GOVERNING BODY. This paper is to update the Governing Body on progress in communications and engagement since July 2015.

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1 Enclosure: M Agenda item: 15 GOVERNING BODY Title of paper: Communications and Engagement: Progress Report Date of meeting: 25.November 2015 Presented by: Diane Jones Prepared by: Helen Eldridge Title: Director of Integrated Governance & contact: diane.jones11@nhs.net Title: Principal Associate communications and engagement & contact: Helen.eldridge@nhs.net 1. To commission high quality, cost effective services to meet the needs of local people which improve health outcomes and reduce inequalities. 2. To ensure that the patients and the public s voice is heard so that we improve the quality of the services that we commission for the diverse needs of our population. 3. To develop Greenwich CCG as a clinically driven organisation with effective member engagement, that can attract and retain excellent staff, deliver effective governance and its full statutory and financial duties. 4. To create and optimise a data and intelligence rich environment to inform commissioning decisions at CCG, Transformation Steering Group, Syndicate and practice level. 5. To develop a long term approach to improving healthcare and delivering more integrated services for the population of Greenwich delivered by sustainable providers through partnership working with RBG, local providers, the community and voluntary sector. Purpose of the report: x x x x x This paper is to update the Governing Body on progress in communications and engagement since July This ranges from procurement and contract monitoring to gaining patient feedback in service redesign. Key work to date has been as follows. Local people have been engaged in the development of our strategy through our Patient Reference Group, through regular meetings with representatives of Healthwatch Greenwich and Greenwich Action for Voluntary Service (GAVS). GAVS and Healthwatch circulate information for feedback through their various network groups. We also engage with the network groups built on our behalf by Citizens UK. Wide engagement has been carried out in respect of Our Healthier South East London with regular briefings issued, website updates and circulation of hard copy materials. We sit on the communications and engagement group, Stakeholder Reference Group and attend Patient and Public Voice groups for the programme, ensuring regular updates are shared and feedback acted on. 1

2 Enclosure: M Agenda item: 15 We use all the feedback gathered from a variety of sources to inform practice and improve quality. This includes questions raised by members of the public at Governing Body meetings, intelligence fed back through the Patient Reference Group, Healthwatch and GAVS reports and face-to-face engagement opportunities. A compliance report is produced quarterly which triangulates soft intelligence from a number of sources, such as complaints, MP letters, quality alerts and incidents. This report is taken to the public Governing Body meeting. Any themes are investigated to share learning, improve practice and to improve the quality of the patient experience. Issues are discussed at the Clinical Review Group meetings and the completion of any actions required are monitored. As one of the first CCGs to be offering Personal Health Budgets (PHBs), over the last year we have been continuously engaging with the public, and patients and carers in particular, in respect of Continuing Health Care and PHBs. This has included presenting to patients and voluntary community groups and events held through the Carers Centre. Feedback has shown that people found the process complicated and confusing. Our Continuing Health Care Team has been working with individual patients, their carers and families to ensure they are all sharing in the decisionmaking in respect of their care. This ensures that they are supported where they wish to selfmanage their care, that their care plans are personalised and that they have access to a PHB where appropriate. The CCG held its third PLT event for financial year on Thursday 12th November This particular PLT event was not themed, but rather a number of high priority work steams suggested by the membership were incorporated into the programme. This included repeating popular work streams from earlier PLT events to ensure all primary care staff could benefit from the training. Some of our Commissioning Project Lead posts were due for recruitment during September and there were a number of new areas identified that required a GP Commissioning Project Lead to support. Applications were invited across these specialities from all clinicians in Greenwich. Successful applicants were then interviewed by members of the Governing Body for suitability and to align each successful applicant to a clinical area dependant on the experience and specialities of each applicant. Issues Arising: Citizen UK funding ends December The CCG will be looking at securing funding to continue this project and the work Citizen Uk have been doing to ensure engagement with local; groups. It is important now more than ever, that we ensure engagement with patients and the public as we move forward with the CCGs commissioning intentions for 2016/17 and QIPP schemes. Similarly, we are also focussing on GP member engagement. Further details of work to date is outlined in the attached report. Summary of Actions: Local people have been engaged in the development of our strategy through our Patient Reference Group Wide engagement has been carried out in respect of Our Healthier South East London with regular briefings issued, website updates and circulation of hard copy materials 2

3 Enclosure: M Agenda item: 15 As one of the first CCGs to be offering Personal Health Budgets (PHBs), over the last year we have been continuously engaging with the public, and patients and carers in particular, in respect of Continuing Health Care and PHBs. The CCG held its third PLT event for financial year on Thursday 12th November Some of our Commissioning Project Lead posts were recruited to during September. We will be looking to strengthen the PRG, by reviewing ToR and setting the agenda aligned to current commissioning issues We will be proactively engaging with patients and the public through all of the commissioning cycle Previous committee involvement: This paper has not been shared elsewhere Recommendations to the Governing Body: The Governing Body is asked to: Acknowledge the report for information (Please provide details below where Yes is indicated below) Impact on Governing Body Assurance Framework (x) Yes No x N/A Impact on Environment (x) Yes No x N/A Legal Implications (x) Yes No x N/A Resource and or financial implications (x) Yes No x N/A Equality impact assessment (x) Yes No x N/A Privacy impact assessment (x) Yes No x N/A Impact on current NHS Outcomes Framework areas (x) Yes No x N/A Patient and Public Involvement (x) Yes x No N/A Communications and Engagement (x) Yes x No N/A Impact on CCG Constitution (x) Yes No x N/A This report updates on progress around communications and engagement and patient and public involvement. Attachments: Communications and Engagement: Progress Report 3

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5 Developments since the Governing Body meeting in July 2015 Communications and engagement activity 1. Procurement A forward planning procurement calendar is posted on the CCG website and is included for information at every Governing Body meeting in public. The public are then able to ask questions about these planned procurements during the public Question and Answer session at these meetings. Engagement is built into the procurement process and carried out proportionately for every procurement. Our engagement is by a number of methods, such as face-to-face or focus groups, surveys, and specific events; and utilises a number of channels, such as social media, website or hard copy materials. These activities are carried out by CCG staff or, when required, by commissioning community groups or specialist companies to work with us. Healthwatch Greenwich are full members of the Market Management and Procurement Committee, and therefore for every procurement local patients are involved in designing the service specifications and assessing all bids. Citizens UK is working with the CCG to support the local Nepalese community. This contract has been extended to end of December. 2. Contract and service monitoring We monitor a variety of patient feedback data to monitor services and to check that providers are meeting their contractual obligations. This includes looking at quality alerts, friends and family test results, complaints, MP letters and provider patient experience data; actions are taken on any themes that emerge. Our Patient Reference Group, made up of representatives from a range of local organisations, share their patient and public feedback on services with us. Issues are raised at the public Q&A sessions at Governing Body meetings and addressed where necessary. Healthwatch Greenwich sit on a number of our committees, such as Quality and the Shared Intelligence Group and are invited to the Clinical Quality Review Group meetings, when providers are held to account. The requirement to engage with patients and obtain and supply regular feedback on services is built into every standard contract. 3. Service planning, design, redesign and decommissioning The CCG has been engaging with its membership on our Commissioning Intentions for 2015/16 and on the development of our refreshed Clinical Strategy. Several workshops have been held with members and letters have been sent out to our providers advising them of the CCG s intentions. (Need what we did with our stakeholders on this) The key areas we are looking at are: o LTC care o Emergency pathway for people aged 65 and over o Musculoskeletal services

6 o Dermatology, gynaecology pathways 4. Commissioning intentions At a number of events last year including the Great Get Together, an armed services families day in Woolwich attended each year by around 17,000 members of the public, we have been talking to the public about their experiences. We have commenced the process for next year s commissioning cycle and have been getting views on four areas this year: Acute, Primary Care, Community, and Mental Health. The feedback will inform our commissioning plans for 2016/ Strategy development Local people have been engaged in the development of our strategy through our Patient Reference Group, through regular meetings with representatives of Healthwatch Greenwich and Greenwich Action for Voluntary Service (GAVS). GAVS and Healthwatch circulate information for feedback through their various network groups. We also engage with the network groups built on our behalf by Citizens UK. Wide engagement has been carried out in respect of Our Healthier South East London with regular briefings issued, website updates and circulation of hard copy materials. We sit on the communications and engagement group, Stakeholder Reference Group and attend Patient and Public Voice groups for the programme, ensuring regular updates are shared and feedback acted on. 6. Patient feedback We use all the feedback gathered from a variety of sources to inform practice and improve quality. This includes questions raised by members of the public at Governing Body meetings, intelligence fed back through the Patient Reference Group, Healthwatch and GAVS reports and face-to-face engagement opportunities. A compliance report is produced quarterly which triangulates soft intelligence from a number of sources, such as complaints, MP letters, quality alerts and incidents. This report is taken to the public Governing Body meeting. Any themes are investigated to share learning, improve practice and to improve the quality of the patient experience. Issues are discussed at the Clinical Review Group meetings and the completion of any actions required are monitored. 7. Self-management, shared decision-making, personalised care planning and personal health budgets As one of the first CCGs to be offering Personal Health Budgets (PHBs), over the last year we have been continuously engaging with the public, and patients and carers in particular, in respect of Continuing Health Care and PHBs. This has included presenting to patients and voluntary community groups and events held through the Carers Centre. Feedback has shown that people found the process complicated and confusing. Our Continuing Health Care Team has been working with individual patients, their carers and families to ensure they are all sharing in the decision-making in respect of their care. This ensures that they are supported where they wish to self-manage their care, that their care plans are personalised and that they have access to a PHB where appropriate. Draft Page 2 of 8

7 8. How IT (including social media) supports engagement Digital and social media channels are used to disseminate news and information regularly to the public and to engage with them. We use Twitter and our website to conduct surveys and work in partnership with a number of relevant organisations on important subject areas. Digital and social media channels are used to disseminate news and information regularly to the public and to engage with them. We use Twitter and our website to conduct surveys and work in partnership with a number of relevant organisations on important subject areas. Our recent quarterly (June-August) website report showed 7,464 users had visited the site and there were 30,727 page views. Most recent visitors were interested in information about Eltham Community Hospital (5,173 page views), home page, contact us page and the local services page. We run a number of campaigns on our website and support our partners with theirs. Recent campaigns include staying well in the heat, NHS 111, antibiotics awareness, living well with diabetes, alternatives to A&E and Our Healthier South East London. We are now preparing for the launch of Health Help Now, a website and app produced by the South East CSU which will provide information about local services and treatments and help direct users to the most appropriate provider as part of our winter resilience activity. Health Help Now has been rolled out in other areas and are now being populated for Greenwich, Bexley and Lewisham residents. We currently have over 8400 followers on Twitter and reach a much wider audience through our networks and partners especially the council and NHS partner organisations - who re-tweet our information. The CCG s new intranet has been launched (to complement the office move to the Woolwich Centre) and the intranet is already proving to be a valuable platform for engagement with staff and members. Staff and practices have responded favourably to the new intranet. 9. Providers engagement Providers are held to account through the Quality Committee and the regular Clinical Quality Review Group meetings. We expect providers to share with us what they have done in terms of patient and public engagement and how that work is informing their practice. We monitor how they are implementing actions that have arisen from patient feedback and share intelligence that we have picked up through our engagement activity on areas which need to improve. Data is consistently monitored, such as Friends and Family Tests, Patient Opinion and CQC reports and we see copies of provider reports on their patient engagement activity. The Shared Intelligence Group also looks at all the soft intelligence gathered about how well providers are engaging. They are held to account on areas of weakness and plans to address these are closely monitored. 10.Development of engagement Where we are now: We have met and exceeded our statutory duties, but realise there is still much work to do if we are to ensure local people are at the heart of what we do and that we can achieve our aspiration of an embedded co-production approach. Draft Page 3 of 8

8 11. Member Engagement 11.1 Training and Education The CCG held its third PLT event for financial year on Thursday 12th November This particular PLT event was not themed, but rather a number of high priority work steams suggested by the membership were incorporated into the programme. This included repeating popular work streams from earlier PLT events to ensure all primary care staff could benefit from the training. Outcomes Over 270 delegates registered for the PLT event with representation from majority of practices in Greenwich. There were a total of 9 work streams running on the day. These included the following: Telephone Triage and Consultation Skills, Gastroenterology Update, Alcohol Awareness and Children's Safeguarding Level 3. These particular sessions were primarily aimed at clinicians. For non-clinical staff the following sessions were available: Advice and Guidance Concerning patient registration, PPG Best Practice and Clinical Notes Summarising. A further 2 sessions were aimed at a mixed audience which included: Understanding Prescribing and Cultural Diversity Awareness. Majority of sessions were well attended and some sessions were oversubscribed. Sessions that were oversubscribed will be repeated at a future PLT event. The next PLT event is scheduled to take place on Thursday 21st January 2016 and the overarching theme will be 'Primary Care Prevention' Greenwich Wide Forum The GWF held on 15 July 2015 focussed on Our Healthier South East London Issue Paper and the clinical work streams that sit within this programme, i.e. Community Based Care; Maternity Services; Children and Younger People; Cancer; Planned Care and Urgent and Emergency Care. The membership held round table discussions on the proposals within the paper on how these pathways could be improved through a much more integrated approach across providers. In order to give this programme more focus across the membership, a CIS survey was released inviting feedback on all of the clinical areas. 37 out of 41 practices were represented across the 4 syndicates, with 44 people attending the event. October Meeting The GWF was held on the 28 th October Agenda items included a presentation from Dr Sally Johnson, from the new Urgent Care and Out of Hours Provider Greenbrook and senior clinicians attending from Oxleas attending to provide information on the Adult Mental Health Pathway redesign. 33 out of 41 practices were represented across the 4 syndicates, which is a lower than normal average attendance due to the date change and clash with half term. Draft Page 4 of 8

9 11.3 Commissioning Incentive Scheme Survey Our Healthier South East London CIS Survey was released to the membership throughout July and August following the GWF presentation and garnered the membership s feedback on the OHSEL paper and proposals. There were 153 responses which were put into a report and shared with the Senior Management Team. These responses have been used to inform some of the commissioning intentions and will be a useful document to touch base with membership views on future developments within these clinical areas Newly Elected Syndicate Lead for Eltham Syndicate The GP Syndicate Lead for Eltham Syndicate was up for election due to their appointment onto the GP Executive & Governing Body. Practices within Eltham were invited to put forward candidates for the post and candidates were then interviewed by members of the Governing Body for suitability. The successful applicant then went out for election. Dr Esme Peters, a GP at Eltham Palace Surgery has been elected to be the Syndicate Lead for Eltham Clinical Commissioning Project Leads Appointments Some of our Commissioning Project Lead posts were due for recruitment during September and there were a number of new areas identified that required a GP Commissioning Project Lead to support Applications were invited across these specialities from all clinicians in Greenwich. Successful applicants were then interviewed by members of the Governing Body for suitability and to align each successful applicant to a clinical area dependant on the experience and specialities of each applicant. The current GP Portfolio chart is below: Draft Page 5 of 8

10 Dr Ellen Wright Chair Leading on: Partnership, Strategy and Organisational Development Dr Ranil Perera Lead GP Clinical Commissioner Leading on: Local Care Networks QIPP delivery Financial Performance NHS Constitution NHS England Assurance Use of technology IT & Business intelligence Information Governance Caldecott Guardian Supported by: Local Care Networks CPL Dr Rebecca Rosen IT & Business Intelligence CPL David James Dr Nayan Patel Lead GP Clinical Commissioner Leading on: Primary Care Co-Commissioning (PMS Review) CCG Constitution and Conflicts of Interest Health and Wellbeing Strategy Health Overview and Scrutiny Workforce & Education Medicines Management LMC Liaison Supported by: Workforce and Education CPL Dr Eugenia Lee Medicines Management CPL Dr Nupur Yogarajah Primary Care CPL Dr Rashmi Goel Dr Krishna Subbarayan GP Clinical Commissioner Delivery Contract management and procurement Quality Individual Funding Requests (IFR) Clinical audit of provider pathways Supported by: Syndicate Lead IFR CPL Dr Ram Aggarwal Urgent Care CPL Dr Jaisun Vivekanandaraja Quality CPL Dr Rebecca Moore Dr Sylvia Nyame GP Clinical Commissioner Realising System Value Care of Older People Programme Integration agenda Interface with Lewisham and Greenwich Trust and Oxleas Mental Health Crisis Pathway Patient & Public Engagement Supported by: Syndicate Lead Long Term Conditions CPL Dr Meena Bajpai Mental Health CPL Dr Vivienne Chai Dr Hany Wahba GP Clinical Commissioner Commissioning for Adults Safeguarding Adults The Commissioning Cycle with Syndicates identifying what needs to change Commissioning Strategy Self-Management Cancer & End of Life care Supported by: Syndicate Lead Planned Care CPL Dr Anuj Chaturvedi Cancer and End of Life CPL Macmillan GP Dr Caroline Hollington Dr Sabah Salman GP Clinical Commissioner Commissioning for Children Staying Healthy Safeguarding Children The Commissioning Cycle - with Syndicates identifying what needs to change Children s Strategy Health & Wellbeing Strategy Workforce Planning Supported by: Syndicate Lead Children & Young People CPL Dr Gurpreet Singh Staying Healthy CPL Dr Adebisi Olunloyo Darzi Fellow for Children

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12 12.Nurse Engagement Workforce Development We have worked in partnership with Health Education England in their workforce development programme which focusses on up-skilling and developing new clinical career pathways to ensure a primary care workforce fit for the future. The projects we have engaged in have been around Nurse Mentorship and Apprentices in primary care working in partnership with the Royal Borough of Greenwich s employment programme for people looking to get back to work. We have been supporting our GP practices to receive Year of Care Training for a cohort of clinicians and non-clinicians in each of our 42 GP practices. The Year of Care is an evidence based approach in improving outcomes for people with multiple Long Term Conditions. The Apprenticeship programme is due to start shortly, working in partnership with Greenwich Local Labour and Business (GLABB). We have a number of GP practices signed up to be part of this scheme. All of our 42 GP practices have received training and we have 3 Train the Trainers (2 Public Health and 1 GP) that have completed their training in order ensure we have sustainability in delivering this training for the future in Greenwich. 13. Knowledge As part of our engagement strategy, we encourage GPs to attend national and local events to enhance their knowledge of issues that are being debated on a wider scale and to feedback as appropriate. Greenwich had representation at the following events during May and June 2015: Darzi Accountable Care Event; Our Healthier SE London Provider Event; Improving Personalisation and Citizen Participation; Our Healthier SE London Workforce Development Workshop.