Given the widely reported impact of Covid on children and young people’s mental health, Healthwatch Somerset wanted to investigate the current situation to find out if young people are aware of the services available to them and how effectively they think these services are promoted and delivered.

The report, which is informed by feedback from 85 young people and their parents/carers, highlights the challenges young people face as they try to understand and get support for their mental health.

The key findings include:

• 80% of young people felt the need for emotional support in the past year.
• 47% of those who needed support did not look or ask for help.
• 11% were unaware of any of the Somerset services offering direct support (via talking to young people).
• Young Somerset emerged as the most frequently contacted service.
• Schools proved to be pivotal in providing information and signposting for young people and adults.

The report identifies key recommendations aimed at streamlining access to services, improving communication, and bolstering support networks for young people. These include:

• Simplifying access to services, making it easier to find information, to self-refer, and to get ongoing support after treatment.
• Enhancing communication and promotion of available support, clarifying which services are best suited to individual needs.
• Establishing a system of support for those experiencing prolonged waits for assessments and treatments.
• Collaborating with schools, youth groups, community organisations, and family services to facilitate effective communication and access to resources to promote good mental health and emotional wellbeing.
• Involving young people in the development of new services and proposed changes to existing provision and communicating the value and impact of their involvement.

Announcing the report, Gill Keniston-Goble, Healthwatch Somerset Manager, commented: “Many young people clearly feel they need support with their mental health, but they are facing barriers in their journey to getting help, including around information and communication, and long waits for support. We are calling on the organisations involved in delivering and commissioning these services to work together to build an accessible, inclusive, and effective mental health support system for young people in Somerset.”

Nik Harwood, Chief Executive, Young Somerset, welcomed the report, commenting: “We really value the Healthwatch Somerset report into children and young people’s access to mental health and wellbeing provision in Somerset. There are a number of insights into both our provision and the wider Somerset system which will be invaluable in our continuous service improvement efforts. It is a useful tool for us to use with our own participation and inclusion work with Young Somerset service-users and stakeholders.”

Fiona Phur, Participation and Partnerships Business Manager, at Somerset Council said: “The Engagement and Participation team at Somerset Council have valued the opportunity to support young people’s voices to be heard in this comprehensive and useful report. We hope this will guide practitioners and commissioners in their decisions about the services and interventions that children, young people and their families tell us need to be available.”

Read the full report, which includes case studies and comments from young people: Reaching out: Looking at mental health support for young people in Somerset

Through their new public survey, Healthwatch Somerset wants to find out how you book appointments with your GP, for example, by phone, in person, online, via App or email. They also want to know if you have been offered a face-to-face appointment or an alternative option, and if that was suitable for you.

Your feedback drives change

Good access to GP services is an important measure of the quality of care being provided locally. Your feedback will help Healthwatch Somerset identify the strengths and weaknesses in the current GP booking processes. They will share their findings with those responsible for GP services in Somerset to help them improve access to GP care.

This research is in response to ongoing concerns raised by local people about the scarcity of NHS dentists, leading to difficulties obtaining both routine and urgent dental care. People are also telling us that a lack of NHS dental care is affecting their physical and mental health, and they are highlighting the high cost and financial strain associated with private dental care.

Demand for NHS dental care in Somerset is currently greater than the services available. Research has shown that the closure of dental practices locally and changes to NHS dental services have contributed to the shortage of NHS dentists in the county.

Gill Keniston-Goble, Healthwatch Somerset Manager, commented: “The consequences of this lack of NHS dental care on the oral health of our communities are likely to be significant, potentially leading to a notable decline in the overall oral health of our residents. Coupled with the rising cost of living, concerns over the accessibility and affordability of dental care have become even more pronounced, contributing to discussions about health inequality, locally and nationally. We want to gain a comprehensive understanding of the current situation in Somerset, so we are investigating local people’s experiences and perspectives of NHS dental care. We will share our findings with those responsible for dental care and oral health in Somerset.”

Making a difference locally, regionally and nationally

In April 2023, NHS Somerset took over responsibility for commissioning NHS dentistry. The insights gathered through this research will be shared with NHS Somerset to help them understand the current challenges surrounding access to dentistry and its impact on the oral health of Somerset’s communities.

At a regional level, we regularly highlight concerns about the local situation by updating the NHS Local Dental Network (LDN) for the South West about public enquiries received around dentistry.

We also share public feedback about dentistry in Somerset with Healthwatch England, to inform their national research and campaign urging NHS England to improve access and affordability in NHS dental care. Find out more

In June 2023, NHS Somerset appointed two Patient Safety Partners (PSPs) to support Somerset’s journey to improve the way patients are involved to help keep others safe. The PSPs, who have a wealth of experience, are hosted by Healthwatch Somerset, the county’s independent health and social care champion.

The PSP’s will:

• have oversight of all patient and public feedback gathered by Healthwatch Somerset, and use this to gain insight and report on issues relating to patient safety;
• become active members of NHS Somerset’s safety and quality committees to ensure the voice of patients is heard; and
• be involved in patient safety improvement projects within Somerset.

To find out more about the role of PSPs, visit: NHS England » Framework for involving patients in patient safety.

Emma Savage, NHS Somerset Deputy Director of Quality and Improvement, said: “Patient and family engagement is one of NHS Somerset’s priorities in developing safer health and care systems in Somerset. Safe care depends on the full involvement of patients and families as users of health and care services at every level and requires a shift from care designed for patients to care designed with patients. We are pleased to be able to fund two Patient Safety Partner roles to help ensure the voices of patients in Somerset are heard.”

Somerset’s new Patient Safety Partners are passionate about using insight gathered from local people to help Somerset NHS deliver safe, quality healthcare.

“Having recently retired from the NHS after almost 50 years’ service, I am privileged in being selected to undertake this role, that will ensure that patient safety is the golden thread which runs through all the processes and procedures that the healthcare services within Somerset provides. By working in partnership with patients, their families, carers and professionals to identify and assist in problem solving the issues of patient and staff  safety, ensuring that the provision of healthcare is safer within the complexities of today’s health service.” Glenys, Patient Safety Partner

“I look forward to representing the patient voice in discussions around the health and social care services in Somerset and to providing that necessary reminder that patient safety must underpin every decision made.  I have worked in the fields of health and social care for almost 30 years and I live in Yeovil with my family.” Claire, Patient Safety Partner

Healthwatch Somerset published six reports last year about the improvements people would like to see to local services. Here are some of the main ways patient and public feedback was used to shape health and care in Somerset.

Making it easier to get healthcare information and support via GP websites: Healthwatch Somerset’s recommendations, based on public feedback and research, are being used by NHS Somerset to inform their work around improving digital services. This includes making GP websites easier to use so that people can find information; developing online consultations as a helpful way to speak to GPs and other health professionals; promoting use of the NHS App to help people manage their health and wellbeing; and working with community partners to train and support people to use digital technology. (Read the report)

Improving care when patients are transferred from hospital to be cared for at home or in the community: Healthwatch Somerset made several recommendations to improve patient experience, mainly around the need for better communication, preparation, and support. Somerset NHS and other organisations involved in the transfer to care process have used the recommendations to inform their ongoing development work, which has already seen the introduction of a new discharge lounge at Musgrove Park Hospital to make it easier for patients to leave hospital when they are ready, and new Ready to Go Units in hospitals to support patient rehabilitation while they wait to leave hospital. (Read the report)

Advocating for better NHS dental care: Throughout the year, Healthwatch Somerset reported to the NHS Local Dental Network about public feedback on dental care in Somerset and the South West. This data is being used to make sure patient voice informs decisions about the development of NHS dental care in the South West.

Monitoring and improving the quality of care homes: As part of its partnership working with Somerset Council and the Care Quality Commission to support quality monitoring of residential care homes in the county, Healthwatch Somerset visited three care homes to speak to people about their experiences of using the services.

Healthwatch Somerset also announced four new projects it will be working on during 2023-24:

• Improving mental health support for young people
• Reducing the barriers people face when accessing services (GP appointments)
• Tackling health inequalities (access to NHS dental care and support for oral health)
• Improving intermediate care (short-term care that helps people recover after illness or hospital).

Announcing the annual report, Judith Goodchild, Chair of the Healthwatch Somerset Board, said: “This has been an exceptional year for Healthwatch Somerset, as the new Integrated Care Board (ICB) took over responsibility for health and social care in the county and our two NHS Trusts merged to form Somerset NHS Foundation Trust. During this time of significant change, we have made sure that the public voice is at the heart of health and care development work in Somerset. We have independently supported the ICB’s public engagement and consultation work and, through our own projects, we have investigated some of the issues that matter most to local people, including access to GPs, the use of digital technology in healthcare, and support for people as they leave hospital to be cared for at home or in the community.

“I want to thank everyone who has shared their feedback and worked with us to help shape health and care in Somerset; it’s vital we that we stay connected and collaborate so that we can continue to create positive change.”

Read the full Healthwatch Somerset Annual Report 2022-23 to find out more.

Since the emergence of COVID in 2020, GP practices have increasingly used websites to communicate with people and to deliver services and support. Most GP practices in Somerset are managed as small independent businesses – they receive guidance from the NHS on what should be included on their websites, but the design and structure is managed through the practice.

In Somerset, 58% of people who completed the NHS England National GP Patient Survey in 2021 said they do not use GP online services to book appointments, order repeat prescriptions, access medical records, or for consultations or appointments. And 50% had not used their GP website to look for information or services.

In response to those results, and ongoing public concerns about difficulties accessing GP care, Healthwatch Somerset decided to investigate the impact of digitalisation on patients using GP services. They gathered feedback from 242 people about GP websites and Healthwatch volunteers also carried out a review and evaluation of all Somerset GP websites.

Based on this research, Healthwatch Somerset has shared the following recommendations with NHS Somerset and Somerset GPs to help improve the quality and accessibility of information and services delivered through GP websites.

• Website design and content should be simple and uncluttered, and frequent changes to design and layout should be avoided so that people can become familiar with using the site.
• Patient input should be sought when developing GP websites, for example through Patient Participation Groups or NHS Somerset Digital Champions.
• Simple instructions should be provided, so that people know how to use the website and how it can help people them get the care they need. This guidance needs to be offered in a variety of formats so that people who do not have to go online to find out how to use the website.
• More help should be provided for people who lack digital knowledge and skills. This could be through Somerset’s GP practice Digital Outreach Team, or by making sure people are directed to support schemes such as ‘Spark iT’ which is provided by Spark Somerset.
• If people are unable or reluctant to use digital services, they must not be criticised or excluded from getting the care they need from their GP practice.

Read the report: People’s experiences of using GP websites to access information

Healthwatch Somerset Manager, Gill Keniston-Goble, said: “NHS leaders believe that digital healthcare services can benefit patients, carers and those providing care, by helping more people to stay healthy and well and helping services manage patient demand. Digital technology is rapidly becoming the main way to get information from GPs and to access their services. It’s vital therefore, that digitalisation is used to make it easier and not harder for everyone to get care and support. Listening to public feedback will help GP practices understand how to achieve this.”

Commenting on the report, NHS Somerset said: “We know that many people access NHS services online… Part of the work of NHS Somerset is to help to improve these digital services. Our Digital Outreach Team (DOT) works with all 64 General Practices in Somerset to help them to provide a range of excellent services… We also know that some people cannot use digital services. That is why we are currently working with partners including SPARK Somerset, our local libraries and our GPs, to offer loans of devices and internet connection to those who don’t have them, as well as training sessions via digital champions in the community, and care coordinators at General Practices. This includes how to use websites, how to use the Somerset apps library, how to use the NHS App, and much more. If you’re interested in finding out more, please ask your GP care coordinator who can link with the NHS Somerset DOT team or contact SPARK Somerset. We will use the feedback in this report to help inform this digital improvement work – thank you for sharing it with us.”

Healthwatch Somerset is working in partnership with NHS Somerset to find out what you know about Same Day Urgent Care, where you get information about these services, and how you use them. They also want to hear how you think urgent care services should be provided going forward.

Healthwatch Somerset is the county’s independent health and social care champion. They have the power to make sure NHS leaders and other decision-makers listen to your feedback and use it to ensure services meet the needs of the community.

In coming months, you will also be able to talk to Healthwatch Somerset face-to-face. Between November 2022 and summer 2023, they will visit community groups across the county to gather more feedback about Same Day Urgent Care. Check the Healthwatch Somerset website to find out when they will be in your local area.

This public engagement project follows on from Healthwatch Somerset’s March 2022 consultation on people’s views of urgent care in West Somerset. Read the report, Same Day Urgent Care in West Somerset, which includes recommendations, based on public feedback, for how to improve information and access to urgent care services.

The year in numbers

• In total, 2,896 people shared feedback or sought information about health and care services.
• 1,903 people shared their experiences of local health and social care services.
• 996 people asked for information, advice, and support on how to get the care they need.
• 35 volunteers supported Healthwatch Somerset last year, giving up 92 days of their time to make care better for their community.
• Healthwatch Somerset published five reports about the improvements people would like to see to health and social care services.

Healthwatch Somerset’s reports and how public feedback has made a difference

1. District Nursing Service: Healthwatch Somerset found that most people were very happy with the care they get at home, but they would like the District Nursing Service to offer weekend and evening visits and many people are cautious about digital consultations. Somerset NHS Foundation Trust is using this public feedback to develop their transformation plan for the District Nursing Service.

2. Young people’s health and care services: Young people told Healthwatch Somerset they want more joined up services and better communication. Somerset’s NHS Clinical Commissioning Group are using the insight from this report to inform delivery of the NHS Children and Young People’s Transformation Plan.

3. How are patients affected by waiting for surgery? Healthwatch Somerset’s report alerted the NHS that patients believed their condition deteriorated while waiting for surgery and they want more support and better communication while they wait. The NHS in Somerset is now piloting a scheme offering exercise to patients waiting for joint replacements to help maintain mobility; they now contact people on the waiting list to check on them; and the Trust is creating information materials to support patients on waiting lists.

4. Patient experiences of the NHS 111 service in Somerset and Devon: This report informed the service provider, the Care Quality Commission, the Clinical Commissioning Groups (CCG) and the NHS in Somerset and Devon, of common and continuing areas of concern. Public feedback influenced Devon CCG to recommission the NHS 111 service in their area.

5. Same day urgent care services in West Somerset: Somerset’s NHS Clinical Commissioning Group wanted to find out what local people know about these services and how they think they should be provided and promoted. The Healthwatch Somerset report has gone to Somerset NHS Fit for My Future Board to inform the ongoing review of how NHS urgent care is provided in Somerset.

Announcing the annual report, Judith Goodchild, Chair of the Healthwatch Somerset Board, said: “Despite another challenging year due to COVID, we have covered an extensive programme of work and made sure your views were heard by health and care decision makers to inform positive change in the services you use. Going forward, we are committed to championing better care for everyone, including those who often go unheard. We will continue to work closely with the NHS, local councils, care providers and the voluntary sector, sharing people’s concerns and queries to help improve access to services and quality of care.”

Healthwatch Somerset priorities for 2022-23

• Reducing the barriers people face when accessing services – particularly around access to face-to-face appointments and digital access.
• Championing the voices of those who often go unheard – including young people in need of mental health support.
• Influencing decision makers on a local level as services evolve – including working with Somerset’s new Integrated Care System (ICS) and looking at people’s experiences of being discharged from hospital to intermediate care or back to their own home.

Read the full Healthwatch Somerset Annual Report 2021-22 to find out more about their work during the past year, including findings and recommendations for changes to services.