Take it to the Top Essex 2014: Summary of Events, Feedback

and Considerations for Future Events

Abstract
Five Take it to the Top Events were advertised, organised and facilitated by South
Essex Partnership University NHS Foundation Trusts (SEPTs) Patient Experience
Team, Executive Team and team leads. These events allowed attendees to voice their
opinions and enquiries about SEPT services. Although some events had lower than
estimated attendance, suggestions have been made to increase the amount of
feedback received for these events. This received feedback has also been discussed,
and summarised for each area.
Introduction
Take it to the Top is an annual event co-ordinated by SEPTs Patient Experience
Team. The following is a short summary of the five meetings that took place in SEPT
localities in Essex. Take it to the Top focuses on allowing carers, members of the
public and SEPT service users the opportunity to directly put their enquiries and
feedback to The Executive Team. All of these events were attended by SEPTs
Executive Director, Sally Morris, alongside associate directors and team leads for arearelevant services.
Preparation
The venues were booked in advance using available dates from the Chief Executives
secretary. Recommendations for previously successful, accessible and cost effective
venues were used. This event information was then used by the communications team
to draft a poster (see overleaf). Here is a list of the events that took place in Essex and
Suffolk:
South East Essex
Wednesday 5th February (10:00 12:00)
Southend University
South West Essex
Monday 10th February (10:00 -12:00)
The Basildon Centre
Suffolk
Friday 14th February (10:00 12:00)
Kesgrave War Memorial Hall
West Essex
Wednesday 19th March (14:30 16:30)
The Park Inn in Harlow
Thurrock
Thursday 27th March (10:30 12:30)
Thurrock and Grays Adult Community College

Gary Brisco
Patient Experience Co-ordinator

-1-

A poster template was requested from Communications to allow various versions of

this poster to be created. This allowed the Patient Experience Team the opportunity
to cater promotion to both broad and specific areas.

Gary Brisco
Patient Experience Co-ordinator

-2-

Promotion
Take it to the Top was promoted throughout local SEPT services and properties, as
well as working with local community groups. The information was first sent to the
membership list, local governors and also to the Communications team for promotion
throughout The Trust. Following this, both digital and paper copies of the promotional
poster, smaller flyer-sized versions, and travel information for each location was
circulated to managers and clinical leads throughout the Trust. These documents
were also sent as hard copies and digitally to relevant local charities, service user
volunteers currently working alongside the trust and local community hubs such as
libraries and community centres. On top of this the event was also promoted
personally by members of the Patient Experience team when talking to service users
and visiting sites and staff across the SEPT.
Structure
Each event consisted of two parts, a group question and answer session and then
the panel and attendees would split into one-to-one sessions. The question and
answer session was managed by the Chair, where attendees were able to raise
compliments, enquiries or concerns with the members of the executive team and
attending team leads. After a short break, attendees were given the opportunity to
have one-to-one sessions with the present Directors and Staff. The Patient
Experience Team was on hand to facilitate and assist with this, and many of the
concerns raised in these sessions were handled by their Patient Advice and Liaison
service. Each session ran for approximately two hours.
Summary of Events
The following is a summary of topics and comments raised at each event, with points
raised by the Executive team and attendees. Event feedback has been collated from
feedback forms given to attendees, and comments given to the Patient Experience
Team after the meeting.
South East Essex: Southend University

The possibility of some services being inaccessible for wheelchair users was
discussed.

A service user was concerned about discharge processes in mental health care.
A fast track system was proposed to help people back into the system.
o Sally Morris explained the process of discharging people back into
primary care when stable, and why a fast track system might have
issues.

Rumours regarding the closure of Clifton Lodge were discussed.

o Sally Morris discussed how the Trust is facing finance challenges and is
having to look at service reductions and a different model of care.
o More intervention in continued care and recognising personal
improvement

Gary Brisco
Patient Experience Co-ordinator

-3-

o Mountnessing Court is now a dementia rehabilitation unit and after a six

week stay, around half of all service users were able to return home.
o Clifton Lodge is a specialist service and SEPT is promoting this to the
Commissioners.
The Taylor Centre
It was raised that paperwork can be left unprocessed for up to a week in the
Taylor Centre. The service user said this was against SEPTs aim to provide fast
access to services.
o Sally Morris said that fast access is important in SEPT services, and
encouraged service users to report when this was not happening.

It was raised that there is drug use in the Taylor Centre elevator.
o Sally Morris explained that it is important to provide services in an
accessible location, however at times the use of drugs in these services
can be difficult to police.
o Tsitsi Adikwu explained dispensary methods to attendees.
o Sally Morris will raise this with the head of the pharmacy service at the
Taylor centre.

A service user was upset that they missed an appointment and was discharged
as a result.
o This issue was handled and resolved by the Patient Advice and Liaison
service.

An attendee commented that the Valkyrie and Wharf Road clinics are brilliant.

It was raised that the Diabetes helpline was difficult to access over the phone.
o Louise Hembrough explained that there were currently four members of
this team on maternity leave, but all answerphone messages were
being answered within 24 hours.

SEPT services in the area

A service user quoted Sally Morris from a previous meeting: Be honest, be
challenging and be constructive. They asked Is Southend CCG getting value
for money for Community and Mental Health Services from SEPT?
o Sally Morris answered that there is not a tariff to evidence this.
o It was pointed out that SEPT is below national average reference cost
of 100, and in light of this providing value for money.
o SEPT focuses on quality and care and measure this through various
methods such as the Friends and Family Test and Patient Experience
Surveys.

A carer asked why Basildon ECT didnt have accreditation from the Royal
College of Psychiatrists. It was also asked how many people receive treatment at
the unit and then return for further treatment (regression rates).
Gary Brisco
Patient Experience Co-ordinator

-4-

o Sally Morris promised to get back to this question personally, and took
contact details from the carer.
Event feedback
It was a joy to hear members of SEPT.
SEPT Sexual Clinics could be more spoken about.
The Event should be more publicised on the outside of the building
Keep volunteers updated with service location changes.
Please put chairs further apart
I am glad I came along.
Publicity for the event locally e.g Local Libraries, Supermarkets, Targetted
Local Contracts.

South West Essex: The Basildon Centre.

Future Take it to the Top Event Planning
Due to adverse weather conditions and an early start time, the panel raised with
attendees how future sessions of Take it to the Top and other events could be
arranged within the trust.
o Although attendance at this event was low from service users and carers,
there were attendees from local organisations and mental health related
groups.

A member of a local mental health and disability group discussed how initial crisis
access to mental health services was difficult, with service users having to use
Accident and Emergency wards. It was suggested that a Mental health Accident
and Emergency could be set up in one of the rooms at Basildon Hospital.
o Although it was suggested that these be available at the Basildon Mental
Health Unit 316 suite. Sally Morris explained how the Trust was not
commissioned by the local CCG to provide this service.
o It was also discussed how SEPT can only use funded staff because of this,
and could not use existing staff for a new service in the building, as this
may affect their current responsibilities.
o The panel ended this portion of the session by highlighting that the Trust
has out-of-hours services for existing service users.

Following these questions, it was explained by the panel that SEPT was under the
same financial constraints that the NHS as a whole is under. It was explained how
the trust could provide both an efficient and high quality service.
o It was also raised that the How did we Do? survey was one of the many
tools used to ensure that SEPT provided a very positive patient
Experience.

Event Feedback
No feedback forms were filled in for this event, but the group agreed that this was a
useful session for the Basildon area services and service users.
Gary Brisco
Patient Experience Co-ordinator

-5-

Suffolk: Kesgrave Memorial Centre.

Transitions of Care
Concerns were raised regarding transition issues, when patients move from
children to adult services.
o Nic Smith-Howell commented that there is a variation in different service
transition procedures, individual circumstances determine how the process
is dealt with.
Childrens general hospital ward only goes up to age of 16 years not appropriate
for all over 16 years to access adult services.
o Pam Sabine acknowledged that this is very difficult issue to manage, some
cases children over 16 years do not want to access childrens services, all
services strive to build services to suit the needs of the service user.
Podiatry
It was raised that there was a high volume of referrals and issues around nail
cutting expectations from patients. Services that previously provided this now do
not have provisions to provide it.
o Concerns were raised by Suffolk Healthwatch around appointments not
being frequent enough, also preventable measures and how cost effective
these are to services.
o Pam Sabine explained that longer living patients also cause issues for
services in Suffolk, locality being so wide spread also causes problems.
o Pam also acknowledged issues and agreed Podiatry services had changed
and it was necessary for patients to take self-ownership of foot care to
prevent more serious problems developing.
o Knowledge for patients does need to be improved and expectations of
what services are available needs to be improved.
Public perception of SERCO
It was claimed that service users were concerned because services were now
provided by SERCO and recent quality report showed low staff morale.
o Simon Bamford explained that this may have been the case in the
beginning, but now staff are happier with the situation and working
alongside SEPT.
o Nic Smith-Howell mentioned that the services are still being delivered by
NHS staff and are commissioned by the NHS. The best is wanted for the
services regardless of who the employer is.
Specialist Services
Concerns were voiced with Patients having to travel out of area for specialist
services that are not provided locally.
o Nic Smith-Howell replied that in some cases the specialist centres are
preferred by patients as there is a common perception that specialist
centres offer a better service. It is not appropriate to have specialist
services in every area as the volume of need does not warrant the cost of
the service. Although in some cases families still prefer to travel to
specialist services out of area as they perceive them to provide better care.
Gary Brisco
Patient Experience Co-ordinator

-6-

o It was agreed that there does need to be better knowledge for patients and
carers.
Suffolk Healthwatch
A member of Suffolk Healthwatch requested for more involvement with Suffolk
Healthwatch and engagement with SEPT services.
o E-mail addresses were exchanged and contact to be made.
Event feedback
No feedback forms were filled in for this event, but the group agreed that this was a
beneficial session for the Suffolk area services and service users.

West Essex: The Park Inn, Harlow

Named GP for over 75s
It was asked if the initiative for over 75s to have and see one named GP was part
of the Frailty Project.
o Sally Morris answered that Primary Care services have their own
requirements and guidelines, however SEPT are working collaboratively
with GPs. Sally acknowledged the importance of co-ordinated care and
this will be an important aspect of the Frailty Project.

It was asked how the project will ensure co-ordinated care?

o Sally explained that clinicians working within the project will be able to
ensure co-ordinated care and work together with the GP. It was also
highlighted that SEPT would realise this project was not working based on
hospital admission figures.

It was asked if the Frailty Project was only taking place in West Essex.
o Sally confirmed this, however other areas are taking on different
approaches to avoid preventable hospital admissions and improve care
after discharge. The goal is to have services in place that prevent
avoidable hospital admissions especially for service users with long term
conditions.

Podiatry access
It was mentioned that there was a lack of access to Podiatry Services for
Diabetics
o Pam Sabine responded that service users are able to self-refer to podiatry
services and professionals can also refer. If after assessment, services are
not needed, the client would be discharged and GP informed. The client
would also be given information on how to care for their feet. The GP is
required to check the clients feet annually and can refer back to podiatry if
needed. It was explained that the number of Podiatrists within a service is
funded by the CCG and there is currently no more funding being made
available for more Podiatrists.

It was asked why there is a lack of toe-nail cutting services?

Gary Brisco
Patient Experience Co-ordinator

-7-

o Pam Sabine: The services are only commissioned to provide toenail cutting
to service users whose feet are at risk. It was acknowledged that SEPT
cannot provide this service to all that request it.
CCG Funding
It was asked how SEPT was funded by the Clinical Commissioning Group.
o It was explained that the Department of Health provide funding to the
Clinical Commissioning Group who then buy services from SEPT. SEPT
has a contract of services with activity with service size depending on the
number of staff that are funded by the CCG.
Funding for services in 2014 was reduced by 4% in comparison to the
services funded in 2013. This highlighted how demand can outstretch the
funding. Sally Morris concluded by highlighting that projects such as the
Frailty Project are designed to drive out inefficiencies and can be
reinvested in.

It was asked how can the CCG justify funding for projects and not current
services.
o Sally acknowledged that there is a need to invest money in health
promotion and prevention to sustain growing and aging population.

It was raised by a member of the public that with the need for people having to
access more Private Healthcare, what are Trust guidelines on seeing clients who
are already on a Physiotherapy care pathway and transfer to NHS Services?
o The Panel explained that there is no immediate access for clients because
they have already undergone treatment privately. The services have
access criteria as agreed with CCG. Although SEPT understands that
there needs to be a better pathway process.
o Sally confirmed that NHS services can be flexible to meet service user
needs, but does not want clients to access private services to queue
jump. It was explained that this would not be appropriate or clinically
driven. Attendees voiced agreement with this.

The panel was asked if the CCG are not aware of the effect on services the lack
of funding is causing.
o Sally Morris explained that healthcare services are suffering as a result of
the Health Economy funding difficulties. The intention is to reduce the
number of inpatient episodes that add additional costs. The CCG needs
services to work collaboratively, address issues and drive out service
inefficiencies.

It was asked if the change to funding means there will be a higher quantity of
lesser qualified staff providing care.
o It was explained that there has been and will continue to be changes to
roles and responsibilities, but this does not affect the quality of care. It is
very important that staff have responsibilities and undertake roles that are
appropriate and monitored. Having fewer senior members of staff but
making sure they are better placed would be an improvement to services. It

Gary Brisco
Patient Experience Co-ordinator

-8-

was discussed how safe levels of service require adequate qualified staff,
but balance is imperative to ensure that this is efficient.
o Lorraine Cabel informed the group that as of next year it will be a
requirement that board members will know what staffing levels in all areas.
Twice yearly reports on staffing levels will be provided to Board members
to ensure that specific areas are monitored and improvements can be
made as required.
Support in the Basildon Area
An out of area service users family attended the meeting to raise a question
regarding lack of services in the Basildon area. Including mental health advocacy,
housing, benefits assistance, and doctors.
o The panel replied that advocacy services have to be independent from the
Trust, and acknowledged that Mental Health funding in South Essex is
reducing and this will continue. This has been raised with commissioners.
o Lorraine added that the Trust is working extremely hard to reduce surplus
services and make back-office savings; including changes to the Executive
Director teams. As a result of this, some services will be affected.
Physiotherapy services
A carer claimed the Physiotherapy team at St Margarets Hospital are under
staffed and over worked. They like the staff and are happy with the service,
however there is not enough of them.
o Pam Sabine replied that the service is currently under review and it is
acknowledged that the funding does outstrip the need. It was also assured
that this team has an eight week target for urgent cases.
o It was also confirmed that this is the only service with Hydrotherapy in the
area, and this can increase demand.
Concerns raised before the event
A member of Harlow Ethnic and Minority Umbrella (HEMU) asked about SEPTs
domestic abuse policy. They also asked how SEPT dealt with domestic abuse
when it is noticed by staff.
o The question was answered through the PALS service by a Specialist
Nurse for Domestic abuse in the trust. Who explained how domestic abuse
reports were handled by the safeguarding team, and how SEPT works
closely with the Police, GPs and Princess Alexandra Hospital.

It was raised that SEPT should put an outpatient service for mental health in
Saffron Walden Community Hospital.
o It was explained how this is not a service that SEPT is commissioned to
provide by the CCG in this area, and that mental health in this area is
currently managed by NEPFT.
o The process of CCG funding was explained.

Event Feedback
* An evening session might encourage more working people to attend.
Gary Brisco
Patient Experience Co-ordinator

-9-

* A worthwhile meeting, enjoyed the various issues and concerns raised and
reassurance provided by Sally and Lorraine.

Thurrock: Thurrock and Grays Community College

It was asked how SEPT and Thurrock services would fare following
government cuts to services.
o Financial cuts in services were addressed, and it was explained how
this will impact on community services.

A mental health service user raised that GPs have little knowledge of mental
health services, and her GP wasnt sure how to refer her to SEPT services
when she first used them.
o The panel explained how a new pilot training scheme with GPs is
helping to improve knowledge and awareness of mental health. It was
also discussed that there has been an addition of new services to help
GPs refer people who are in mental health crisis, or are in need of selfreferral services such as Cognitive Behavioural therapy.

A member of the local section of charity MIND talked to the panel and rose
that initial assessment over the telephone could be improved. As a result a
service user he had recommended to SEPT services disengaged from their
assessment, as they felt it was inappropriate to discuss certain conditions and
persona issues over the phone.
o It was explained that with any referrals received from GPs, initial
assessments are usually by telephone but some may need a face
appointment. It was expressed that the service user should have been
given a face to face assessment, and that service users and clinicians
could request one from the Trust when engaging with SEPT services in
future.

It was raised by the panel that the Single Point of Contact service was being
promoted to GPs, and this is increasing awareness of the services available to
them from SEPT.

Availability of AMHPs in Thurrock was raised, with an attendee voicing that

this is a growing concern in this area. Especially for mental health service
users and their carers.
o The panel explained that AMHPs are not directly provided by the trust,
but the group were told that there are plans to improve this outside of
SEPT.

It was raised that there was a new provider of Community Drug and Alcohol
services (CDAS) and support in the Thurrock Area, as this had been newly
commissioned to the group KCA. This provider of CDAS services will be
working in Thurrock

Gary Brisco
Patient Experience Co-ordinator

- 10 -

Sally announced that SEPT introduced a dementia garden at Thurrock

Hospital. The garden facility is available for local people with dementia and
their carers.
o A Tree planting scheme has also been part of this project, and SEPT
have been working to plant trees both in this dementia garden, and also
across the trust to keep SEPTs carbon footprint low.

The Panel updated attendees about SEPTs 6 Cs, a set of standards

expected of staff within the trust, especially clinical teams.
o These include care, compassion, competence, communication, courage
and commitment.
o It was demonstrated that even the executive team have these close to
hand, and how staff are encouraged to carry these.

There are changes to outpatient appointments, including a new system where

appointments will be booked by the clinicians.
o It was also discussed how accessibility can be improved for services,
and how outpatients are now given information to help them with their
appointments.

Event feedback
Liked informality, but a short presentation may have been helpful on a specific
trust-relevant topic for community mental health. This was my first attendance
at these meetings.
Verbal feedback was raised by a service user during a 1:1 session, saying that
he supported the NHS reaching out to the people it helped.
Suggestions for Future Take it to the Top sessions
Throughout these events, service users, staff, carers and members of the public were
asked if there was anything they would like to see in future at Take it to the Top.
Following these five events in Essex and Suffolk, it was also discussed with the
Patient Experience Team how this project could be improved in future.
Promotion was a long term operation through multiple channels, and performed by
both the Patient Experience Team and the Communications Team. Although the
Patient Experience team visited trust locations and local relevant groups and services
to promote this event, perhaps a joint effort between these teams could allow an
even stronger plan of promotion for this event. A promotional stand at the local town
centre in Basildon for example may have made the general public more aware of this
event in the Town Hall. It could have also acted as a way for people to pass topics for
discussion onto the executive team, or to collect general SEPT feedback. To do this
whilst also managing their other responsibilities effectively, the Patient Experience
and Communications teams could also temporarily draft volunteers to manage stalls
and collect feedback alongside them.

Gary Brisco
Patient Experience Co-ordinator

- 11 -

One of the main issues that these events face is attendance. Although many of these
sessions were well attended and there were many salient points raised, it is the goal
of any event to reach as large a target group as possible. It should also be
considered that the timing of any event can always unintentionally exclude interested
parties, such as people who work weekdays, or those who may feel vulnerable
attending an event in the evening. One suggestion is that SEPT doesnt solely work
with face-to-face feedback for these events, and that a persons ability to contribute
to Take it to the Top shouldnt be limited by their ability to attend.
As a trial of this for the west Essex session in Harlow, two enquiries were raised as email replies to the event promotion. As a previous event had less-than-expected
attendance, these two questions given a formal write up when the issue was
resolved. These written summaries were then given to the Executive teams, and
could be used as talking points if there were few enquiries raised on the day. I think
that in future sessions this should be encouraged, as the Patient Experience Team
already has processes for handling these enquiries, and it allows feedback to reach
the Executive Team regardless of attendance rates.
Following on from this, an online version of Take it to the Top should also be
considered. Younger service users, carers and members of the public may feel more
comfortable sending feedback through to a Take it to the Top email address, or by
completing an online form that labels them for the event and sends them directly to
PALS. This could also incorporate QR labels to allow people fast and easy ways to
comment directly to the Executive team. Feedback for these concerns could be
displayed publicly through one of the Communication Teams social media outlets
(Twitter and Facebook especially). This option is currently in development for other
projects, and could be easily adapted for next years sessions.
It could also be recommended that an entire session of Take it to the Top be done
online, streaming video of the panel and fielding questions from online service users.
The equipment for video conferencing is already available in The Lodge, and holding
an online event could encourage people who do not wish to provide feedback in a
public setting, or are unable to travel to the venue.
Summary
Take it to the Top 2014 was a successful way of allowing the people who use SEPT
services to access the people who lead them. Although some events suffered from
less than expected attendance, there was a strong dialogue in each, and feedback
from SEPT service users and members of the public. Key areas of Essex and Suffolk
benefitted both directly and indirectly from these events.
When analysing written evaluation for these events, all of them scored the question
was this event useful to you? highly, as well as questions regarding quality of the
venue and if they were satisfied with the event. Attending service users did not
request further intervention from the Patient Experience Team or Executive Team
following the one to one sessions. This information strongly suggests a high level of
satisfaction from attendees of this event.
Gary Brisco
Patient Experience Co-ordinator

- 12 -