Healthwatch Wirral
Annual
Report
2014/2015
 1
Thank you for the very
successful day you
organised in the park on
Tuesday. I spoke to 38
people interested in
walks and our gym
equipment
(self care)
(
I am writing to express
my gratitude to HW
Wirral and all of the staff
that helped make the
Over-60s fair such a
resounding success
(Partnership working)
Great! Many thanks for
agreeing to present at
our student intervention
day.
(Raising Awareness)
A gentleman came with
three children. He was
moved to tears by the
welcome he was given and
the interest that was shown
in him and his family – thank
you
(Tackling social isolation)
Healthwatch Wirral  2
Contents
Contents ................................................................................................. 3
Introduction............................................................................................. 4
About Healthwatch Wirral ........................................................................... 5
Our vision and strategic priorites ................................................................... 6
Engaging with people who use health and social care services ............................... 7
Enter & View........................................................................................... 9
Methodology:........................................................................................9
Hospitals and PLACE ............................................................................. 10
Care Homes ....................................................................................... 10
General Conclusions ............................................................................. 14
Authorised Representatives ..................................................................... 14
Providing information and signposting for people who use health and social care
services ................................................................................................. 15
Influencing decision makers with evidence from local people .............................. 16
Producing reports and recommendations to effect change ................................... 16
Putting local people at the heart of improving services ...................................... 18
Working with others to improve local services ................................................. 20
Our plans for 2015/16 ............................................................................... 21
Commentaries and Statements ..................................................................... 22
Our governance and decision-making............................................................. 24
Financial information ................................................................................ 25
Contact us .............................................................................................. 26
Glossary ................................................................................................. 27
Introduction
For this year’s annual report we wanted to tell you what we have achieved and
to share what we are proud of.
During difficult times Healthwatch (HW)
has remained positive about the future of
our health and care services.
Healthwatch staff and volunteers worked
hard to gather the views of the public to
ensure experiences are learned and used
in the design and delivery of care.
There are two ways in which we can
measure Healthwatch impact. One is on
an individual basis; has the
patient’s/carer’s life received better
treatment or care? The other way is to
see if services have changed, as a result of
the information that Healthwatch Wirral
has gathered or shared.
Healthwatch Wirral does not handle
individual concerns, these are signposted
to people who are set up to deal with
them. However, some of the complex
issues that Healthwatch Wirral has dealt
with gave a huge amount of rich data. This
information has been shared with both
Commissioners, Providers and with the
general public.
We have gathered feedback from people
we have supported, and stakeholders, who
told us that, where Healthwatch have
been involved things have improved or
changed.
For example, Healthwatch Wirral used its
powers of Enter and View and worked with
Wirral University Teaching Hospital NHS
Foundation Trust (WUTHFT) to look at the
Surgical Assessment Unit (SAU) in the
hospital, and as a result of our work the
Trust identified the need to recruit
additional Emergency Consultants.
This year Healthwatch Wirral will be
working closely with the Scrutiny
Committee of the Council and the Health
and Wellbeing Board to ensure that the
soft intelligence, that Healthwatch often
gathers, is recognised and valued when
designing services.
Healthwatch Wirral’s statutory seat on the
Health and Wellbeing Board means that
the experiences of patients, carers and
other service users are taken into account
when local needs assessments and
strategies are prepared.
The Board would like to acknowledge the
efforts of the staff team and volunteers
who carry out the day to day activities,
aiming to improve the experiences for all,
when using health and social care
services.
Karen Prior (Healthwatch Wirral
Manager) and Healthwatch Wirral
Board (Phil Davies, Patricia
Goulborn, David Hughes, Annette
Roberts & Phil Rostance)
Healthwatch Wirral  4
About Healthwatch Wirral
We are here to make health and
social care better for everyone. We
believe that the best way to do this is
by designing local services around
needs and experiences.
Everything we say and do is informed by
our connections to local people and our
expertise is grounded in their experience.
We are the only body looking solely at
people’s experience across all health and
social care. We are uniquely placed as a
network, with a local Healthwatch in
every local authority area in England.
As a statutory watchdog our role is to
ensure that local health and social care
services, and the local decision makers,
put the experiences of people at the heart
of their care.
Learning from the real time experiences
of the people of Wirral we have strived to
ensure that voices from all sections of our
communities, and those who care for
people, are heard and considered when
planning and delivering services.
Local Healthwatch alerts Healthwatch
England to concerns about specific care
providers.
Local Healthwatch provides people with
information about their choices and what
to do when things go wrong; this includes
either signposting people to the relevant
provider or to Healthwatch Advocacy
Support for people who want to complain
about NHS Services.
Healthwatch Wirral is here to engage
with the widest range of local people
to ensure that they are aware of the
health and social care services
available to them and that their views
and experiences are listened to.
Through public engagement we raised
awareness of what HW does and
demonstrated that we listen. HW strives
to prioritise its work based on what the
public says. We will continue to challenge
commissioners and service providers by
sharing this ‘softer’ intelligence. This will
ensure that this information is recognised
as a valuable source of evidence in the
creation of appropriate services.
We have strengthened, and will continue
to develop, our campaign to recruit
Healthwatch Champions in every
Organisation, Patient Participation Group,
Community, shop or even street.
We have built strong relationships with
groups who have communication barriers
to accessing services and treatment. We
have also built robust partnerships
working with organisations which support
people with sensory impairment and this
model will be built on in the coming year.
We have conducted several formal Enter &
View visits to Hospitals and Care Homes
and we have also undertaken some
informal visits to conduct surveys in Minor
Injury Units and GP practices. HW Wirral
visits always include staff and volunteers.
Healthwatch Wirral  5
About Healthwatch Wirral
Our vision/mission

Influence the commissioning and
provision of health and social care
services by presenting clear,
realistic, well researched,
evidence-based reports and
recommendations to the
commissioners and providers of
health and social care services in
the appropriate forums

Recruit and retain volunteers who
represent the breadth of the Wirral
community using their experience,
skills, knowledge and commitment
as a key part to Healthwatch
Wirral’s success

Establish and build up networks
and partnerships to ensure there is
a range of cohesive and effective
services without unnecessary
duplication or gaps

Maintain excellent up-to-date local
knowledge of local health and
social care provision in Wirral

Maintain an up to date signposting
service for the benefit of all of the
residents and organisations of
Wirral
Our vision is to ensure that the voice of
the individual is heard and services are
responsive to their needs; that everyone
has the opportunity to have their say and
understands how and when to access their
local health and social care services.
The core purpose of Healthwatch Wirral is
to be the consumer champion for health
and care service users (through section
221 activities set out in the 2007 Health &
Social Care Act). It will involve patients,
service users and the public in shaping
local health and care services; and raise
awareness of their views and experiences
in relation to those services amongst those
in charge of commissioning provision and
regulation.
Our strategic priorities

Ensure that Local Healthwatch is
accountable to the people of Wirral
for operating on their behalf by
making sure that there is clarity
and good communication about
decisions taken and how they were
arrived at
Healthwatch Wirral  6
Engaging with people who use
health and social care services
Understanding people’s
experiences

Healthwatch Wirral has a weekly,
continuing, presence at One Stop
Shops and Tesco supermarkets.
Healthwatch Wirral uses the experiences
of service users of health and social care
service to gain feedback on what works
and where there are problems.
Healthwatch Wirral gathers this
information in many ways and from a
diverse audience.

Articles in Waiting Magazine which
promotes Healthwatch Wirral and
encourages members of the public
to share their experiences of
Health or Social Care.
Some ways in which we gather information
are:
‘Your voice’ leaflets –
Healthwatch, with the help of
volunteers and staff, have left
leaflets and holders in various
services across Wirral. The leaflets
can be completed anonymously, or
details left, and sent into
Healthwatch Wirral using the
FREEPOST address that appears on
the leaflet. We log and report on
the data we collect from these
leaflets and all other feedback we
receive.

Telephone calls

Emails and messages sent via the
‘Speak Out’ page on our website.

Healthwatch Wirral staff and
volunteers attend many networking
events. We also have an annual
Healthwatch Week were we visit a
range of different places across
Wirral to promote Healthwatch and
to gain feedback from the public.
We collaborated and arranged sessions
with harder to reach people such as the
older population, the younger population
and people with sensory and physical
difficulties and disabilities. We found that
when engaging with the younger
population we needed to gain trust,
resulting in them being open to discuss
their issues with us.
391 issues were raised with
Healthwatch Wirral during 2014/15 by
patients, their families / carers or care
staff. We are on target to more than
double this figure in 2015/16
Healthwatch Wirral also communicates
with service users via Healthwatch
Associates by sharing information through
newsletters and consultations. From 1st
April 2014 – 31st March 2015 Healthwatch
Wirral sent out:

10 regular E-Bulletins which we
have now increased to 2 a month
this year (2015)

20 Consultations on behalf of other
organisations, trusts and services
including:Healthwatch Wirral  7
Department of Health
Consultations;

Wirral Clinical Commissioning
Group policy

Have Your Say on Improving Eye
Health and Reducing Sight Loss,

North West Ambulance service
users consultation

Personal Independence
Payment (PIP)

Care Act

Macmillan

Changes to the Mental Health
Act, Codes of Practice -

Clatterbridge Cancer Centre
patient council

Transparency in Care: Visible
Ratings for Health and Care
Providers -

Clatterbridge Cancer Centre new
hospital decision

Special Enquiry

Carers

Department of Health Children
and Young people’s Mental Health
services

Wirral University Teaching
Hospital Improving care for
patients with Learning Disabilities

Patient Transport Service

Department of Adult Social
Services
Updating the NHS Constitution NHS
England Consultations;

Congenital Heart Disease
Consultation

Making Health and Social Care
Information Accessible
Wirral Borough Council
Consultations;

Wirral Core Strategy Local Plan

Neighbourhood Development
Plan for Devonshire Park
Other Consultations;

Disability Hate Crime SurveyCommunity Action Wirral

Non-Emergency Patient
Transport Service
Questionnaire – North West
Ambulance Service

Merseyside Fire and Rescue
Consultation – Merseyside Fire
and Rescue

'We Stand Together' –
Merseyside Police

Exploring How Choice Is
Working in NHS Adult Hearing
Services – Monitor


Transforming Cancer Care;
Clatterbridge Cancer Centre
Healthwatch Wirral has engaged with the
public and our Associates to raise
awareness on many subjects. HW has
promoted training and awareness sessions
such as :
Expressive communication

Dementia Awareness

North West Ambulance Transport
service

Social Isolation

Breast & Cervical screening
awareness

Local Patient Network

Patient experience
HW has taken part in five Quality Accounts

Community Trust
21 Consultations distributed directly
via email, including:-

Wirral University Teaching Hospital

Clatterbridge Cancer Centre

Mental Health Taskforce

Cheshire & Wirral Parntership

End of Life, Have your say

Wirral Hospice, St John’s
Healthwatch Wirral  8
Enter & View
Healthwatch Wirral has the statutory right
to carry out Enter & View visits to any
publically funded health and social care
settings to gather the views and
experiences of patients, families and staff
for the purpose of service improvement.
Service providers have a duty to respond
to our reports and recommendations,
which are in the public domain.
Healthwatch Wirral carried out a planned
programme of Enter & View visits to care
homes and hospital wards in Wirral from
April 2014 to March 2015. All services
visited were provided with a draft report
of our findings and were asked to make a
formal response. Some common themes
and trends were identified which could
provide opportunities for shared learning.
The report provides a summary of findings
from the visits, highlighting examples of
good practice, issues of concern and
makes recommendations for
improvements based on national and local
best practice.
Reports are published on the
Healthwatch Wirral web site and are
shared with the general public, the
service visited by Healthwatch Wirral,
the Care Quality Commission (CQC),
Wirral Clinical Commissioning Group
(CCG) and all Social Care Service
providers in Wirral.
Methodology:
Healthwatch Wirral receives intelligence
about a wide variety of health and social
care services from various sources. This
intelligence is used to plan activity and to
inform options for Enter & View visits.
All of the services received notification
explaining the purpose of the visits.
The Enter & View visits were carried out
by a number of Enter & View Authorised
Representatives and a member of the staff
team. A variety of methods were utilised
at each visit to gain an understanding of
the service provided, including:
Discussions with management, staff
and visiting professionals

Requests for documentation, such
as meal menus and resident
activity plans

Conversations with residents and
their families and friends
Healthwatch Wirral Authorised
representatives observed residents and
staff throughout the visit. Observations
were recorded on:
The general environment

Condition and presentation of the
home or ward

The nature of the care and support
received by residents or patients

The nature of staff interactions
with residents, patients and visitors
Residents, visitors and staff comments
were recorded anonymously to protect the
identities of contributors.
Leaflets explaining the role of
Healthwatch Wirral and the purpose of the
Enter & View visit were left for families
and visitors. These included Healthwatch
Wirral contact details should families wish
to raise any concerns or forward
compliments about the setting.
The visits focused on service areas
including :-.

Environmental

Service Provision and Management

Staffing levels

Safeguarding Alerts

Nutrition (Meals and Diet)
Healthwatch Wirral  9

Exercise and Activities

Personal support and Choice
The reports provided summary information
including comments and feedback from
staff, residents and visitors.
A number of common themes, issues and
examples of best practice have emerged.
Hospitals
Healthwatch Wirral visited two
departments at Wirral University Teaching
Hospital NHS Foundation Trust during the
year. These were the Emergency
Department (ED) and the Surgical
Assessment Unit (SAU)
The purpose of these visits was to verify
service user feedback and both visits were
unannounced.
The findings and conclusions of the
Authorised Representatives from both
visits were taken on board by
management. This has resulted in the
appointment of four emergency
Consultants to provide designated cover
on SAU.
Patient Led Assessments of the Care
Environment (PLACE)
PLACE visits aim to improve standards
across all hospitals, hospices and
independent treatment centres providing
NHS-funded care.
They put patient’s wishes at the centre of
the assessment process, and they use
information gleaned directly from the
patient assessor teams to report how well
a hospital is performing – in terms of
national standards and against other
similar hospitals.
Healthwatch Wirral Authorised
Representatives were invited to be part of
the assessment teams during the year.
They visited Wirral University Teaching
Hospital NHS Foundation Trust (Arrowe
Park and Clatterbridge sites) Wirral
Hospice St Johns, Clatterbridge Cancer
Centre and Spire Murrayfield Hospital.
Within each ward/department cleanliness,
privacy/dignity and general maintenance
and décor is assessed. The Team are also
required to assess food on one or more
wards and complete assessment forms for
each area.
The information is then forwarded to the
Health and Social Care Information Centre
for analysis and each hospital will have a
separate score for each domain.
Care Homes
Environmental Observations
Internal environments varied with some
settings being modern buildings with
contemporary styles of decoration and
others that had décor more in keeping
with older properties.
Internal and external layout & facilities
The layout of main lounges was similar in
most settings with seating placed around
the perimeter of the room. Some homes
had less formal seating arrangements,
with seats grouped together which was
conducive to enabling residents to engage
with each other. This enabled smaller
groups to meet or read quietly. Dining
rooms were usually light and airy
providing opportunities for group seating
or 2-4 seating arrangements. In some
settings the dining areas were used as
extra social areas for residents.
In all settings viewed, residents were
encouraged to use their own home
furnishings and personal effects in
bedrooms. This helped residents to settle
in and provided some familiarity in their
personal space.
Outside recreation areas varied in access
and use. In some settings, outside areas
were well utilised by staff and residents,
Healthwatch Wirral  10
with provision for gardening activities,
including greenhouses and flower beds.
Most settings had seating areas for
residents to use however, in a small
number of homes pathways around the
grounds were not always maintained to a
good standard.
General décor and upkeep
In nearly all cases the settings were clean
and well maintained but there were areas
for improvement. A common challenge is
the need to ensure a programme of
regular maintenance and decoration.
In a small number of settings, hand
sanitizer gel dispensers were empty. This
is an unfortunate indicator of good
practices and procedures not always being
followed through, on a 24/7 basis.
Conclusion / Recommendations
The importance of a well maintained
and welcoming environment cannot be
understated and is a key factor
influencing the initial and more lasting
impressions of each home visited. The
majority of settings observed had well
equipped and well set out internal and
external environments that appeared
beneficial to residents' health and
wellbeing.
Safeguarding
Healthwatch Enter and View visits are not
intended to specifically identify
safeguarding issues. However, if
safeguarding concerns arise during a visit
they are reported in accordance with
Healthwatch safeguarding policies which
includes contacting the Care Quality
Commission, the Local Authority and local
NHS Clinical Commissioning Group.
Staffing
Staffing levels and ratios varied from
setting to setting. It was evident that in
some cases there appeared to be low
levels of staff compared to the number of
residents and/or the size of the premises.
There are no specific guidelines for the
number of staff required other than a
requirement that the service must have
adequate staffing to meet the needs of
residents and to ensure that individual
care plans can be delivered. It was clear
from the visits that needs can vary
dramatically over the course of the day
and that this can result in peaks of
demand at specific times or when an
individual resident needs one to one care.
It was noted that staff sickness or
unplanned leave could cause additional
staffing implications. This was generally
addressed through 'doubling-up' of shifts,
bank workers and management covering
shifts where necessary. Some settings
used Agency staff in an emergency.
Additional staff were employed in homes
and were often present during visits.
Domestic staff are an addition to the total
care provided for service users.
Maintenance staff are employed at the
majority of settings to provide routine
maintenance tasks. Many Domestic or
Maintenance staff appeared well known to
residents and maintained a rapport with
staff and residents alike.
Overall, it was apparent that the majority
of care staff across the settings were
committed and enjoyed their work
although at times found it challenging. It
appeared that staff genuinely cared about
the residents and tried to ensure that
quality of care and safety standards were
maintained.
Healthwatch Wirral  11
Conclusion / Recommendations
Care Homes should continue good
practice by reporting potential
Safeguarding alerts to Wirral Council
Central Advice and Duty Team. It was
not always made clear to Healthwatch
Representatives how much of the
training offered was undertaken by
staff. Healthwatch would recommend
that Management encourage all staff
to participate in training to be able to
provide the best care and to support
the individual with personal
development.
Where staffing levels were low, due to
unplanned absences which could cause
additional strain on the setting and
staff, flexible working patterns and
the availability of extra staff during
peak times could help to ease the
pressure and increase the
effectiveness of the care offered to all
residents.
GP and Pharmacists
All settings visited said that they had a
good relationship with the GP Practice and
Pharmacy service. Most homes registered
their residents with local GP Practices but
some allowed residents to keep their own
GP if they wished to do so.
Conclusion / Recommendations
Care Homes should continue to foster
good relations with both GP practices
and local Pharmacists.
Complaints, Concerns & Compliments
At all settings visited the complaints /
compliments / comments policy was
discussed or observed. It was common for
homes to adopt an informal approach to
managing complaints and concerns. It was
often reported that no formal complaints
were made and that concerns and ideas
for improvements tended to be raised
more informally through an 'open door'
policy and conversations between staff
and visitors.
Additional Services
All settings had some services externally
provided, such as community nurses,
chiropodists, hairdressers, and in some
settings, alternative therapy practitioners.
Conclusion / Recommendations
It was clear from residents that had
the opportunity to use some of the
non-clinical external services, such as
hairdressers, that there was a positive
impact upon wellbeing.
Conclusion / Recommendations
Healthwatch would recommend that
homes, who do not always use a formal
procedure, should ensure that all
feedback received is recorded in order
to monitor trends, support learning,
drive improvements and tackle issues
quickly.
Residents and their families should be
encouraged to report all concerns,
complaints and compliments. Regular
analysis of common issues raised can
be used to drive improvements and
inform training needs.
Healthwatch Wirral  12
Communication
Good communication is essential between
staff, residents and all care home visitors.
However, the approaches and skills in
communication varied. In some homes
there was greater awareness of the need
for a variety of methods to meet residents'
individual needs. Some settings used 'easy
read', large print, colour and pictures as
an aid to communication but this was not
prevalent in all settings visited. Effective
use, updating information and positioning
of noticeboards also varied. Some settings
had implemented dementia friendly
signage and environments.
Conclusion / Recommendations
Sharing good practices in
communicating, sector wide, could be
effective for organisations to help
them improve their communication
with residents.
Conclusion / Recommendations
All settings provided meals that
appeared to be appreciated by the
residents. Good practice could include
the provision of staff with
responsibility for monitoring appetite
and weight management and to ensure
residents are adequately hydrated
throughout the day.
Exercise, Activities & Mobility
Observations
The level of activities provided varied
across settings. In some settings activity
coordinators visited daily to provide
mobility and creative activities. However,
in some settings at the time of our visit,
there was no evidence of any activities
taking place.
Nutrition (Meals & Diet) Observations
Where activities were observed, they were
delivered in a professional manner. At
some settings there were personal records
and weekly plans displayed for residents.
In all of the settings visited it was evident
that residents and families felt that
nutrition and diet were well catered for.
It was evident in some homes that
meeting the needs of all residents was
difficult.
Residents were given choices and
individual needs were also addressed.
Catering staff provided specialised meals
including gluten free, soft foods and high
protein options, when required, and there
was ample evidence of the provision of
drinks and snacks in between main meals.
Conclusion / Recommendations
Settings should review their activities
regularly to ensure that they are
providing a variety of activities that
can cater for all resident's choices and
needs, as far as is achievable.
An example of good practice noted was
the provision of staff to help residents to
eat their meals. Staff were also given the
responsibility of ensuring that residents
were kept hydrated by providing drinks
throughout the day. In some homes there
were jugs of water and juice available so
that residents could help themselves.
Support & Choice Observations
In most of the settings it was clear that
dignity and respect of the residents
underpinned all activity. From asking
residents how they would like to be
addressed to giving residents control over
the times they get up and go to bed times.
Residents were included in the choice and
nature of the care they received.
Healthwatch Wirral  13
In many settings end of life planning was
discussed on admission either with the
resident or with family members.
Many settings had invested in end of life
training for staff, which provided them
with the necessary skills and knowledge to
deal with end of life situations.
Conclusion / Recommendations
Care homes should continue to invest
in the provision of End of Life services
for residents and training for staff.
General Conclusions
Through this programme of Enter & View
visits we observed a broad range of
facilities and services at provider settings
in Wirral.
Generally the settings were suitably
equipped and set up to provide a quality
environment for residents. The majority of
services were delivered and managed
well.
There are opportunities for improvements
in relation to:





Staffing levels and ratios,
especially at peak times and to
cope with unexpected pressures.
The systematic recording of and
learning from feedback,
compliments, and complaints.
An enhanced approach to regular
stimulation, exercise and activity
provision
Regular and effective
communication in a variety of
formats including dementia
friendly environments.
Maintenance and refurbishment of
some settings
Generally staff appeared well trained and
caring. Overall the nutritional
requirements of residents appeared to be
met. Some settings had a good variety of
activities for their residents and showed
great initiative in trialling new ideas.
Resident choice was encouraged at most
settings and end of life choices showed
adherence to best practice by including
the resident and/or family members in the
decision making process at an early
opportunity.
Healthwatch recruited a Quality Assurance
Team, made up of staff and volunteers,
who set outcomes for visits and ensure
that those outcomes have been met, post
visit.
Healthwatch Wirral would like to thank all
of the staff, residents and families we met
for sharing their views and experiences
with the Healthwatch Wirral Enter and
View team.
Enter & View reports can be found on our
website www.healthwatchwirral.co.uk
Authorised Representatives
Healthwatch Wirral has a pool of
volunteers who have been trained to act
as Authorised Representatives for Enter
and View.

Diane Hill

Margie Gill

Kate Gratwick

Audrey Meacock

Tricia Harrison

Heather Ward

Elaine Davies

Peter Walton

Mary Rutter

Mike Sowden

Marilyn Wallace

Pauline Evans

Debbie Hurst
Healthwatch Wirral  14
Providing information and
signposting for people who use
health and social care services
Helping people get what they
need from local health and social
care services
Healthwatch Wirral provides information
and signposting in the following ways:

Online support for people who
email through the website or by
using the email address that is
published on all literature – this
email is checked daily and
responded to within 24 hours.

Telephone line – offering single
point of access straight through to
a member of staff who can signpost
or help with the query/concern.

Outreach work. Regular sessions in
the community where members of
the public can talk face to face
with someone who will take action.
Members of the Healthwatch Wirral team
have a good relationship with
commissioners and service providers,
whether public sector or voluntary sector
and can usually help the caller in assisting
them with the right information to their
query.
Some organisations HW signposted to are:
Department of Adult Social Services

Central Advice and Duty Team

Livewell programme

Age UK Wirral

Wirral Well
We have also signposted callers to:

Healthwatch Advocacy support

General Practice Managers

Other Healthwatch and out of area
equivalents of Healthwatch such as
Community Health Councils in
Wales.
An issue that came up a lot for
Healthwatch Wirral in the last year
was Continuing Health Care Funding.
We were able to help families to
obtain the support they required when
they felt they had exhausted every
option to them. The families who we
were able to help were very grateful.
“Following on from a short stay in
hospital, I had some issues
regarding my stay. I contacted
Healthwatch as I wanted some
independent information on how
best to deal with my concerns.
Healthwatch staff were very
helpful and understanding, and
explained the correct procedure
to follow. The outcome was very
positive, so thanks to Healthwatch
for your help.”
Healthwatch Wirral  15
Influencing decision makers with
evidence from local people
developing the Service Level
equality actions to a Health
Summit that Healthwatch Wirral
assist in facilitating. This may be
once or twice a year which ever
seems more productive during a
review of overall progress with the
action plan.
Producing reports and
recommendations to effect change
As well as the recommendations from our
Enter and View Visits (see pages 9-14),
during 2014 / 15 Healthwatch Wirral has
made a number of recommendations to
service providers. There were no providers
or commissioners who did not respond to
our reports and recommendations during
the year

Recommendation 2: That a
representative of Healthwatch
Wirral attends the Trust’s Equality
& Diversity Group which will meet
bi-monthly so that the
representative can observe and
support matters that come before
the group in relation to developing
the equality action plan.

Recommendation 3: That
Healthwatch Wirral recognise that
the current actions listed in the
EDS2 Equality Action plan reflect
the gaps identified by the Mersey
Internal Audit Agency (MIAA) audit
and do not represent the additional
work that has been done at service
level. The Trust continues to work
through those actions but waits
until sufficient time has elapsed
and the 2014/15 service level
actions have been progressed.
Recommendations to the Care Quality
Commission (CQC)
In 2014/15 Healthwatch Wirral made one
recommendation to CQC. This
recommendation was for them to
undertake a responsive visit to a care
home. However there are still some
outstanding issues.
Recommendations to Wirral
Community NHS Trust
Healthwatch Wirral had concerns about
the increase of significant untoward
incidents reported by Wirral Community
Trust and in particular the reporting of 1
Never Event*. Healthwatch recommended
that the Trust should continue using a
robust learning process which includes
Root Cause Analysis.
Equality and Diversity monitoring (using
Equality Delivery System EDS2)

Recommendation 1: That the
Trust agrees to present a series of
Case Studies that will demonstrate
how it is making progress in
*Never Events are serious, largely preventable patient safety
incidents that should not occur if the available preventative
measures have been implemented. Primary care trusts are
required to monitor the occurrence of Never Events within the
services they commission and publicly report them on an
annual basis
Healthwatch Wirral  16
Influencing decision makers with evidence from local people
Recommendations to Wirral University
Teaching Hospital NHS Foundation
Trust
Contingency Wards
Healthwatch Wirral made the hospital
trust aware of concerns around
Contingency Wards (winter wards) being
opened at times of high capacity and the
implications for both staff and patients.
The Trust have set up and equipped a
ward in readiness for winter and are
recruiting staff at present for the
opening of these wards.
Emergency Department
Healthwatch Wirral reported concerns
around signage at the Emergency
Department.
The Trust invited Healthwatch to visit
the site to review and comment on the
proposed changes to the signage.
Surgical Assessment Unit
Healthwatch Wirral conducted an Enter
and View visit to the Surgical Assessment
Unit (SAU) and highlighted concerns
around waiting times and admissions to
inappropriate wards for patients
“We are pleased to have
continued our collaborative
relationship with Healthwatch
throughout the last year. We
especially appreciate their
involvement in a number of key
work streams within the Trust,
in particular revised signage
within the Emergency
Department and helping us with
an assessment of care and
experience in the Surgical
Assessment Unit. Both of these
schemes are beginning to have
positive outcomes for patients.
“We view Healthwatch as a key
partner in developing our
services as well as a critical
friend in helping us improve
care and experience for all
patients.”
Michael Chantler, Head of Patient
Experience & Involvement,Wirral
University Teaching Hospital NHS
Foundation Trust
The Trust have recruited 3 senior
clinicians (with a further one to be
recruited soon) and waiting times for
discharge have improved.
Healthwatch Wirral  17
Influencing decision makers with evidence from local people
Putting local people at the heart
of improving services
We have continued to focus this year on
promoting and supporting the involvement
of local people in the commissioning,
provision and management of local health
and social care services.
We promoted 41 consultations on health
and social care issues (see page 8), and
trained and supported volunteers to be
actively involved in influencing how
services are improved.
Quality Accounts
Quality Accounts are an important way for
local NHS services to report on quality and
show improvements in the services they
deliver to local communities and
stakeholders. The quality of the services is
measured by looking at patient safety, the
effectiveness of treatments that patients
receive and patient feedback about the
care provided.
A Quality Account is a report about the
quality of services by an NHS healthcare
provider. The reports are published
annually by each provider and are
available to the public. Each year
Healthwatch Wirral are invited to supply a
commentary or supporting statement to
be included in local hospital trusts and the
Community Trust annual Quality Accounts.
A subgroup of Healthwatch volunteers,
Diane Hill, Audrey Meacock, Kate
Gratwick, Tricia Harrison, Alison Shead,
Carmel Calvert, Stanley Mayne, Pauline
Evans, supported by the staff team, met
during the year to scrutinise Clatterbridge
Cancer Centre, Wirral University Teaching
Hospital, Wirral Community Trust,
Cheshire and Wirral Partnership and
Liverpool Royal and Broadgreen Hospital
Trust's Quality Accounts.
Statements were prepared and forwarded
to each of the trusts during April and May
2014. Each quality account for 2013/14
can be found published on the
organisations web sites.
The group continued to meet with
providers during the year to scrutinise the
2014/15 quality accounts to enable
Healthwatch Wirral to supply
commentaries or supporting statements in
April and May 2015.
Health and Wellbeing Board
Healthwatch Wirral has a seat on the
statutory Health and Wellbeing Board,
ensuring that the views and experiences of
patients, carers and other service users
are taken into account when local needs
assessments and strategies are prepared,
such as the joint strategic needs
assessment (JSNA). This ensures that local
Healthwatch has a role in promoting
public health, health improvements and in
tackling health inequalities.
Healthwatch Wirral’s Chair, Phil Davies,
representents Healthwatch on the Health
and Wellbeing Board. Regular meetings
between the Chair and Healthwatch
Manager ensure that he is up-to-date on
current Healthwatch work and issues being
raised by the public. Healthwatch have
been actively involved in setting the
Board’s priorities as well as taking part in
a Peer Challenge Review organised by the
Local Government Association.
Safeguarding Adults Partnership Board
During the year, Diane Morley continued
to represent Healthwatch Wirral on the
Safeguarding Adults Partnership Board,
providing Healthwatch with a range of
contacts and current data and information
on all aspects of safeguarding across the
Wirral. We were invited to meet with the
Chairman of the Safeguarding Board when
we discussed a range of issues, including
whistleblowing and also attended a
development day.
Healthwatch Wirral  18
Influencing decision makers with evidence from local people
We are pleased to report that, since the
evolution of Wirral LINk into Healthwatch,
the emphasis on safeguarding has
increased. This relates particularly to our
Enter and View team of volunteers who
have benefitted from a training session
with a member of the Safeguarding Team,
as well as completing their mandatory
safeguarding training. As part of our bimonthly support to our volunteers, this
face to face session will be repeated on an
annual basis to keep our team up to date
with any changes. As safeguarding is
everyone’s business, all of our volunteers
and staff understand the need to report
concerns and are provided with contact
details of the Central Advice and Duty
Team should they need to seek advice.
As part of our Enter and View reports, we
have strengthened our coverage of
safeguarding incidents in places we visit
by requesting information on reported
safeguarding incidents, and the outcomes.
This is included in our published reports
which can be found on our website.
Wirral and Western Cheshire Cancer
Partnership Group (Wirral and
Western Cheshire Clinical
Commissioning Groups)
Audrey Meacock represents Healthwatch
Wirral on this Partnership Group. The
group meets quarterly with the aim of
representing the voice of patients and
carers to improve psychological support.
This group also reviews the results of
patient satisfaction surveys and makes
recommendations for action.
The group would like to develop links to
patient and carer groups across the
Network and with Clinical Network
Groups.
End of Life and Palliative Care
Kate Gratwick attends the End of Life and
Palliative Care Meeting for Wirral
University Teaching Hospital at the
Arrowe Park site. This meting is led by
Chief Nurse Gill Galvani and held monthly.
Cheshire and Merseyside End of Life
Steering Group including Care of the
Dying Evaluation (CODE) and Advance
Care Planning (ACP)
This group is led by Kathryn Davies.
The Palliative and End of Life Steering
Group feeds in to the above group and
meets quarterly.
A sub-group of this is the Advanced Care
Planning (ACP) Project Management Group
which looks at documents and the way
that these can be disseminated across the
Network. This is led by Dr. Clare
Littlewood.
Palliative Care and End of Life Charter
Led by Kathy Collins, Quality Improvement
Programme Lead for Palliative, End of Life
Care and Cancer.
The Wirral End of Life Charter Task and
Finish Group includes Healthwatch
Representatives, led by Julie Gorry.
Training for Staff and Volunteers





Enter and View Training –
November 2014 and March 2015
Dementia Awareness Training –
September 2014 and January 2015
Adult Safeguarding Awareness
Training – February 2015
Eye Health – February 2015
Healthy Living – March 2015
Bi-monthly training is planned and
available to staff and volunteers in
2015/16
Healthwatch Wirral  19
Influencing decision makers with evidence from local people
Working with others to improve
local services
PLACE Assessments
The Department of Health and the NHS
Commissioning Board recommend that all
hospitals, hospices and independent
treatment centres providing NHS-funded
care undertake an annual assessment of
the quality of non-clinical services and
condition of their buildings. These
assessments are referred to as Patient Led
Assessments of the Care Environment
(PLACE). They look at:

How clean the environments are

The condition – inside and outside –
of the building(s), fixtures and
fittings

How well the building meets the
needs of those who use it, for
example through signs and car
parking facilities

The quality and availability of food
and drinks

How well the environment protects
people’s privacy and dignity.
The assessments apply to all hospitals of
all types. This includes acute, specialist,
children’s, mental health, learning
disabilities, community hospitals, and
independent hospitals that provide NHSfunded care. The assessments also apply
to hospices and independent treatment
centres.
Harrison and supported by the
Healthwatch staff team.
“Thanks for the support
Healthwatch Wirral have given
this year to enable the PLACE
Inspection on both Arrowe Park
and Clatterbridge Sites to go
ahead. In particular the two
representatives who attended
Clatterbridge Arrowe Park on
two occasions as the audit was
carried out in two parts. I look
forward to working with you in
the coming year.”
Maureen McGenity, Assistant
Facilities Manager, Wirral University
Teaching Hospital NHS Foundation
Trust
The findings and results from the
assessment can be found on each of the
organisations web sites. The national
results are published on the Health and
Social Care Information Centre website.
Healthwatch Wirral were asked to provide
representatives to be part of a team of
assessors to look at Clatterbridge Cancer
Centre, Spire Murrayfield, Wirral Hospice
St Johns and Wirral University Teaching
Hospital.
The assessors were selected from the
Enter and View Authorised Representative
team, Kate Gratwick, Elaine Mortimer
Davies, Audrey Meacock and Tricia
Healthwatch Wirral  20
Our plans for 2015/16
Opportunities and challenges for
the future
People have told us that they want funds
given to front line services in a place that
is safe and where they know they will be
treated well. We have shared this
information with the decision makers and
the providers of services to ensure your
experiences influence how services are
designed and delivered. However, a
recognised threat is that substantial
savings must be made. Healthwatch Wirral
aims to work with the NHS and Social Care
organisations to ensure proper processes
have been observed if services are
changed or reduced; the processes
followed should include impact
assessments, engagement and feedback.
Wirral is one of 29 Vanguard sites1 in the
UK and one of our aims this year will be to
support engagement with Wirral residents
to ensure that people have a substantial
input into the health and social care plans
for the Borough. The challenges will be
raising confidence in the services in the
community and changing culture to take
the “self care” approach.
Healthwatch Wirral has supported the
development of the new Healthwatch
Quality Statements, which are being
1
Vanguard sites are new models of integration of health and
social care. Collaborative proposals were put forward and
Wirral was one of 29 successful applications. Vanguard
sites have been given the freedom to find new ways of
working placing self care and accessing community
services as the “norm” rather than going to hospital or GP
as the first option. There is now a greater need than ever
to engage with the public to ensure that these plans meet
patients’ needs.
developed to demonstrate what you, your
family and the people who design and run
services can expect, as a minimum, from
your local Healthwatch. The Quality
Statements will be embedded within our
Strategic Plan and throughout our
activities.
Healthwatch Wirral was invited as 1 of
only 3 of the 152 Healthwatch to take part
in the pilot stage of the Quality
Statements.
Throughout the Country, all local
Healthwatch organisations have been
given different lengths of contract and
different budgets by Local Authorities.
The local Healthwatch Complaints
Advocacy Service has been given a
contract until 2020 and we will be seeking
to work with commissioners and contract
leads to establish a way of bringing all of
these contracts into alignment.
Most people only feel the need to contact
Healthwatch when something has gone
wrong for them e.g. when they have been
in hospital, seen their GP or when they
access social care services. Healthwatch
can signpost people to services before
things get too difficult and complex and
provide advice and information on who
can help and support them best. At the
same time, we share those experiences
with Commissioners to
ensure lessons are learned
and changes in service
occur, where necessary. It
is imperative, therefore,
that people talk to us and tell their
friends, family and colleagues about
Healthwatch.
Healthwatch Wirral  21
Commentaries and Statements
Thanks to Healthwatch Wirral, Arrowe Park Hospital is continually raising the
standards of services for deaf patients, even allowing deaf groups in to assess
and suggest changes to A&E services. Taking deaf needs seriously, from
giving access to health information to sitting and listening to the experiences
of deaf people, Healthwatch Wirral are true Deaf Health Champions.”
Jo Slater
Project Director - Deaf Health Champions Project, North West
Healthwatch Wirral and the Joint Strategic Needs Assessment (JSNA)
Work has developed to consider how the JSNA content can best be provided to
the public, using Healthwatch expertise to support the development of new
sections, the refresh of current content and general information.
A virtual group of Healthwatch members now receive advance drafts of
content to provide added value to its presentation. This relationship will
develop over the next 12 months with both partners able to access the
others’s content base to widen the awareness of their respective work and to
promote added insight to the respective audiences.
John Highton – JSNA Programme Lead
“We are pleased to have continued our collaborative relationship with
Healthwatch throughout the last year. We especially appreciate their
involvement in a number of key work streams within the Trust, in particular
revised signage within the Emergency Department and helping us with an
assessment of care and experience in the Surgical Assessment Unit. Both of
these schemes are beginning to have positive outcomes for patients. “We view
Healthwatch as a key partner in developing our services as well as a critical
friend in helping us improve care and experience for all patients.”
Michael Chantler, Head of Patient Experience & Involvement,Wirral University
Teaching Hospital NHS Foundation Trust
“Thanks for the support Healthwatch Wirral has given this year to enable the
PLACE Inspection on both Arrowe Park and Clatterbridge Sites to go ahead. In
Healthwatch Wirral  22
particular to the two representatives who attended Clatterbridge and Arrowe
Park on two occasions as the audit was carried out in two parts. I look forward
to working with you in the coming year.”
Maureen McGenity, Assistant Facilities Manager, Wirral University Teaching
Hospital NHS Foundation Trust
Wirral hospice is delighted to provide its support to Healthwatch Wirral.
We have worked with the Authorised Representatives from Healthwatch Wirral
on several occasions over the past year. They have supported us to help raise
awareness of Wirral Hospice St John’s to enable us to include patient, carer
and user views, in shaping our services and decision making.
We received valuable support during the PLACE assessment and more recently
as representatives on the task and finish group that was instrumental in the
implementation of Wirral End of Life Care Charter.
We are extremely grateful for the ongoing support of Healthwatch Wirral and
look forward to continue working with the team in 2015/16.
Julie Gorry, Chief Executive
Wirral Hospice St John's
Aknowledgements
Healthwatch Wirral would like to thank:
All of the stakeholders that worked with us during the last year and we look
forward to developing relationships.

All of the public who spoke to Healthwatch Wirral and trusted us with their views
and experiences helping Healthwatch influence how Care Services are designed and
delivered.
Healthwatch Wirral  23
Our governance and decision-making
Our governance and decisionmaking
Our Board
Healthwatch Wirral’s Board members were
recruited not only for their business skills
and forward thinking, but also for bringing
a fresh approach to engagement and
communication. Their role on the Board of
Healthwatch Wirral is voluntary and nonremunerated, and their primary focus is
on helping the organisation function
effectively. Our Board Members for
2014/15 were:

Phil Davies (Chair)

Patricia Goulborn

David Hughes

Annette Roberts

Phil Rostance
Annette Roberts and Phil Rostance
stepped down from the Board at the end
of March 2015, and have been replaced by
Karen Livesey and Mike Sowden.
Healthwatch Wirral would like to thank
Annette and Phil for their time and
expertise during their two years on the
Board.
The day-to-day work of Healthwatch
Wirral is undertaken by a team of staff
and volunteers based in Liscard.
Our staff team has taken an ‘out-in-thecommunity’ approach to work over the
past year. This has resulted in speaking
with people on their “own turf” and who
would not normally have the opportunity
or feel comfortable sharing their stories.
How we involve lay people and
volunteers
As a local Healthwatch, we have a duty to
involve volunteers and lay-people in our
work. We have a team of more than 35
active volunteers who work regularly
alongside our staff team in Consultation &
Engagement, Operations, Research,
Administration and Quality Control, and
our Board of Directors is made up of
volunteer lay-people.
Our Board have primary responsibility for
monitoring and updating our governance,
and do so as part of regular Board
meetings, delegating to the staff team as
appropriate. We have also established an
Operations Group made up of staff and
volunteers to make suggestions about
which issues to prioritise based on
information received from the public or
issues arising locally or nationally.
Our Quality Assurance Team make
decisions about which care premises
should receive Enter and View visits, set
outcomes and ensure these outcomes are
achieved. This group is also responsible
for ensuring the quality of reporting is
consistent, and is again made up of staff
and volunteers
Healthwatch Wirral  24
Financial information
INCOME
Funding received from local authority to deliver local
Healthwatch statutory activities
Additional income
Total income
£
£170,000
£3,000
£173,000
EXPENDITURE
Office costs
£17,778.01
Staffing costs
£80,349.08
Direct delivery costs
£57,566.29
Total expenditure
Balance brought forward
£152,693.38
£17,233.53
Plans for the brought forward are to recruit a Policy and Research Officer and to retain our
current apprentice as an Adminisrative Assistant.
Healthwatch Wirral  25
Contact us
Get in touch
Address: 220 Liscard Road, Wallasey, CH44 5TN
Phone number: 0151 230 8957
Email: info@healthwatchwirral.co.uk
Website URL: www.healthwatchwirral.co.uk
We will be making this annual report publicly available by 30th June 2015 by publishing it
on our website and circulating it to Healthwatch England, CQC, NHS England, Clinical
Commissioning Group/s, Overview and Scrutiny Committee/s, and our local authority.
We confirm that we are using the Healthwatch Trademark (which covers the logo and
Healthwatch brand) when undertaking work on our statutory activities as covered by the
licence agreement.
If you require this report in an alternative format please contact us at the address above.
© Copyright Healthwatch Wirral 2015
Healthwatch Wirral  26
Glossary
HW
-
Healthwatch Wirral
HWE
-
Healthwatch England
DOH
-
Department of Health
NHSE -
National Health Service England
WUTHFT
Wirral University Teaching Hospital NHS Foundation Trust
CT
-
Wirral Community Trust
CCG
-
Wirral Clinical Commissioning Group
CWP
-
Cheshire & Wirral Partnership Trust
H&SC -
Health & Social Care
CQC
-
Care Quality Commission
MIAA
-
Mersey Internal Audit Agency
EDS2
-
Equality Delivery System
JSNA
-
Joint Strategic Needs Assessment
NHS
-
National Health Service
LINk
-
Local Involvement Network
ACP
-
Advanced Care Planning
PLACE -
Patient Led Assessment of Care Environment
27
Healthwatch Wirral  28