NHS England Consultation about evidence-based interventions

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The local NHS is asking the public to take part in a NHS England consultation about plans to stop offering interventions that are not clinically effective.  This would mean that several treatments currently prescribed would not be routinely performed or only performed under specific circumstances.

The aims of the proposal to stop offering the below listed interventions are to increase patient safety, save professional time and avoid waste for patients and taxpayers whilst helping clinicians to keep up to date with evolving evidence based practice. 

The proposals are that the following interventions would not be routinely available/ commissioned by local Clinical Commissioning Groups (CCGs) due to their clinical ineffectiveness.

  • Snoring surgery (in the absence of Obstructive Sleep Apnoea)
  • Dilatation and curettage for heavy menstrual bleeding in women
  • Knee arthroscopy for patients with osteoarthritis
  • Injections for nonspecific low back pain without sciatica

There are also recommendations that a further 13 interventions only be performed under specific circumstances where they have been proven to be clinically effective. These include breast reduction, removal of benign skin lesions, grommets for glue ear in children, tonsillectomy for recurrent tonsillitis and haemorrhoid surgery.

The consultation runs until Friday 28th September and is part of a joint programme – the Evidence Based Intervention Programme – between NHS England, the Academy of Medical Royal Colleges, NICE, NHS Clinical Commissioners and NHS Improvement’s GIRFT Programme.

For more information and to respond, please visit the NHS consultation website.

https://www.engage.england.nhs.uk/consultation/evidence-based-interventions/

Tricia D’Orsi, Chief Nurse of NHS Castle Point and Rochford CCG and NHS Southend CCG said:

“We would encourage members of the public to get involved and take part in the survey so that their views on the proposals can be heard.”

Recovery College Consultation

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Castle Point and Rochford CCG, Southend CCG and Southend Borough Council have launched these surveys to find out what people using REACH (Recovery College) and those that do not currently access the Recovery College think about what’s on offer. REACH is an acronym which stands for Recovery Empowerment Achievement Community Hope, coined at the commencement of the Pilot with a consortium of mental health providers. The offer aims to enable people to self-manage their own mental health by building up their own ‘toolkit’ and strategies to facilitate their own personal recovery pathway.

An independent evaluation by Anglia Ruskin University found that the results showed significant improvements in mental wellbeing and social inclusion and ‘reports of increased confidence, reduced anxiety, and increased social inclusion/reduced social isolation. Furthermore, at final follow-up 87%  of students said they would recommend the Recovery College to a friend, 96% enjoyed attending, 91% said their skills had developed, 83% said their confidence had increased, 87% said that they felt more positive about things and 87% said their relationships with others had improved as a result of attending.

The pilot ends on the 31 March 2019 with the intention to formally procure a new service to run from April 2019.

Two online surveys are now available on the Southend Borough Council website consultation portal - the consultation closes on 7 September 2018.

The surveys are aimed at different groups; one will be for people with mental health issues and their carers; the other for stakeholders such as GPs; social workers; DWP; voluntary sector partners etc to complete.

We need the views of many other people as possible to ensure the Recovery College service moving forward is delivering the right offer and courses to people across Castle Point and Rochford and Southend.

We want to reassure anyone currently using REACH that we will do all we can to make sure REACH continues to run as smoothly and effectively as possible during this process. If you are concerned or anxious please speak to one of the recovery coaches.

Community Engagement Advisory Group

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Janis GibsonThis is the core steering group for the CCGs engagement and involvement activities and it is chaired by the CCG's lay Governing Body member for engagement, Janis Gibson (right).

The group has a diverse membership across many different areas of our local community and has a wide range of different age groups from late teens, to older people. Membership consists of representatives from:

  • Local voluntary organisations
  • Residents Associations
  • LGBT groups
  • Cultural and minority groups
  • Mental health groups
  • Community Advisors
  • Patient Participation Groups
  • Health specific support groups
  • Citizens Advice Bureau
  • Public Health
  • Southend Borough Council
  • Southend Youth Council
  • Southend YMCA
  • Healthwatch (Southend)
  • Local Acute Trust
  • Ambulance Trust
  • Learning Disability groups

The meetings are held once a month and the style and agenda for meetings is mixed, with a formal agenda giving items for discussion and regular workshop sessions, where members engage in specific pieces of work or projects to assist the CCG in the development and implementation of plans.

Some comments from current steering group members:

“The Public Health Team at Southend-on-Sea Borough Council has been an active participant in the Community Engagement and Advisory Group. The Group has provided opportunities for engaging with members who play an active role in representing their organisation. The Group has provided Public Health a space to promote its role of improving population health; informing members about public health services; and, enabling the Group to participate in activities such as the Physical Activity Survey.” Simon Ford – Health Improvement Practitioner Advanced, Southend Borough Council.

“As a member of the Community Engagement Advisory Group is part of a journey. Those of us who are active in our community must try and integrate our input into the CCG and utilise all opportunities with our co-members, to assist the work of the group but to ensure we look to develop and keep the work topical and practical for our Community. We cannot all be there every meeting, but I find the feedback is essential, thus to stay up-to-date! It is an essential level I believe as a filter and progressor for process!” Kim Woodyer-Byers, Squirrels Voluntary Club

“My name is Judith Snell, and on the Community Engagement Advisory Group, I represent a charity called SAFE (Supporting Asperger Families in Essex). Autism is described as a hidden disability and people with the condition are lacking in social skills. By representing this group, I am able to pass on information that may not otherwise be reaching our members, due to their disability.I have also found that I can be the ‘voice’ for our members that are so very often forgotten. I count it a privilege to have a seat on the advisory group and trust that our contributions go a little way to making life easier for all the organisations that are represented.” Judith Snell – SAFE, Essex.

"I represent Citizens Advice Southend on the Community Engagement Advisory Group. Our involvement allows us to link issues raised at the CEAG with our social policy work. We can also highlight issues to our clients, our paid staff and volunteers who predominantly live in the Southend area. An example of this is the information received about the introduction of the GP Weekend Service in Southend." Trish Carpenter Manager Citizens Advice Southend

How we ensure we are inclusive

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In a project to target communities who face health inequalities, the CCG has put in plans to embark on some face-to-face engagement led by our partners in the voluntary sector.

The aim of the project is to reduce inappropriate or avoidable attendance at the local A&E department. Growing academic theory suggests that traditional communications channels – such as newspaper stories, posters, social media or radio advertising – do not influence people living in poverty. More so, face to face engagement is increasingly considered the most influential form of communication when dealing with residents living in poorer areas.

A volunteer team will knock on doors in targeted areas supported by a script that provided key messages about alternative health services with easy to read printed online materials. The project is expected to run in April 2018, hence more details on the project will appear in next year’s Annual Report.

8 out of 10 mums – Facebook group

In 2017/18 we engaged with a popular Facebook forum aimed at parents in Essex. We asked them which aspect of health they felt least informed about to help them care for their children. Sepsis was identified as the most popular area that local parents wanted to be more informed about. As a consequence, we linked up with the forum and the specialist sepsis nurse at Southend Hospital to launch a communications campaign to educate followers on sepsis to ensure swift action is taken using a local case study. The video was viewed over 1,500 times over two months and it helped raise awareness of symptoms to prevent delayed diagnosis and the need for intensive, costly care.

Reaching new audiences

We have a developed a good relationship with our local Football club, Southend United. This partnership has helped us to reach a predominantly male audience with two communications, one to encourage appropriate use of NHS services and the other to encourage those with respiratory conditions the importance of self-care. Use of popular football players and a 360 photoshoot of the stadium has helped secure wide engagement for both campaigns.

Reprezent Essex engagement programme

There are almost one million young people in Essex, and at least 10% experience mental health issues. 10% of referrals to the Children and Adolescent Mental Health Service are currently for active self-harm, and 30% for historic self-harm. There are an audience which historically have been hard to reach.

Following 15 years of successful broadcasting and youth-led training and engagement in London, Reprezent was asked to extend its activities to Essex.

With increasing pressure on Mental Health services, it’s vital that we increase awareness of issues amongst young people in Essex, and give them the tools to become resilient and to take control of their own health. This will result in better life quality, the ability to support friends and family, and reduced pressure on the NHS.

Engagement

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NHS Southend CCG strives to engage with Southend patients, carers, partners and residents, throughout the commissioning cycle to ensure that local people have a strong voice.

We engage with our local community to:

  • identify health needs and aspirations, develop our commissioning intentions and priorities
  • design and improve services
  • to take patients’ views into account when we procure services
  • use patients’ experience to improve safety and quality of care

Engagement reporting on how we are achieving our statutory duties

Every year in September, CCGs have to submit a report to NHS England which shows how we are meeting our statutory duties around patient and public engagement and involvement. The reports are assessed as part of the assurance process for all CCGs.