Black and Minority Ethnic Service Monthly Report February 2014
Use of Accident and Emergency
Services
A total of 39 participants were engaged in their usage of Accident and Emergency services within Cheshire East.
o
No of people engaged, with
specific information on:
- Location of
engagement /
postcodes
o
o
-
Age
-
Gender
-
Ethnicity
Key themes / issues raised
from the engagement
Recommended actions
/solutions to respond to
the key themes / issues
raised
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Ethnicity
Volume
CCG Footprint
Asian / Asian British - Bangladeshi
Asian / Asian British – Indian
Asian / Asian British - Pakistani
Asian - Chinese
Asian - Filipino
Asian - Thai
White Other - Polish
White Other - Spanish
White Other - Portuguese
White Other - German
White Other – Irish
Black / Black British - African
Other – East Timor
White – Gypsy & Traveller
6
5
3
3
2
2
6
1
2
1
2
2
2
2
EC (5) VR (1)
EC (4) SC (1)
EC (2) SC (1)
EC (2) SC (1)
EC (2)
SC (2)
SC (4) EC (2)
EC
VR
EC
VR
SC (2)
VR (2)
SC
Services used by those engaged:


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

17 Macclesfield District General A&E Department
11 Leighton A&E Department
5 Leighton MIU
4 Victoria Royal MIU
2 Congleton MIU
Frequency of use within the past 12 months:


31 participants identified that they had used the service only
once in the past 12 months: SC (12) EC (15) VR (4)
8 participants had used the services 2-5 times in the past 12
months: SC (4) EC (4)
Age of participants:
2




1 participants Under 20: EC (1)
22 participants aged 20-35: SC (9) EC (10) VR (3)
14 participants aged 36-50: SC (6) EC (7) VR (1)
2 participants aged 51-65: SC (1) EC (1)

2 Did not disclose
Conditions for admission
Leighton A&E Department
High Temperature - 2
Injury / Cuts – 4
Feint - 2
Allergy -1
Burns – 1
Cold / Flu – 2
Kidney Infection -1
Hernia - 1
Sickness – 3
Abdominal Pain – 0
Recurring Injury - 2
Stroke – 2
Fracture – 2
Food Poisoning - 1
Child related – 6
*Attendance for Child equated to 43% of total attendance. Predominant conditions for child attendance were
high temperature, sickness and cuts (69%)
Leighton MIU
Sickness – 1
Child Injury - 1
Macclesfield A&E Department
Alcohol - 1
Cold / Flu – 2
High temperature - 2
Chicken pox – 1
Sickness and Diarrhoea - 3 Burns – 1
*Child injuries relate to fractures, cuts and burns
Congleton MIU
Injury - 1
High temperature - 1
Injury - 2
Sickness – 3
Heart - 2
Dizziness - 1
Child Related – 8
Chest Pain - 2
Injury – 4
Injury - 1
Burns - 1
Fracture – 1
Victoria Royal Infirmary MIU
Head Injury - 1
Not specified - 1
*data indicates conditions /injuries for attendance at A&E (identifies for some more than one attendance)
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Reasons for attendance at services:




9 participants attended because their GP surgery was
closed
17 Participants attended as they felt their conditions
required emergency treatment
8 participants attended as they were not registered
with a local GP: SC (3) EC (5)
5 participant attended as there were no available
appointments at GP surgery
Quality of services





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15% of participants felt the services they received were
poor
44% of participants felt the services they received were
average
28% of participants felt the service they received were
good
3%of participant felt the service they received were
very good
10% of participants felt the service they received was
excellent
26% of participants engaged identified that they required support from Interpreters at appointments, 60% in
Eastern Cheshire and 40% South Cheshire. Languages where translation support was needed: Polish,
Bengali, Urdu, and Punjabi. Only 2 participants suggested that they were offered Interpreter support from
services, both Polish patients.
Choose Well Campaign
o
No of people engaged, with 8 Workshops have been facilitated within the community this month, 3 South Cheshire, 3 Eastern Cheshire and 2
within Vale Royal. 2 Have been facilitated at Eaglebridge, 1 Danebridge and 1 at Watersgreen. Of the other 4, 3
specific information on:
- Location of
engagement /
postcodes
o
o
-
Age
-
Gender
-
Ethnicity
Key themes / issues raised
from the engagement
Identified barriers faced to
have been delivered within Children’s Centres at Broken Cross, Hurdsfield and Victoria. The final workshop was
delivered at a community event in Alsager.
In total, over 50 people have been engaged in the 8 Choose Well workshops. Attendees have spanned across 17
different ethnicities including: Polish, German, Finnish, French, Portuguese, Italian, Russian, Greek, Filipino,
Chinese, Bermudan, Sinhalese, Indian, Pakistani, Bengali, East Timorese and Irish.
78% of those engaged identified that they knew nothing about Choose Well. Several commented that they had
seen materials at their local GP practice but didn’t really understand or didn’t invest much time in reading through
the materials. Some key themes to come out of the workshops were;
 No appointments available at their GP surgery therefore looked to other services (mainly A&E)
 Where injuries related to a child, it was identified that A&E would be preferred choice due to accessibility
of appointments
 Not registered to GP, doesn’t access health services, if needed will visit then
 Language barriers and accessibility of support ie waiting for friends and family to support / availability of
interpreters determined when appointments could be attended
 Gender of HCP
 Costs of medication
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o
uptake of the Choose Well
message
Recommended actions
/solutions to respond to
the key themes / issues
raised / barriers faced




Past experiences
Attitudes of staff; several commented on the ability of hospitals / A&E departments to provide quick, easy
consultations rather than waiting several days at GP
Aids, such as the computerised check in system available at some surgeries, supported patients where
language may be a barrier.
Lack of information sharing that leads to duplication can be frustrating for patients
Other objectives – Maternity /
Smoking / Screening / Elderly
People
o
No of people engaged, with We have this month consulted with CVS Cheshire East, Healthwatch Chehire East, Healthwatch Cheshire West,
Cheshire, Warrington and Halton Race Equality Centre, Crewe Womens Aid, PPG’s and Cheshire East Council to
specific information on:
- Location of
engagement /
postcodes
o
-
Age
-
Gender
-
Ethnicity
Key themes / issues raised
from the engagement
Recommended actions /solutions to
share local population data, trends within local areas / wards and to understand different cultural needs/ barriers
to services.
We have been working with CVS Cheshire East in contributing population data, trends, issues / barriers,
engagement opportunities as part of an exercise for the JSNA. When were first approached by CVS, we were asked
to consult on data that was originally populated in 2009, therefore somewhat outdated. The population of
Cheshire East and Vale Royal has altered significantly over the past 5 years, the makeup of its residents has
changed. In sharing data of BME communities living within Cheshire East, it was identified that 92% of Cheshire
East population are defined as White British, the remaining 8% made up of over 160 different ethnicities (DORIC
2011, Cheshire East Council). This data, was collected within the Census of 2011, however, since then several more
countries have joined the EU, of which continues to expand allowing the rights of EU citizens to move freely
within its boarders. There has been nationally, an increase in the number of Visa’s issued for work, study, and
family, with an 18% increase in permanent stay visa’s from 2012. Until such time that further data is collected
within Cheshire East and Vale Royal, we will continue to make assumptions on what has been collected in 2011.
With significant changes to the population over the past decade, services, more so health, need robust strategies
and operations to cope with the additional needs of their service users . With a continual growth in its population,
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respond to the key themes / issues
raised
Cheshire services need to be suitably resourced to cope with additional needs, such as access to language support
services, Cultural Awareness and Equality Training of its service providers to avoid further (non cost effective/ non
resourceful) issues arising. If patients continue to be turned away from their GP due to language barriers,
difficulties in registering at surgeries, non-effective communication between user and provider, it will undoubtedly
put pressure on other services, such as A&E / hospital departments.
Ethnicity Data for each CCG footprint (broken down by constituency DORIC 2014)
Congleton : 106
Crewe / Nantwich : 133
Macclesfield : 117
Vale Royal: 108
There have been 2 Tulip sessions facilitated during February with 6 attendees at the sessions. We had originally
proposed 4 sessions, however there has been a change in the ‘set-up’ of the HV teams and therefore we need to
reconnect with the new team. The time out of the sessions has also allowed us to remodel the programme. We
are currently looking at other opportunities with the Local Authority, Health Visitors and Children’s Centres to
deliver future sessions.
We continue to work with the PPG’s at Eaglebridge and Waters Green. Our proposed meeting with Waters Green
has been rescheduled until April due the shortage of availability of members and GP’s at the meeting. Delemere
surgery at Eaglebridge have asked us to consult on their patient data, identified by ethnicity and look for
opportunities. We are hopeful that this will be undertaken in April.
The BME Service is delivering a workshop on Thursday 20th March 2014, aimed at local service providers and
Commissioners, to identify the change in populations, a more diversified community, understanding how this
could impact and to identify solutions for services and their consumers.
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Asset Mapping
o Table of identified
community assets with
specific information on:
-
Name
-
Description
-
Location
-
Target audience
-
Contact details
Data is continually being obtained and database updated regularly from engagement with BME communities. We
currently have information of over 70 agencies, (local and national) either supported by or facilitated by BME
groups / community groups that offer support to local populations within Cheshire East and Vale Royal
- Frequency of
meetings (if applicable)
- Services offered (if
applicable
Patient Experiences
o No of patient stories
produced on film with
specific information on:
-
Location
-
Age
Videos continue to be collected with clients / communities on what services are accessed and what were the
participant responses.
We are currently collecting patient experiences on why they access the services they do, what services are they
accessing and their responses to service delivery with a specific focus on Accident and Emergency, knowledge of
services, primary, secondary and acute and collaborating with Choose Well.
The Case study this month concentrates on a mother who suffers with incontinence and is prone to bladder
infections following the birth of her third child several years ago. She is a member of the Gypsy and Traveller
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o
o
-
Gender
-
Ethnicity
Type of service
commenting in (acute
hospital, primary care,
community provision,
mental health etc)
Positive or negative
experiences
community and is embarrassed to talk about her condition openly. When she went to her GP, 8 months after the
birth, she was advised on lifestyle changes and exercises that could benefit her. She was handed a set of leaflets
however did not understand the information / content within them. When she addressed this with her GP, the GP
suggested that she get a friend or family member to help her read through them. Gill was however reluctant to
share the information / her condition with family member through fear of embarrassment and has suffered since.
Our Health and Wellbeing Advisors have supported her to understand the condition and identified how key
lifestyle changes that could benefit. We have been working with her to introduce those lifestyle changes and
continue to monitor progression.
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