1. Bath and North East Somerset
February Issue 3
This issue’s Top Topics
Introduction
Update on Transformation Plans
You Said, We Did
Feel The Difference Fund
Call to Action
HealthWatch visit
NICE guidance
Introduction
Welcome to the February edition of the Bath and North East Somerset Citizens Voice – your Citizens’ Panel newsletter. You are receiving this newsletter because you have signed up to be a member of the Bath and North East Somerset Citizens’ Panel. The newsletter will also give up to date information on progress that has been made in transforming health and social care in our area.
Update on Transformation Plans
Mobile Working
This project is moving forward with a number of key activities underway. Trials of devices are currently underway with clinical teams.
Integrated Care Record
We are working to join up IT systems across health and social care. By standardising the structure and content of electronic health records clinicians and social care professionals will be able to record, share and access to health and social care data consistently across different care settings
The first stage of testing the Integrated Care Record will begin within Virgin Care with our Community Matrons in February. The Integrated Care Record will be delivered in a series of projects which will build on the work of each stage. Once the Integrated Care Record has been tested within Virgin Care health services, the next stage will be to connect it to social care systems followed by systems used by primary and secondary care.
Social Care
We are working with B&NES Council and Avon and Wiltshire Mental Health Partnership Trust to support the 3 Conversations model – a strengths and assets-based approach to social care across the whole system which will be trialled over the next year at a series of pilot sites. We are currently identifying which pilot sites we will set up and are working with staff to trial it.

2. Transformation Plans cont.
Reablement Review
The review is progressing well and productive joint meetings have been held with commissioners. We are holding workshops with our teams to review our clinical system – SystmOne – which will help us to capture more information about the service we provide. We have also met with the strategic domiciliary care providers whose reablement therapy staff work with our reablement teams to understand more about how they work and any areas for improvement.
Mental Health Review
A meeting was held in December with local mental health organisations, commissioners and HealthWatch to plan mental health pathway engagement in a consistent and joined up manner locally.
You Said We Did You Said We Did is a national Virgin Care programme which sees us make more than 1,000 changes a year across our services as a direct result of feedback from the people who use them. Here’s some of our highlights from the last month in B&NES.
Specialist Rehabilitation Services
You Said: staff were speaking too quickly when answering the phone in the Early Supported Discharge office.
We Did: The team have agreed a standardised message and to speak more slowly when answering the phone in the office.
School Nursing
You Said: Bath College asked for a bespoke session for their pupils with special educational needs.
We Did: We provided sessions about infection control, immunisations and antibiotic use.
Learning Disabilities Day Services
You Said: the high chairs in Southside café (run by the Vocational Hub) are in a poor state
We Did: we have ordered 4 new chairs
Internal Service Reviews
Internal Service Reviews are designed to support service managers to show how they can evidence to the Care Quality Commission (CQC) that they comply with regulations.
An electronic tool pulls together information and action plans and service managers can monitor that they are maintaining compliance levels.
Services registered with CQC completed their reviews back in August 2017 and have to repeat the reviews every 6 months. These services are 100% compliant in completing these reviews.
Services who aren’t registered with CQC are currently completing their first review. They will be required to do this on an annual basis. These services are not monitored by CQC but these reviews will help us to demonstrate that all services are caring, well led, safe, effective and responsive.

3. Care Quality Commission
Quality Impact Assessments We are introducing a Quality Impact Assessment screening tool for all service areas we are planning to develop. This will require us to look at six areas of risk in relation to quality of services. Each plan for development will need to be assessed whether the proposal may have any negative impacts on service users, staff and organisations .
Care Quality Commission
We are now building close and productive relationships with the Care Quality Commission (CQC) by having quarterly meetings with them. This ensures an open and honest transfer of information between us and them and also provides them with assurance that we are identifying risks and running services as they should be run. The meetings also provide an opportunity to raise any concerns.
HealthWatch visit
HealthWatch made an Enter and View visit to Paulton Memorial Community Hospital in November. They talked to service users and their families and staff and observed the usual routines of the wards and waiting areas. They have produced a report on their visit and a list of recommendations for Virgin Care to respond to.
Recommendations included:
improving signage; reviewing parking provision and storage facilities and providing wi-fi in the waiting area.
The final report will appear on the HealthWatch website soon.

4. Feel The Difference Fund
Each year Virgin sets aside £100,000 to fund projects designed, developed and implemented by colleagues delivering services across the country as part of our commitment that everyone feels the difference. The Citizens’ Panel votes on the B&NES applications monthly.
Successful Applications - November
Funding for two pumps for the IV Service
£3846 awarded. The service provides support to patients who have been assessed for fluids at home. The purchase of 2 pumps (one for Bath City and one for rural North East Somerset) would enable the IV team to provide patients with a pump for use at home enabling them to function without the need for a drip stand or carer support (eg toileting). The team primarily support women with Hyperemesis Gravidarum and service users requiring ongoing fluid replacement. The service have recently trialled a portable pump which has enabled a patient to administer IV fluids safely at home. The pump allows the user to mobilise without the need to be attached to a drip stand. Access to the pump will free up nurses time in that a competent patient can be left with fluids running at a set rate and reduce. In managing these patients in the community, especially the hyperemesis women, we can help prevent avoidable admissions.
Bio-feedback equipment for the Adult Speech and Language Therapy Service
£1330 awarded to pay for equipment, software and a laptop. The funding is to provide cutting edge, innovative, evidence-driven swallowing therapy for service users using a technique called bio-feedback. Small electrodes are placed under the persons chin over the floor of the mouth muscles. They are then taken through various stages of therapy which involve modifying and adapting their own swallowing function using feedback on the screen. This has been found to affect the persons neurology (function within the brain) and it is at these levels of function that swallowing rehabilitation has been demonstrated to be effective. There is evidence that the use of these techniques can result in the removal of feeding tubes – thus giving a direct impact upon the quality of life and reducing funding for feeding equipment.
There were no Feel The Difference Fund applications received for Bath and North East Somerset in December and January.

5. New Managing Director Want more information?
Following a rigorous assessment process we have appointed Kirsty Matthews as the new managing Director of Virgin Care Limited in Bath and North East Somerset. Kirsty started work in early November. She was formerly Chief Executive of the Royal National Hospital for Rheumatic Diseases and more recently has been working with commissioners on integrated commissioning arrangements.
Since she arrived Kirsty has been meeting the teams delivering services and listening to the pride and passion they convey as they describe the service they provide.
Want more information?
If you would like more information about anything mentioned in this newsletter, if you have any ideas about items we could feature or have any feedback about the Citizens’ Panel then please contact Martha Cox, B&NES Engagement Lead on or
Help the Citizens’ Panel grow We are sending out a press release in the local media in February advertising for new recruits to the Panel and we are also putting a piece in the B&NES Council Together magazine that is delivered to all households in B&NES. We have been working with a staff member from the Shared Lives Service to develop an easy read poster and sign up form. These are currently being shared with other Citizens’ Panel managers who work for Virgin Care in the rest of the country for their comments. We will send them round to Panel members for your comments. We now have some publicity materials for the Citizens’ Panel, such as posters and postcards. If you would like some and some paper sign-up forms to distribute locally then please let us know.