DropBy

Dear Members in Surrey, Out-of-hours services in Guildford & Waverley, Surrey are due for review and a new contract will be awarded in January 2014. 'Out-of-hours' care is the access that you have to many NHS services outside of normal surgery hours. This might mean healthcare professionals making home visits, access to walk-in centres, or advice over the phone. We are keen for as many members of the public in Surrey as possible to contribute to this process, as your views help us to design services suited to your needs. We therefore invite you to fill out this anonymous questionnaire. You don't have to answer every question and can ignore any questions that aren't relevant or that you don't want to answer, however the more detail you give, the more we can represent your views in the process. https://www.surveymonkey.com/s/ZDLJRMC Thank you for your help. Dr Ann Hennell Clinical Lead for Unplanned Care Guildford and Waverley CCG ann.hennell@nhs.net

http://healthkicks.podbean.com/ This week, the Health Kicks Show went 'on the road' to a natural burial centre in the beautiful, rolling, Surrey countryside in the UK. John Hicks met the management of Clandon Wood Natural Burial Centre (http://clandonwood.com/). Natural Burial, Woodland Burial, Meadow Burial, Eco Burial, Green Burial ...different names but the same idea. John finds out if Natural Burial really is the responsible answer to how we deal with our dead. In addition, John met local organisations which support Clandon Wood: DropBy (http://www.DropBy.co.uk), The Brigitte Trust (http://www.brigittetrust.org), Surrey Hills Area of Natural Beauty (http://www.surreyhills.org) and PR specialist and professional photographer Dani Mamoine (http://www.danipics.com/). Great interviews. Great location. Unmissable radio! http://healthkicks.podbean.com/

This article refers to Surrey and more details can be found at news.surreycc.gov.uk  but it will apply to all County Councils.

Obesity, smoking and drinking are among the issues Surrey County Council will tackle after taking control of public health.

Responsibility for improving the health of Surrey’s communities and reducing inequalities officially transferred from the NHS on Monday (1 April).

The county council is now responsible for 23 public health functions, which will see it tackle issues such as reducing obesity, helping people to quit smoking and supporting those who drink too much alcohol. It will work alongside Surrey’s districts and boroughs because of the close link between housing, leisure and health.

The changes form part of a major national overhaul of the NHS, where GP-led clinical commissioning groups have taken over from primary care trusts and are responsible for how money is spent on healthcare.

Surrey County Council’s Assistant Chief Executive Susie Kemp said: “We have put in all the preparation and now we can get to work on really making an impact on improving the health of people in Surrey.

“Promoting healthy lifestyles and helping people live independently longer is already at the heart of what we do and taking on public health means that together with local communities we will decide how best to improve the health and wellbeing of residents.”

Surrey has joined forces with councils nationwide in a bid to help drive down energy bills.

Already more than 6,000 people have registered for the county council’s switch and save scheme. Now the authority has teamed up with more than 60 councils to make the most of their collective clout.

It means they will potentially be able to draw on the people power of up to 100,000 bill-payers to secure the best possible deal on the annual cost of gas and electricity.

The news comes after British Gas reported profits rose by 11% last year following a round of price hikes by major energy suppliers.

The councils will negotiate a group deal at an auction with energy suppliers on 9 April, with the lowest bid winning. To register, visit www.surreyswitchandsave.org or call 03456 009 009 and choose option five.

Surrey County Council’s Cabinet Member for Change and Efficiency Denise Le Gal said: “This should significantly swell the purchasing power of the collective group and that means even bigger potential savings for residents.

“People power can really pay off and I’d ask everyone in Surrey looking for some help in coping with the spiralling cost of heating and lighting their homes to join because they could knock £200 or more off their annual bills.”

Surrey has extended its deadline to register for the scheme to 8 April. People will need to provide contact details, the name of their supplier and information about their current energy usage and tariff.

The deal will be announced to people in Surrey during the week beginning 15 April and they will then have until early May to decide whether to switch.

Newsletters are being sent to Surrey residents and businesses within 100 metres of the Olympic cycling road race and time trial routes to help people plan ahead for the 2012 Games. The newsletters include detailed information about road closures, parking restrictions, maps of the route and tips for how to make the most of the once-in-a-lifetime events. Helyn Clack, Surrey County Council’s Cabinet Member for Community Services and the 2012 Games, said: “Mark Cavendish could win Team GB’s first gold medal on Surrey roads so we’re expecting huge crowds. There’ll be road closures and parking restrictions along the route on event days, so please avoid driving in the area if you can. “If you want to catch the action, think about the best viewing option for you. We’d advise people to walk and stay close to their local areas because it’s going to be very difficult to get around. And think carefully if it’s a good idea to watch the races on the roadside if, for example, you have small children. “I’d ask people to read through the newsletters carefully and to plan ahead by visiting gosurrey.info for all you need to know to make the most of the Games. “We understand there will be disruption, but we’re doing everything we can to keep it to a minimum.” Businesses will receive a tailored newsletter that includes tips and advice about how they can benefit from the events and how to plan ahead to reduce disruption. The Olympic cycling road races will be staged on the opening weekend of the Games, with the men’s event taking place in London and Surrey on Saturday 28 July and the women’s on Sunday 29 July. The Olympic road cycling time trials will be held on Wednesday 1 August. Visit www.gosurrey.info for more information about Surrey’s involvement in the 2012 Games.

The NHS Surrey Public Health team have been working with Eagle FM on mental health podcasts as part of mental and emotional health promotion. Through the Surrey Suicide Prevention Strategy Group; they have coordinated podcasts on different themes - partner agencies who work in that area have delivered the podcast. Each month there is a new theme. This month the theme is Chronic pain. Link to the podcast: http://www.964eagle.co.uk/podcastdirectory/nhs-mental-health.php Previous themes included debt, Christmas stress and depression.

Extracts from a recent report: Carers have been telling us for many years that they feel the effect that caring has on their own health has gone largely unnoticed by health professionals -“ignored and invisible”. National studies, as well as the stories we hear from carers locally, indicate that caring can take a huge toll on a carer’s health, both physical, mental and emotional. The 2001 census updated in line with 2008 population projections indicates that in Surrey there were over 106,000 carers of all ages, which equates to: * 9.6% of the population. * 51,234 carers providing over 20 hours care a week (48% of the carers). * Of these, 32,021 provide over 35 hours a week (30% of carers) and 23,482 were providing 50 hours a week or more (22% of the carers). * Just over 60,000 carers reporting struggling to balance work and caring (57% of the total number of carer's). The 2001 census figures updated for population growth show that in the county there were just over 106,000 carers who save the public purse an estimated £1.595 billion a year. In the Carers’ Strategy of November 2010 Government allocated an additional £400m over four years (2011–14) to the NHS for primary care trusts (PCTs) in England to provide breaks for young and adult carers. The Government requested PCTs to work with local authorities and carers’ organisations to develop policies, plans and budgets to support carers and make provision available to local people. National Picture The Government has highlighted carers as a group experiencing health inequalities within their plans to promote public health . Evidence of comparative poor health of carers includes: • A four year study of 392 carers and 427 non-carers aged 66-92, which found that carers who were reporting feelings of strain had a 63% higher likelihood of death in that period than non-carers or carers not reporting strain; • Carers providing high levels of care being associated with a 23% higher risk of stroke; • 52% of carers providing substantial care in one study being treated for stress-related disorders. In another, over half the sample said they were in good health, but General Health Questionnaires (GHQs) indicated that 94% could be identified as having psychiatric disorders; • More than 80% of carers saying that their caring role has damaged their health; • Carers providing more than 50 hours of care per week are twice as likely to report ill-health as those not providing care. What Carers Asked For (in order of priority): • Carers Breaks, night time, weekend, palliative care trained staff • Health Checks often referred to as MOT’s • Counselling services, including bereavement, future planning, and emotional support. • More Training in the Disease/Condition of the cared for person, and back care. • Recognised and valued as carer during Hospital Discharge • Flexible appointments with GP. • Support from Employers. • Access to leisure activities, including sports centres, pampering days. According to Carers UK report 2004 ‘In poor health’: Carers are twice as likely to suffer from mental ill health if they do not get a break from caring. Carers should not have to ignore personal health concerns and needs because their caring role does not allow time to address them. The services and support available to carers should be such as to enable them to stay as mentally and physically well as possible throughout their caring role. (DH, 2009:20) The three key areas of importance to Surrey carers were: • Carer Respite including evening, weekend and overnight respite with palliative care trained staff • Counselling. This could be divided up between bereavement, emotional support and future planning especially for parent carers, Stress and anger management training were also cited. • Annual health checks often referred to as annual MOT’s Carer quote ‘Yes we have the GP projects but the basic problem in every day practice is that Carers remain ignored and our role is not universally respected. Carers can be seen as trouble makers and people who deny patients their privacy and rights. The fact that Carers provide the lion’s share of the care has been missed and we have not to date been seen as an essential part of the network of care – often the only care!’ Quotes from Carers Counselling, counselling! A support network is vital…… talking to those who care to be bothered No time to attend appointments nowhere to leave my disabled child Some counselling for parents of disabled children is desperately needed. I have tried for years to access this through my GP with no success. I wouldn’t ask for it if I didn’t think I needed it. But because I’m generally competent all together, efficient sort of person (because I have to be) no one knows how it feels to be a parent of a disabled child every day…… and one day I might go over the edge, but where would that leave my child? Had to give up job, employer not sympathetic Can’t afford to attend dentist – local dentist private no NHS dentist near enough I have sacrificed my career, health and marriage and financial security by being a carer for my son No energy permanently tired and short tempered For my needs to be taken seriously before I commit suicide or put M into care Need help preparing for the worst i.e. Death and bereavement counselling My main anxiety is focused on when we are no longer around I need help with the district nurse calling to do blood tests as I’m currently taking warfarin. The GP surgery is saying that as I am mobile I must attend the surgery for these tests. I cannot leave my husband unattended. He has severe Parkinson’s People with severe difficulties are often bad tempered and aggressive. This can be the worst part of being a carer to be made to feel worthless by the person you love. I have arthritis in my neck and knees and spine, which has obviously got a lot worse since caring for my wheelchair bound husband I have been caring for 31 years I am getting very tired. Get rid of my husband! He is doubly incontinent and I get no help Being a male carer I’ve been ridiculed for living with my mother, which I didn’t bargain for. I am angry but I’ll do my best by her. My employer hasn’t helped and increased my hours. I need more respite and one million pounds in my bank account see what you can do please! I feel that once initial fire fighting is over the NHS loses track. No one seems to check up on our well-being. As always it’s up to us to be pro active I am the walking dead I have been made to feel as a waste of space There is no light at the end of the tunnel Health Checks 4.11 The Government is committed to the future of the national NHS Health Check programme. As part of the programme, 40 to 74 year olds will be offered a free NHS Health Check that will help carers, among others, stay well for longer. Everyone receiving an NHS Health Check will receive a personal assessment and individually tailored advice and support to help them manage their risk of heart disease, stroke and diabetes. The assessment can be carried out locally and in a variety of settings, including pharmacy and community settings, to help to ensure that the service is accessible to all those eligible, including carers who may find it more difficult to access some health services. Carers should be encouraged to take up their offers of a free NHS Health Check when they receive them. 4.12 The carers’ demonstrator sites focusing on health and well-being checks are testing different ways of reaching out to carers, including those in ethnic minority communities, and offering structured consultations to discuss their own health and well-being. The final report from the independent evaluation of the demonstrator sites, particularly around accessibility for carers, will be fed into the on-going policy considerations for the NHS Health Check programme. According to the DH evaluation of the National Carers Strategy Demonstrator Sites Programme, four months after the check about a quarter of respondents felt the way they looked after themselves, took care of their health, and the exercise they took had improved. Of the almost 2 million people aged 16-74 who are permanently sick or disabled, 273,000 provide some unpaid care for other people and 105,000 provide 50 or more hours care. Furthermore, the Supporting Carers: An Action Guide for General Practitioners and their Teams, 2008 highlighted the following statistics: • More than 80% of carers say that caring has damaged their health. • Out of all carers caring for more than 50 hours a week, one third report depression, a half report disturbed sleep and 25% report back and other strains. • The prevalence of psychiatric morbidity is significantly higher in those who care for others in their own home. End of Life (EOL) Carers Support National EOL Intelligence Network Report Feb 2011 indicates that 60% of people would choose to die at home; but only 21% do. Where an end of life care service has been available, this has resulted in more people dying at home because the carer has felt supported. In line with ‘Supporting people to live and die well: A framework for social care at the end of life’ (DH NEOLCP 2011) it is a key priority for Surrey that we deliver high quality end of life (EOL) care and support to people approaching EOL and their carers, to allow them to live and die well in the place of their choice. As part of the wider National End of Life Strategy, NHS Surrey in partnership with Crossroads Care Surrey has developed an EOL carers’ support service, providing palliative care trained staff. The service is designed to ensure that the provision of breaks services, funded in line with the National Carers Strategy, is accessible to carers in "End of life situations”. The aim of this new service, which will be available to all carers, is to address the need, highlighted in the End of Life Care Strategy and in ‘Healthier People, Excellent Care’, to support carers and patients, enabling them ‘to choose where they die and not be admitted to hospital in the last days of life, if that is their preference’. This service is being rolled out across Surrey from November 2011 and is funded by NHS Surrey on an annual basis via a Surrey County Council grant. The funding is for £300,000 annually.

Surrey Police is warning residents of an increase in fraud offences committed against elderly and vulnerable people. The scam involves fraudsters obtaining people’s bank cards by using false pretences. The scam works as follows: The victim gets a phone call, or indeed a number of phone calls from, someone claiming to be from their bank. The caller says that there is a problem with their bank card and it will need replacing. The victim is told a courier has been arranged to pick up the faulty card and replace it with a new bank card. The caller will also ask for their bank details, including PIN number and bank balance. Alternatively another tactic is to leave a courier-style “we have missed you” notice through the victim’s letterbox, purporting to be from the bank. The sole purpose of this is to get the victim to ring the number on the slip, but it is actually offenders who pick up the phone call. Once the victim has been drawn in to the scam, a person dressed as a courier will arrive at their front door to take the card. Significant sums of cash have been taken from victims’ accounts throughout the county. Detective Inspector Paul Rymarz of the Cross Border Investigation Team said: “We have seen a rise in the number of fraud incidents committed in the last few months. It is important that people are aware of the scam, which targets the most vulnerable. Banks do not use courier services to deliver or pick up bank cards, and you should never give your PIN number to anybody. If you are unsure if a caller is genuine, do not give them any information and say that you will call back the bank on a number you recognise, for example on the back of your bank card. "We are working closely with our partners to catch the criminals, and bring them to justice. If you suspect anything please contact the police.” Please refer to the Surrey Police website for more details and further useful information relating to policing is Surrey http://www.surrey.police.uk/home.asp

The importance of nutrition in aiding patients’ recovery is now very much in the spotlight and this week the National Patient Safety Agency are raising the profile further with a week focused on nutrition and hydration – ‘A Taste of Patient Safety’. 

 

At the Royal Surrey County Hospital there has been a continued focus on ensuring that the nutritional needs of patients are one of the top priorities as Head of Nursing Ellen Bull explains:

 

“At any one time we are looking after around 100 patients who require help with direct feeding or assistance with feeding.  That accounts for almost 20% of our inpatients and requires a huge team effort from staff across all disciplines.  There is a nutrition action group that takes responsibility for ensuring that we meet the nutritional needs of all our patients and the group will also tackle any issues that come to light.

 

“We undertake comprehensive assessments of patients nutritional and hydration needs when they are admitted and we are continually building a team of volunteers to help patients who have difficulty feeding themselves.”

 

That team of volunteers now includes 90 A-Level students from in and around Guildford who give up their time to come in and help to feed patients during supper time.  One of the team is Liam Naybour aged 17 from Bookham, who attends The Howard of Effingham School.  Liam has been volunteering on Ewhurst Ward for the last few months and comes in once a week to help feed patients at supper time. 

 

Liam says:  “I want to study medicine after my A-Levels and I wanted some experience of working in a hospital.  I find helping the patients, particularly the more vulnerable patients with dementia, extremely satisfying and I am pleased to be able to offer them some comfort and support.  It has also been very useful to be exposed to working in a hospital environment.”

 

Family members and friends of patients who need help are also invited and encouraged to come in and support their relatives during mealtimes. 

 

To ensure that the patients who need help are easily identified and prioritised, the meals for these patients are served on a red tray and this is also indicated to catering staff on the menu cards.  The red trays were adopted following recommendations from Age Concern and they make the patients easily identifiable to ward staff and volunteers who are helping them.   

 

To help ensure that there is enough time dedicated to feeding and nutrition on the wards, Protected mealtimes are in on all wards.  During this period routine visiting and ward rounds are minimised, which allows the ward team to focus on ensuring that the patients are all adequately fed.

 

Making sure patients are well fed and hydrated plays a hugely significant part in their recovery and there is a huge team dedicated to this. 

 

The team includes nurses, doctors, dieticians, speech and language therapists, nutrition specialist nurses, catering, pharmacy, receptionists, healthcare assistants, housekeeping, occupational therapists and physiotherapists.  To complement this, the Trust has invested in a Nutrition Specialist nurse Service and Speech and Language Therapy team which provide services to patients who cannot eat normally and require specialist intervention and assessment.

 

A focus on hydration involves monitoring and offering drinks throughout the day using a newly developed chart.  Drinks are offered in mugs or cups and jugs with red lids are used to indicate when someone needs help with drinking.

 

Assisting with feeding more than 100 patients a day across the hospital is a large scale logistical effort and involves the production of huge quantities of food on site.  Every year the hospital provides around 570,000 meals for patients, which equates to more than 10,000 loaves of bread, 157,000 pints of milk, 73,000 portions of orange juice, 14,600 tubs of yoghurt and 10,500kg of meat. 

 

The menu is very varied and runs across a 28 day cycle to ensure there is limited repetition for inpatients.

 

The menu covers the requirements of a range of diets including gluten free, vegetarian, diabetic and halal and there are also soft and puree foods available.  The specialist meals are produced by our catering team working closely with the dieticians and speech and language therapists.

 

To ensure the distribution of meals runs smoothly, there is a daily catering operations meeting and the food is tasted and checked every day by the team before going up to the wards.  The catering team and all other staff involved with the food provided for patients work very hard to ensure that they can still meet the needs of all individual patients and will do all they can to meet special requests.  

 

The Royal Surrey’s approach to nutrition was assessed as part of a series of spot checks carried out by the Care Quality Commission in 2011.  The CQC inspectors and an experienced nurse found the Trust to be compliant with meeting the nutritional needs of elderly patients. Patients and family members spoken to by the CQC team were complimentary of the meals offered to patients, stating that the food was good quality and good sized servings.

 

But the team at the Royal Surrey are not complacent and are always looking for feedback from patients on the quality of food and whether it met the needs of patients.

 

Ellen Bull continues:

 

“To help track the success of the nutrition and hydration initiatives questions are included in our patient e-survey and this, and information reported to PALS and Complaints, is reported to the Board. 

 

“We also held the first of a series of Patient Experience workshops in November and invited patients who had experienced the food or had a particular interest in nutrition and food to participate.  We went through the system for assessing the nutritional needs of patients, how the menu is devised and invited the attendees to feedback their experiences and suggest improvements and ideas. 

 

“The attendees were also invited to taste our winter menu and the catering team received some useful comments and suggestions.  The Nutrition Group are now working through the ideas from the workshop and have drawn up an action plan to implement the changes.

 

“We are always happy, and in fact want, to hear from patients and their families about the food, our approach to nutrition and what they feel we can improve as it helps us to ensure that we get it right and meet the needs of our patients.”

 

 

 

Surrey Police is reminding residents and visitors to the area to stay safe, keep warm and look after vulnerable and elderly neighbours and relatives as the adverse weather conditions remain throughout the area. Detective Superintendent Ray Marley, said: “Most people have listened to early weather warnings which has meant traffic problems have been kept at a minimum throughout the county. “I would urge people to only make essential journeys and to allow additional time to get to their destination. “I would also like to ask people to check on elderly and vulnerable neighbours, friends or relatives and make sure they are safe and warm.” Surrey Police is working closely with partner agencies to make sure disruption is kept to a minimum during the cold snap and would like to thank those who have helped in anyway. Useful Information For up to date travel information in Surrey visit www.highways.gov.uk (roads), www.heathrowairport.com or www.gatwickairport.com (flights) or www.nationalrail.co.uk (rail) before you travel. Weather information can be found at www.metoffice.gov.uk. Follow @SurreyTravel on Twitter for an overview of travel in the county.