You said, We did

Getting feedback on our work as commissioners and on local health services is key for us.  What is also important is ensuring that the feedback we receive has an impact on our plans and improving local healthcare.

We welcome feedback, comments and suggestions from local people about healthcare services in the borough and would appreciate hearing from you.  

On this page, we share examples of what we have done in response to feedback and how it has made a difference to our work. We also show how we are feeding back to our population about the difference their feedback has made. 

2019 Support for ME in primary care

As part of our community outreach programme we visited Kingston & Richmond MG group - our local ME (myalgic encephalomyelitis) support group - to follow up with them since our last visit. They were also keen to share their experiences of local health services. We had an extensive discussion covering a range of services and issues and some examples are included below. 

You said:

• The CCG should be aware of and share with GPs the group’s view that Graded Exercise Therapy (GET) is not a suitable therapy for ME patients, that it is currently under review by NICE and therefore should not be used GP practices.
• Wanted clarification whether ME is included as an “at risk” group for flu
• Asked that the CCG ensure that all GP practices in Kingston and Richmond can access the “Purple book” published by the ME Association which is a clinical and research guide for those affected by ME/CFS
• Would like to find out how the group can link with the Primary Care Networks (PCNs) in Kingston and Richmond.
• Share their experience of referrals.
• Would like more information about the eligibility criteria for non-emergency patient transport.

We did: 

• We noted the group’s concerns about GET and that it is currently under review by NICE. Our position is that the current guidance still holds, until it is updated by the review.
• Provided more information about the “at risk groups” for flu as set out by NHS England and encouraged them to talk to their GP or a community pharmacist about getting a flu jab.
• Confirmed that we will be arranging for all GP practices in Kingston and Richmond to get the current edition of the Purple Book published by the ME Association.
• Shared their feedback on referrals with the South West London e-referral team.
• Provided the group with more information about the eligibility criteria for non-emergency patient transport.
• Provided information about the new PCNS in both boroughs.

2019 Developing our local health and care plan 

Working with our health and care partners we used the ideas generated at an all-day engagement event with local people in late 2018 to develop draft proposals for our local health and care plan. We published these in a discussion document to continue the conversation with local people with local people most involved in and affected by our draft proposals. We did this through a mix of face to face discussions at local groups and forums, an online survey and written feedback.

You said:

We received a wide range of feedback to our health and care plan discussion document. Read an overview of our engagement and feedback received to inform the development of our local health and care plan.  Read the Kingston Health and Care Plan engagement report   Here are some examples of what people told us about our draft proposals: 

• Children and young people told us that they would value some education around how to look after their own mental health and how to support their friends if they are having difficulties.
• End of life care should be discussed openly and frankly – the plan should talk about death and dying rather than ends and ending.
• There was an ask to provide more detail about the actions to be taken to achieve the priority supporting unpaid carers.

We did:

Working with our local health and care partners we considered the feedback to inform the final version of the health and care plan.  We made several changes to the plan in response to feedback from local people.

Our responses to the feedback examples above: 

• We have included actions working with young people to design and develop peer lead services to reduce involvement in risky behaviours and developing the emotional wellbeing programme in schools.
• We have revised the actions around end of life care to reflect the request for more open and frank discussions.
• The plan now includes more actions to support the priority for unpaid carers including implementing Kington’s carers strategy.

We produced a “you said, we did” document which sets out in full our responses to the feedback received and how it has informed the final plan.  Read the Kingston Health and Care Plan you said we did.

If you have any questions or would like to know more about our local health and care plan you can contact us on kingstonccg.engage@swlondon.nhs.uk

2018 Children and young people – reducing self-harm 

Children and young people living in Kingston have high rates of self harm. We spoke to 56 children and young people, 109 parents and carers and 19 teachers in Kingston about what we could do to reduce self-harm.

Parents told us

“We are desperate for help and we don’t know where to go”

We did

We are developing an online list of services which shows the support available in our Borough.

Children and Young people told us

“Groups are great because they help you feel more accepted and less likely to take frustrations about loneliness out on yourself” "You can focus on friendships within activities."

We did

We are developing a whole school approach which provides support to children outside of a medical environment.

Teachers told us

“A lot of teachers are really lacking confidence when it comes to addressing or talking about mental health issues with children and young people. Improving their awareness and confidence (as well as their own wellbeing.”

We did

We are working closely with schools to develop a whole school approach and to deliver mental health and wellbeing training to teachers and other staff.

What we heard very clearly was that, whatever improvements are made, children and young people, their parents and carers and teachers need to be further involved.

2018 Parents of children with special educational needs and disabilities (SEND) living in Kingston 

You said

“We’d like to be more involved in service change for our children”

We did

Working with and a local SEND charity, we have set up a parents co-production and information group to help us shape our services so they work for people living in the borough. 

2017 Choosing Wisely 

The CCG has a substantial financial challenge and we have a duty to spent our funding wisely. We asked local people, patients, carers, local groups and organisations for their views on the proposals.

We asked:

Should we change the criteria for IVF and specialist services?

You said

"This will impact more on some people that on others and will create health inequalities."

We did:

We decided not to change the criteria for IVF.

We are doing:

We continue to work with the assisted conception unit to monitor clinical outcomes for women using their services. 

We asked:

Should we support patients to lose weight and give up smoking before funding surgery?

You said:

"It is against the principles of the NHS to place restrictions on who can access it based on lifestyle choices. While support should be offered to help people stop smoking, weight is more complex. People with Type 1 diabetes and low thyroid function, for instance, will be discriminated against."

We did:

Based on your feedback we decided not to make losing weight and stopping smoking a requirement of surgery. We have reviews our guidance to GPs to support patients to be in the best possible health before surgery. 

We are doing:

We continue in our efforts to work with partners to help people in Kingston stop smoking and to live healthy, active lifestyles. 

We asked:

Should we stop prescribing self-care medications, gluten free foods, baby milk and specialist infant formula, and vitamin D?

You said:

There could be a longer term impact on both parents and the NHS if people are not able to access appropriate diet and supplementation. Milk protein allergies are very complex and this could impact on some people in Kingston more than others.

We did:

We decided to continue prescribing baby milk and specialist infant formula and recognised that some of our healthcare professionals needed further training.

We are doing:

We are developing improved guidelines and education for GPs and other healthcare professionals to advise when prescribing formula is suitable or not.

Earlier feedback and response 

Proposals for changes to St George’s Mental Health Trust facilities were put forward for consultation in December 2014

You said:

• Significant public support for building two new centres of excellence at the Springfield and Tolworth sites
• Concern expressed about the level of proposed provision and clinical expertise within community mental health services
• Preference for adult deaf services to remain at Springfield instead of being relocated to Tolworth, as originally proposed
• Concerns were also expressed about the number of available inpatient beds, in light of future increased demand

We did:

• Keeping adult deaf services on the Springfield site
• Location of future mental health inpatient services at Springfield and at Tolworth
• Provision of robust community mental health services to support people close to home through Home Treatment Teams
• Flexibility to increase the number of inpatient beds within the overall development at Tolworth hospital to reflect demand

Improving ophthalmology (eye) services in Kingston (April 2015)

You said:

• Patients want improved access and signage for visually impaired people
• The appointment system is too complicated 

We did:

• Kingston hospital is looking at improving patient access by installing directional lines from Norbiton station and bus stops outside the hospital
• Administration issues at Kingston hospital are listed as a priority in the Trust’s Quality Accounts, with an action plan approved

Empowering people with long term health conditions (LTC)

You said:

• You need education to understand and have confidence to manage your own LTC
• You want to talk to one another and share experiences with those managing similar conditions, through activities such as networking and peer support

We did:

• Run the Expert Patient Programme (EPP). 10 EPPs have run across Kingston in 14/15 offering support to around 100 people
• Many patients are now involved in voluntary work and community projects, and enjoying a better quality of life and more control of their condition