voices of experience - age uk · web viewquestionnaire 42 report november 2017 with the nhs having...

Voices of Experience

Questionnaire 42 report

November 2017

With the NHS having to make savings of £55 million across the three boroughs of Redbridge, Barking & Dagenham and Havering, local CCGs have had to look closely at where savings can be made. Having involved members in discussions about the first round of proposals for saving money in the spring, in the consultation ‘Spending NHS Money Wisely’ we decided to involve members in the proposals for further cuts to current NHS funded services. The first round of proposals, once adopted, will save around £3 million. This second round of proposals if adopted will save in the region of a further £4 million.

The proposals in this consultation are to stop funding the following procedures:

Additional over the counter medicines (antimalarial; threadworm; short term sleeping tablets; Hay Fever medicine; travel sickness medicine; Vitamin D supplements; Pro-biotic supplements; skin rash creams; bath oils; shower gels and shampoos; sunscreen)

Ear wax removal (using microscope and suction device, but will still be used as a last resort for those at risk through other methods)

Back Pain injections (those intended for temporary pain relief, tingling and numbness such as disc, facet joint and epidural)

Osteopathy (only offered in Redbridge – 3 sessions) Cataract Surgery (proposal to tighten eligibility criteria from6/9 to 6/12 visual

acuity. 6/12 is the legal limit to drive a car. Surgery would only be offered if cataracts affect people’s ability to carry out daily activity such as reading or driving)

Podiatry ( Corn and callus care and toenail cutting to be available only to those with an underlying medical condition like Diabetes or Rheumatoid Arthritis)

We gave the information necessary to complete the survey to participants in a covering letter.

The second part of the questionnaire was about people’s experiences of getting to their hospital appointments, the results of which will support our National Charity’s campaign, ‘Painful Journeys’.

Due to the large amount of information involved, this questionnaire just had 2 topics.

We sent the questionnaire to 176 people on the questionnaire database, of which 61 were returned, (35%) and to 10 residents of Golding Court and the participants in one of the exercise classes at our Activity Centre in Wanstead. We received 74 responses in total, although some did not complete both sections and some returned the NHS part directly to the CCG.

Section 1

1


Hospital appointments.

Q1 asked: Thinking about the last year, how often have you had appointments at the hospital, excluding any emergency visits? 66 people responded to this part of the questionnaire.

8%2%

9%

20%

36%

26%

How often have you had ap-pointments

Monthly6 weeks3-5 mths6 monthsOnceNone

Q2 asked: If you have had appointments in the last year, how do you normally get to your hospital appointments?

44%

20%

13%

19%4% 1%

How do you get to and from hospital?

Public transportTaxiDriveFamily/ friendNHSOther

2


Q3 asked: When thinking about travelling to and from your hospital appointments, what, if anything, do you find difficult or struggle with? Participants were asked to tick all options that applied

Number %

Parking 20 41%

Length of journey 9 18%

Transport connections 15 31%

Relying on friends and family 10 20%

Having no one to travel with 5 10%

Not being able to take someone with you on hospital transport 1 2%

Something else 2 4%

Nothing 9 18%

3


Q4 asked: When thinking about travelling to and from your hospital appointments, to what extent do you agree or disagree with the following statements?

Agreestrongly

NeitherAgreeNordisagree

Disagreeslightly

Disagreestrongly

N/A/Don’tknow

NoResponse

You feel anxious about missing your appointments because the journey time is unreliable

15

31.5%

10

20%

5

10%

3

6%

7

14%

9

18.5%

You don’t ask friends or family for help because you worry about being a burden

13

27%

7

14%

5

10%

5

10%

14

29%

5

10%

You don’t like having to rely on friends or family for help but have no other option

12

24.5%

7

14%

3

6%

6

12%

19

39%

2

4%

You feel alone and wish you had friends or family who could help you with the journey

2

4%

5

10%

7

14%

6

12%

24

49%

5

10%

You dread having to go to a hospital appointment because the journey is difficult

48%

612%

612%

1020%

1837%

510%

People made the following comments:

I am mobile at present but am concerned about this in the future Having to set out early so as not to miss an appointment is a nuisance

4


It is having someone with you to remember to ask questions I may have forgotten or to remember what the consultant has told me

The cost of hospital parking is ridiculous! I suspect that I am not a typical patient because I can drive or have family who

can drive me. However friends are reliant on us or other friends to take them and dislike asking for help

Parking at all our local hospitals is very bad My daughter normally takes annual leave from work to take me to appointments.

Even if my appointment is in the morning it goes on the whole day resulting in her taking a full day off.

5


Section 2

Spending NHS Money Wisely

This survey was produced by the Redbridge, Havering and Barking & Dagenham CCGs and distributed to the questionnaire group and residents of Golding Court. Some were also taken by the participants of one of the activity classes at our Wanstead Activity Centre. Some people returned the survey directly to the CCG, and we received 67 responses to this section. Ethnicity of respondents: Any white = 49; any black = 3; any Asian =9; unstated = 6

Q1 asked: What do you think about no longer giving prescriptions for these things?

24%

22%28%

19%4% 1%

Antimalarial medicinestr suppsuppdon’t mindagainststr againstno resp

13%

19%

39%

21%7%

Threadworm medicinestr suppsuppdon’t mindagainststr against

18%

27%33%

16%6%

Sleeping tablets

str suppsuppdon’t mindagainststr against

6

The charts in this report have been abbreviated and have the following meanings:Str sup = strongly supportSupp = SupportStr against = strongly against


21%

25%24%

24%6%

Hayfever medicine


24%

31%

31%

7%6%

Travel sickness medicine


21%

27%30%

13%7% 1%

Vitamin D supplement

str suppsuppdon’t mindagainststr againstno resp

7


27%

25%30%

12%4% 1%

Probiotic supplement


40%

22%

22%

6% 9%

Oils, gels and shampoos


18%

15%

37%

21%

4% 4%

Skin rash creams


8


42%

24%

19%

6% 9%

Sunscreen


Respondents made the following comments:

If the condition is so bad that over the counter buying doesn’t clear it then the GP is needed. Otherwise all of these are personal choices and you should pay for them yourself

Bath and skincare should be given to children if GPs think this could help them

People’s financial state should be considered

Sleeping tablets are dangerous, can be dealt with in other ways more naturally. Sunscreens bath oils etc can be purchased cheaply from shops

People should take more responsibility for themselves.

Skin rash creams depends on the severity of the rash

If people want a holiday where they are liable to get malaria they can afford the medicine

Skin rash - having a skin rash for some unknown reason - had to seek medical advice and special cream was prescribed

Often the item is cheaper over the counter than the cost of the prescription

People travelling abroad should be able to pay for some of the items; some medicines are not very expensive. We should keep our cost down to support the NHS

Skin creams should only be repeated if effective

9


GPs these days try not to give you anything. It’s not fair to people on low incomes and senior citizens who would normally get prescriptions free

Medicines should only be prescribed to treat a specific condition to alleviate suffering not for simple ailments or for foreign travel

Lots of people take medicines abroad to their families. If they can pay for plane tickets they can pay for medicines

Over the counter sleeping tablets are rarely effective for severe sleeping problems. Not getting enough sleep can lead to loss of concentration, falls, other problems.

I believe that most anti-malarial and sleeping tablets should remain on prescription, particularly the latter to enable usage and possible addiction to be monitored.

If people’s symptoms become worse because of lack of prescribing that will cost the NHS more money, penny wise-pounds foolish

Q2 asked: Should the local NHS stop paying for ear wax removal?

10%

22%

24%

26%

18%

Ear wax removal

Str suppSupportDon't mindAgainstStr against


I know if I use over the counter treatment or olive oil as soon as I know things are not right the blockage clears, but when I don’t act the ears need syringing. Its laziness and the NHS shouldn’t have to pay

10


A doctor has to agree this treatment is needed. To be able to hear what people say is very important and could stop people going out

This could also be a time for testing for deafness

I have micro-suction 3 times a year because of a mastoid cavity and if I didn’t have this treatment would have balance and dizziness problems

Ears are very awkward to do on your own and need a trained person

As a sufferer where ear drops do not help am against stopping where needed

Wearing hearing aids - I once a week take a cotton bud, moisten it in liquid paraffin and pop in round inside my ears

Unfortunately I suffer from ear wax and have to have my ears syringed. I would agree to pay but am a bit dubious of the 'microscope & suction' method.

Advice should be available with what else people can use

Against except for elderly or disabled patients

Providing more serious conditions would still be treated I would support this

Bad hearing can cause road accidents. Elderly patients can suffer more injuries which won’t help the NHS budget or doctors shifts

I think this compromises older people

Q3 asked: Should the local NHS stop funding spinal disc injections, facet joint injections and epidural injections for lower back pain?

All

Strongly support

Support Don't mind Against Strongly against

Spinal disc

710%

23%

1015%

2943%

1928%

67

Facet joint

57%

11%

1522%

2842%

1827%

67

epidural

69%

23%

1421%

2740%

1827%

67


11


If pain is acute and exercise doesn’t help then surely people need the injections. If they are elderly they may not be able to afford to pay

Patients could be referred for exercise to relieve the pain

Back pain arises for various reasons - overweight, poor posture and can be dealt with by natural means

From my experience injections only offer temporary relief. Physio much more beneficial

This is difficult to answer as I can't say how someone has back pain - through injury in which case they need help

People in pain should get help, many of these injections are a necessity for some people.

This should depend on the amount of pain they are suffering

If GP thinks this treatment is necessary and considered effective it should be available

To relieve back joint pain would allow sufferer mobility. Being mobile has a beneficial effect generally

I am concerned that these injections are given if it is believed they are ineffective. I'm sure people who get them would be upset about this.

Should continue paying for all

Strongly against this. Pain has to be managed correctly and back pain is completely debilitating. Two tier pain system- those who can afford treatment and those who can’t or have to prioritise limited funding/income

Hope that people who devised this questionnaire do not need any one of these

If people cannot work because of back pain they can't earn money

Q4 asked: Should the local NHS stop paying for Osteopathy (currently only offered in Redbridge – 3 sessions)?

12


15%

10%

22%28%

18%6%

Stop funding Osteopathy

Str suppSupportDon't mindAgainstStr againstNo response


Osteopathy is very helpful and would be out of reach for people on a low income

Osteopathy is a dubious therapy it can cause more damage than it alleviates

Osteopaths are experts in their field

I get great relief after visiting the osteopath

Have paid for osteopath in the past, Never asked for it on NHS

I thought osteopathy wasn't recognised by the NHS

Unless it has been proven that it has been helpful and qualifications of osteopath have been checked

Not funded in Havering as far as I know - I pay for mine!

Mixed views on this. Stopping NHS funding takes this treatment out of mainstream treatment but can be a valuable non - invasive treatment for back pain and other conditions.

As it is, the very limited sessions of osteopathy do virtually no good. Sessions should be increased

Has helped me greatly and stopped dependence on painkillers and enabled me to sleep better

13


Q5 asked: Should the local NHS tighten the eligibility criteria for cataract surgery?

4%9%

13%

40%

31%1%

Eligibility for cataracts

Str suppSupportDon't mindAgainstStr againstno resp


This could invite accidents which would cause more cost to NHS. I have osteopenia and am aware of the dangers of falling and breaking bones. I have leg ulcers which I try to deal with myself paying for dressings but am thankful for the cataracts being removed making self- support possible

Cataracts are widespread and can cause problems. Removing them can greatly improve people’s lives

The new criteria seems unfair to the elderly Sight is precious for the elderly, falling comes into the equation This needs to be done Surely if an optician decided you needed cataracts removed it's an NHS job?

The effect on people's quality of life Sight disability could lead to accidents such as falls etc causing more expense to

the NHS

Depends on how it affects their life It must be awful not to be able to see TV or read a book

People can’t walk around nearly blind, eventually it will have to be done anyway

Poor sight prevents enjoyment of TV/indoor pastimes/activities. Causes lack of independence and confidence to go out and about alone to shop or socialise. Creates depression and isolation and illnesses. Ongoing treatment would cost the NHS more than removal of cataracts

14


Poor sight will inevitably result in more falls or accidents in the home - may cost more to treat these!

Although tightening criteria will save funds, worried about older people with failing sight and possible increase in falls. Could lead to more in patient stays, and social care packages.

Will result in more accidents and more cost to the NHS

Q6 asked: Should the local NHS tighten the eligibility criteria for podiatry? Should podiatry care only be funded for people who have a medical condition?

13%

21%

16%27%

9%13%

Tighten eligibility

Str suppSupportDon't mindAgainstStr againstNo resp

24%

37%7%

13%

9% 9%

Only with medical condition

Str suppSupportDon't mindAgainstStr againstNo resp

Respondents made the following comments: GPs need to be aware that patients may not be able to reach to deal with their

own feet any more. If eyesight is poor he needs professional attention and if he is

15


old his nails are probably tough and power in hands is weak. Foot care is really important if people want to continue being active

Older people can’t manage to cut their toenails but still need them done with or without a medical condition. I have to go every 3 weeks

Bear in mind that some people are housebound and can’t leave the house to get their nails cut privately

I think this has already been withdrawn I was referred by orthopaedic dept 2 years ago and haven’t heard anything yet, then again by GP two months ago still nothing

Having comfortable feet helps older people remain active which brings enormous health benefits

All who need it should have it

Had a corn on sole of my foot - couple of visits to podiatrist and it was gone - He has since cut my toenails twice a year. Have to find someone to do this and I will have to pay them.

Diabetics should still be treated free because of the risk of complications

This service is so poor now I can't think how it would be if this is agreed

I have Fibromyalgia and because of the constant pain I put the weight on my toes causing inflammation and infection. I have never received free podiatry care.

Foot health is vital, already difficult to access and difficult for older people to manage

Foot care is vital for mobility in older people

Q7 asked: In the last 2 years have you or a member of your close family had any of the following procedures:

Yes No No responseHad ear wax removal paid for by the NHS 16

24%5075%

11%

16


Had injections for back pain 57%

6090%

23%

Had treatment from an NHS funded osteopath 812%

5785%

23%

Had routine podiatry by the NHS 1116%

5379%

34%

Had NHS funded cataract surgery 1421%

5278%

11%

Respondents were then asked for any further comments.

All of these things should only be available to people who have paid their NI contributions. (3 people said this)

Getting people to care for their own wellbeing would save a lot. Lifestyles, laziness etc and we expect the NHS to pick up the pieces. It would be good to go back to the days when we would only go to the GP after doing our best to sort ourselves

Charge people for treatment for being drunk or drug abuse

Repeat appointments should be made before leaving hospital, would save on post and lessen the stress of waiting to hear when an appointment is being made (2 people said this)

Accept the return of crutches, walking frames etc Cleaning these must surely be less costly than new equipment and better for the environment as many go to landfill

Stop wasting money on drugs. A late friend had cupboards full of drugs which she had been prescribed only to have them changed shortly afterwards. Even when they are unopened pharmacies won’t take them back

Stop chopping and changing policies. The proposal to amalgamate several boroughs into 1 CCG will limit patients having a voice. Too many chiefs not enough salary increases for nurses and junior doctors.

Don’t prescribe anything that is cheaper to buy over the counter

A small charge for some procedures depending on income

Bit cross about all this. Being born in 1926 have seen the NHS start - now at 92 I'm seeing it end

Devise way people visiting our country pay something at least, as we do who go abroad. People should think about calling ambulance for minor problems, they are for emergency. Perhaps leaflets to show what emergencies are as many

17


people who live in our country may not understand the system.

GP surgeries give out regular prescriptions via computers so giving patients medication they no longer take, given when the patient says they no longer require them. The chemist then dispenses the prescription having been told by the patient they don't need them. This is a huge waste of NHS money!

Improve administration & efficiency of doctor's surgeries/health centres

Review medication prescribed especially in older people many of whom are taking multiple tablets for many years. Also repeat prescriptions which some people don’t take but still order no one questions the continuous prescriptions

To get free treatment you must have worked in this country for 5 years

Stop all IVF and elective cosmetic surgery. Charge any non NHS contributor and anyone who has paid in less than 5 years. Make more effort to claim back from health migrants and visitors without insurance. Strive for greater efficiency and stop so much wasted time

People shouldn’t go to the GP with a list expecting to get everything for free

Improving efficiency of appointment systems so conflicting information isn't sent. Communicate by email where possible to save on printing, postage etc. Perhaps it's time for people to have an insurance scheme or increased NI contributions? Ensure overseas visitors have insurance or means to pay before treatment (unless emergency).

There is still too much overprescribing

Investment in prevention is vital through public or voluntary organisations. Investment in social care packages to help people live safely in their homes with appropriate support could save NHS costs of inpatient care

My general view is against cutting the budget. Any curtailed essential services will cause more spending not less so the object will be defeated. Some sort of minimal payment system during a person’s working life to be put in the NHS pool would help

Conclusions: Respondents to the first section of the questionnaire about hospital appointments indicated that the majority who attend hospital regularly rely on public transport and they have real concerns about getting to their appointment on time and get anxious about making travel connections. For those who rely on friends or family to take them, the biggest issue is that of parking. For all of our local hospitals, when the car parks are full, there is little or no parking outside of the hospital within a reasonable walking distance. These surveys and this report will be returned to Age UK our national charity to support their campaign ‘Painful Journeys’.

18


Respondents to the ‘Spending NHS money wisely’ part of the questionnaire showed that the most objections to the proposed cuts to funding were those for injections for lower back pain and for changing the criteria for cataract surgery. For the three types of injections currently funded, the majority were against or strongly against stopping funding for these procedures. For spinal disc, (71%) facet joint (69%) and epidural (67%) Equally, 71% were against or strongly against changing the criteria for cataract surgery. Respondents provided some very compelling reasons for these views.With regard to the proposals mostly supported by our respondents, all of those mentioned in Q1 with regard to prescribing had stronger support than those against the proposals. The completed surveys were returned to Redbridge CCG for consideration alongside on line completed surveys.This completes the report.

NB A further 3 surveys were returned late and not included in this report. This takes the total who participated to section 1 to 77 and to section 2 to70.

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voices of experience - age uk · web viewquestionnaire 42 report november 2017 with the nhs having...

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