT+ Sparkle social group to learn more about how they support the LGBT+ community. We first met the social group when co-producing our approach to working with people and communities, to ensure views of the LGBT+ community informed our approach. During the visit, we spoke to members of the social group and listened to their experiences of NHS services in the Black Country.
LGBT+ Sparkle was set up three years ago to provide support and friendship to the LGBT+ community in Wolverhampton and the surrounding area. The group works closely with local partners, including Healthwatch Wolverhampton, to signpost members to relevant services and provide members with a safe space to make new friends. Social events are often organised for members, including talks from local organisations.
Our involvement colleagues Meg, Erica, and Phil, spoke to six group members, and when discussing health services, they noted what matters most to them is being listened to and having more of an active role in their care.
Unfortunately, several group members shared negative experiences of local NHS services. In response, the team signposted those individuals to our customer service team, Time2Talk so that a resolution could be found and any lessons learned shared with service providers.
One of the reflections from the visit was the need to raise awareness of the Time2Talk team. This was raised with Time2Talk, and we are delighted that the team will be talking to the social group on Friday 18 November to share more information on their service.
Feedback and experiences from the visit have also been shared with our LGBT+ focus group. The focus group is part of the ICB’s Inclusion Network, working towards creating and maintaining a safe, inclusive, and equitable environment for LGBT+ staff. The focus group aims to sustain visibility and a sense of community throughout the organisation, as well as address barriers where they occur, both in the workplace and in work we commission.
If you would like to find out about the LGBT+ Sparkle social group, please contact lgbtqsparkle
During September we visited The Good Shepherd outreach and support for homeless people across the City of Wolverhampton.
We heard about their work which includes offering hot meals, delivering a food bank, cooking and a service user forum to support homeless people who often have complex issues. We learnt that some of the challenges that the homeless face with health services include, GP registration, it’s sometimes hard to get into Mental Health services and that some support is refused for drug users.
We will share this learning with Primary Care Commissioners and the Local Commissioning Board
October was a busy month for the ICB involvement team. A very satisfying sort of busy.
For those of us working in community involvement jobs, the pandemic meant many changes to the way in which we were used to meeting, listening and communicating with the public. For many, it meant interactions took place largely through screens and that, inherently, stifled relationships. That’s not to say that new connections weren’t made… on the contrary. But I suspect a feature in the day of all those slowly returning to the workplace is the feeling, at least once a day, that you know, or have met, the person you just passed in the corridor or smiled at whilst making a cup of tea. Only now are we putting lower limbs to virtual faces and realising that ‘Brendan’ or ‘Raj’ is in fact, much taller than you’d imagined.
So now more than ever, we recognise that ‘one size doesn’t fit all’ and that we must always ’start with people and communities’ (these are two principles from our Involving People & Communities Approach), if we are to create healthier, happier futures for residents of the Black Country.
It was great to welcome two new additions to the involvement team in October – Erica Pearce joined as the Lead in Dudley and Anna Butters as Lead in Wolverhampton. And with the two newbies inducted, excitedly, the whole team headed out into neighbourhoods and communities across the Black Country meeting, listening and learning from the people we met and the groups we spent time with.
We were warmly hosted by the likes of Walsall Refugee and Migrant Centre where we heard stories and experiences of those who’ve resettled in the UK, their first language isn’t English and the complications they face accessing health and care. Autism West Midlands invited Natalie, our Walsall Lead, to spend a few hours with the team and some people who access their support, and she learned all about the hidden disabilities’ sunflower, a globally recognised symbol for non-visible disabilities. Insight and information which we’ll be sharing with colleagues and decision makers across the ICB.
We hosted 2 more People Panels in the style of world café workshops where we invited people to come together and respond to the question ‘What does it really mean to start with people and genuinely work together to build healthy communities? How do we create the conditions for it to happen?’ More than 100 people joined and contributed to the Cafes at community venues across the Black Country.
A small group of hosts and participants have reconvened to harvest and reflect on the conversations heard, make sense of the insight shared, deeper questions for future conversation and actionable intelligence which we might co-design solutions to. The major themes arising from the Café’s were ‘access’, communication’, ‘digital’, ‘empowerment’, ‘funding’, ‘inequalities and social injustice’ and ‘lack of knowledge/education/training’. Some of these themes were recognised as barriers to building healthy communities together, some as enablers, some as both. In quick response, we’ve convened a group to explore the full meaning of the ‘communications’ theme and co-design scalable solutions. We’ll be inviting Café participants to access and share details of digital device loan scheme called Black Country Connected. And senior leaders and decision makers have been primed for participation at future People Panels as participants felt it was important for them to ‘listen to understand’ and bring people and communities closer to decision making.
The Café’s were an exciting snapshot of what’s really possible when we think about how residents, front line staff and decision makers can come together as equals to share, learn and tackle issues. The 2 People Panels in October, as well the 2 we hosted in September, showed us all how a new dialogue is needed and welcomed and how conversation can be ‘health creating’ as well as guiding us toward more meaningful, sustainable solutions. We’re looking forward to exploring how we might nurture the emergence of ‘citizen spaces’ such as People Panels with partners in the coming weeks with the aim of rolling out the next cycle of People Panels in the new year – watch this space.
In Octobers ‘Feet on the Street’, the team headed to shopping centres, places of worship, the high street, health centres and leisure centres to ask the public a series of questions which can be played back to the ICB Board as a video. The questions we’ve been asking are:
- What’s worrying you and how will this impact on your health now or in the future?
- What should the NHS be focussing on? Today and in the future?
- What steps could health and care leaders take to support people and communities to manage their own health and happiness?
We heard concerns about waiting times, loneliness, mental ill health and the future state of the NHS which are recurring topics from our conversations and something which the pandemic has sadly worsened. But we’re also hearing more about worries relating to changes in leadership (locally and centrally), exam related stress and support for children/young people, paying bills and cost of living. It’s important that our local NHS hears and understands what concerns people so we can better understand how it impacts on health and happiness and together, prevent people from becoming unnecessarily unwell.
The video, audio and written replies we gathered will be edited and produced into a video by our communications colleagues ahead of the next ICB Board meeting and the insight will also be used in the pre-consultation draft of the Joint Forward Plan. You can view past “Feet on the Street” productions which the Board were shown here: Feet on the street - YouTube.
The satisfaction in being busy this month, stemmed from the connections we made, and the connections we remade. We’ll continue to create the conditions and space for our team, our people and our communities to come together and for more sharing and learning to be exchanged.
In October we visited Saltbrook Place, which provides independent living for Dudley borough residents who have been homeless or vulnerably housed. We joined colleagues from Healthwatch’ at their monthly breakfast club drop in session. Healthwatch have been holding these monthly drop in sessions since July to signpost residents to local services, better understand barriers to health and care and to get a sense of what it feels like to be homeless in Dudley borough.
During the session we talked to the residents about the ‘what it’s like to be me’ initiative and asked them how they would like to get involved. It was decided that we would hold fun and creative sessions, that involves arts and crafts.
The Breakfast Club arts and crafts session took place on 26 October, where residents used creative art to express themselves, using a mindfulness approach. Residents also had the opportunity to share their experiences and the support they need through talking tiles (audio). Saltbrook Place residents have powerful stories to tell and are creative, open and want to get involved. Their experiences are unique and can help shape what future services should look like for other homeless people.
Healthwatch will lead on the project by capturing anonymised first hand stories about 'what it's like to be me' and create a complementary piece of art to include visual and audio elements. The artwork will be displayed in Saltbrook Place and reproduced to completement a 'Saltbrook Stories' feature that will be shared with the Midland Heart leadership team and with the Integrated Care Board, who will also support the creative sessions. The audio element of the artwork will enable everyone to participate, including people who struggle to read and write.
On 24 October, we had an introductory meeting with the Refugee and Migrant Centres (RMCs) in Wolverhampton and Walsall. Natalie, a member of our involvement team, spoke with Stephen Baines, who runs the centres, to discuss health services and some of the difficulties that refugees and migrants face when accessing their services.
The RMCs consist of a team of qualified and experienced caseworkers, who offer a wide range of support to clients who include asylum seekers, refugees, EU migrants, undocumented people, and those with uncertain immigration status. The service provides casework, advice and guidance on immigration, housing/homelessness/destitution, welfare, education, and health and on average 45 people a day visit the centre requesting help and support.
Several topics arose during the meeting, such as:
- Ensuring women access pre-natal healthcare
- Promotion of primary care services for minor ailments to reduce A&E attendances
- Access to interpreting services for healthcare appointments, to limit the reliance on family members to translate.
It was agreed that the involvement team would attend some of RMC’s women’s groups to get their views and experiences on healthcare. This will allow us to address some of the topics raised above, as well as provide a better understanding of the NHS services available to refugees and migrants. Feedback from these groups will then be shared with relevant NHS services to ensure continued learning and enhanced help and support where required.
We attended a fantastic networking event at Merry Hill Centre in Dudley alongside a number of partner organisations who are all part of a Living Well and Feeling Safe partnership group.
We discussed and collected feedback on the following topics:
- Vaccines – nasal spray for those living with learning disabilities / people that have a fear of needles
- Trauma informed procedures for people that have experienced domestic abuse i.e. doctors being transparent and explaining the procedure and the feelings to expect etc before it takes place
- New-born babies to be checked for heart defects
- More events like the one today – people don’t really know what is out there and where to go for information. You need to search for it when you need it and don’t always find what you’re looking for.
- Better waiting times for procedures
- NHS app is brilliant – to encourage more people to use it
- GP appointments – long wait times on the phone to book an appointment with a GP. Only way of booking an appointment is by telephone, as can’t use online booking. Once you’re in the system, the service is good, but it’s getting an appointment.
On October 14, we joined BRIDGES for their partnership event at the Village Hotel in Walsall. The event celebrated the achievements of the Bridges Project to date, and highlighted the benefits of collaborative, partnership working. It also provided us with the opportunity to network and forge meaningful relationships with local professionals and organisations.
BRIDGES works with 15 partner organisations across the Black Country with the aim to provide those with multiple barriers, individually tailored support to meet their needs and to help move closer towards employment.
The partnership consists of a diverse range of organisations who focus on specialisms such as: mental and physical health issues and disabilities, drug and alcohol dependency, LGBTQ+, refugees and migrants, along with many more.
Our involvement colleague Natalie, spoke to a number of attendees from various organisations and exchanged ideas on how we can work together.
When discussing local health services, Walsall Healthcare Trust shared information regarding their Expert Patient Programme for self-care. A member of the self-care management team noted that they will soon be running a health-related event for those on the Self-Care Programme, and that the invitation would be extended out to our Involvement and Time2Talk Team at the ICB. This will provide an excellent opportunity to gather feedback and experiences from patients, to ensure they feel confident and satisfied with the skills and information provided during the programme.
On 7 October, we attended a community event in Walsall, and met with West Midlands Autism to learn more about how they support young people living with autism and their families.
During the visit, we spoke to members of the group and listened to their thoughts and experiences on health services in the Black Country.
West Midlands Autism are the leading charity in the West Midlands for people on the autism spectrum. They aim to enrich the lives of autistic people and those who love and care for them – their expert staff and volunteers work across all age groups and abilities, providing direct support.
Natalie, a member of our involvement team, spoke to family and carers of people with autism during a coffee morning.
The group members found that usage of the sunflower lanyard was an extremely useful tool as not all disabilities are visible. The sunflower lanyard is a national initiative which makes people aware that the person wearing the lanyard has a hidden disability. People living with these disabilities often face barriers in their daily lives including a lack of understanding and negative attitudes, and so individuals choose to wear the lanyard to discreetly identify that they may have access needs in shops, at work, on transport, or in public spaces.
Another useful tool mentioned, was health passports (provided by NHS organisations) – this is a document that a disabled person carries to medical appointments which explains their disabilities, it is a useful document for the professionals and families living with autism to refer to as every disability is different.
During the visit, it was brought to our attention that accessing NHS healthcare services or getting a GP appointment/referral is difficult, with many feeling that the only alternative is paying for private treatment. A lot of participants were also not aware of GP enhanced access which had recently been launched.
Feedback and learning have been shared with the ICB’s primary care lead in Walsall, to ensure that NHS services continue to be accessible to those living with autism, and that we continue to provide a high standard of specialist support and advice to autistic people of all ages and their families living in the Black Country.