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NHS England’s recent report and guidance on improving orthotics services came about as a result of a formal escalation from Healthwatch England. Ahead of a meeting between a HWE Committee and the NHS England Board tomorrow, Jan Sensier, Chief Executive of Healthwatch Staffordshire and Neil Churchill, NHS England’s Director for Patient Experience, explain its importance:
Jan Sensier: In 2014, we received a user experience as part of our work with children and parents.
We began to make links with a local campaigner advocating the need to improve orthotics services. While this campaigner had worked very closely with the local Clinical Commissioning Group and had been able to influence changes to their commissioning strategies, she was concerned that the problems she had experienced were national and not just local.
We worked with her to gather information, evidence and patient stories to back up and then escalate the concerns to Healthwatch England, urging them to take action at a national level. Healthwatch England found that other areas were reporting similar problems. As a result, Healthwatch England then formally escalated these concerns to NHS England.
We are pleased that we were able to raise the issue nationally and give it a high profile. Commissioners are now more aware of concerns about the quality of orthotics services and the action plan is designed to improve services for patients and ultimately prevent young people having to undergo intrusive and painful medical procedures which could otherwise be avoided.
For me, a key role for all local Healthwatch organisations is now to monitor the impact of this work.
Neil Churchill takes up the story:
I was conscious when I received Healthwatch’s evidence that orthotics services are commissioned locally by CCGs and had to establish whether there was a role for NHS England.
On reviewing the evidence, it became clear there were important gaps which made it difficult to commission orthotics services effectively. There were no published quality standards, for example, and very little data about quality or performance, both of which influence commissioning strategies.
One of the best things about this escalation was that as well as highlighting problems, the Orthotics Campaign and Healthwatch were able to highlight good practice too. Our aim was to make clear the variation that currently exists in quality but also give commissioners and providers practical tips on how to improve. The report, published earlier this month, also includes a model service specification for orthotics, composed by a number of CCGs.
Our work is not over. The lack of data makes it hard to compare or assure quality.
As a result, we held a workshop with commissioners, providers, professional and trade bodies and users and carers to use the national service specification to create a national data set for orthotics services.
Some already provide an excellent experience, with high satisfaction and products available the next day. Other services require users to wait an unacceptably long time, which can cause harm as well as inconvenience. By highlighting this variation, we will help commissioners and providers improve. And strikingly, better quality services appear to save money, in the experience of some commissioners, because care is more co-ordinated.