Meeting of Bristol Clinical Commissioning Group Governing Body. Title: PPI, Equalities and Communications Annual Reports Agenda Item: 17

Transcription

1 Meeting of Bristol Clinical Commissioning Group Governing Body To be held on Tuesday 30 June 2015 commencing at 13:30pm at the Greenway Centre, 119 Doncaster Road, BS10 5PY Title: PPI, Equalities and Communications Annual Reports Agenda Item: 17 1 Purpose To enable members of the Governing Body to discuss and approve the following three CCG annual reports, Patient and Public Involvement (PPI), Equalities and Communications. All of the reports cover the year 2014/15. 2 Background Each of the three annual reports includes the relevant action plan for the year 2014/15. In addition, draft action plans for 2015/16, for each of the three areas, are also attached. These three areas of work are important enablers of effective commissioning and the three actions plans are inter-related and should be read in conjunction. These three annual reports and draft action plans for 2015/16 were discussed and approved by the PPI, Equalities and Communications Steering Group at meetings on , and and by the Quality and Governance sub - committee of the Governing Body on How have service users, carers and local people been involved? Service users, carers and local people have not been involved in the production of these annual reports. The reports do, however, set out in detail the arrangements made by the CCG to involve service users, carers and local people in the CCG s commissioning activity; to communicate effectively with Bristol residents about the CCG s aims and objectives and to describe the CCG s equalities activities undertaken during the year. 4 Implications on equalities and health inequalities. The Equalities Annual Report outlines CCG activity in relation to equalities issues in 2014/15 Please indicate below the age group/s covered by the service/affected by the issue discussed Children/Young People X Adults X If you need this document in a different format telephone the CCG on Page 1 of 2

2 Meeting of Bristol CCG 30/06/ PPI, Equalities and Communications Annual Reports 5 Evidence Informed Commissioning Not applicable 6 Financial Implications None arising 7 Legal implications Both the Equalities and PPI Annual Reports describe how the CCG has fulfilled its statutory duties in these two areas. 8 Risk implications, assessment and mitigation None arising 9 How does this fit with Bristol CCG s Operational Plan or Strategic Objectives? These reports describe activity which supports effective commissioning 10 Recommendation Governing Body members are asked to discuss and approve the three annual reports Tony Jones PPI Programme Manager 18 June 2015 Judith Brown Operations Director 18 June 2015 Page 2 of 2

3 Patient and Public Involvement Annual Report 2014/15 DRAFT FOR COMMENT

4 Patient and Public Involvement Annual Report 2014/15 Introduction A summary of the arrangements made by the CCG to involve patients and the public in the commissioning of local health services was included in the CCG s Annual Report and Accounts for 2014/15. This report provides more detail about these arrangements. It is the second such annual report on patient and public involvement (PPI) activity undertaken by Bristol Clinical Commissioning Group (CCG). This report covers the CCG s second year of operation 2014/15. The report is set out as follows: Background to the CCG s approach to PPI The context in which PPI takes place in Bristol The arrangements that the CCG has made to involve patients and the public throughout the commissioning process The CCG PPI Action Plan for 2014/15, included as appendix 1 A report on PPI activity undertaken by member Practices as part of an agreement with the CCG to promote PPI and community engagement by Practices, included as appendix 2 Background The CCG has a clear set of values: We put patients at the heart of our decisions We embrace the diversity of our communities We are clinically led We work with partners across boundaries We are open and responsive. These values have been tested in what was a challenging and difficult preelection year for the NHS, both locally and nationally. Local health service providers struggled to meet NHS Constitutional standards on waiting times in Emergency Departments and the time taken for a patient from referral to treatment. This inevitably meant that time and energy was invested by local acute trusts in responding to these challenges and, as a result, slower progress was made in working with the CCG to further embed PPI in their day to day activities. In addition, a local campaigning group in Bristol, Protect our NHS, challenged the CCG, in part, over its approach to PPI. This challenge concluded with a Court arbitrated agreement which meant that the CCG made some amendments to its PPI strategy. In addition, the CCG s constitution was changed to reflect the amendments made to the PPI strategy. 2

5 Despite these challenges, the CCG launched two major PPI initiatives during the year as it began the process of re-commissioning both adult and children s community health services. In addition, the CCG developed a strong and productive relationship with the new People Scrutiny Committee of Bristol City Council, which delivers the health scrutiny function in the city, as well as continuing to develop our good working relationship with Bristol Healthwatch. Internally, the CCG developed the ability of its clinical steering groups to integrate the patient and public voice in service development. For example, both the cancer and mental health and learning disabilities steering groups now have patient representatives as full members of the two groups, and the Bristol Parent Carers has joined the children s steering group. In addition, to further embed PPI in the organisation, the CCG provided training for staff on the legal duties relating to PPI, as well as running a seminar for Governing Body members on the linked issues of involvement and equalities. Finally, CCG staff meetings started with a patient story to bring alive the concept of putting the patient at the heart of the CCG s commissioning. CCG Member Practices were active in reaching out to local groups and communities as they developed their PPI activities. For example, practices came together in clusters to host focus groups to enable their patients that had used adult community health services to give their views on the services. In addition, over the summer, practices participated in three locality based events aimed at bringing together GP practices, the voluntary and community sector and the City Council Area Based Community Teams (social workers). The events brought together organisations that play a vital part in the lives of local people, aiming to build relationships and understanding of how others work, in order to give better support to people in Bristol. For more information about some of the involvement work undertaken by practices during the year see Appendix 2 Co-ordination of the CCG s PPI activity continued to take place through the PPI, Equalities and Communications Steering Group (PEC). This steering group brings together these three enablers of effective commissioning, and co-ordinates and monitors activity in the three areas. The PEC reports into the CCG Governing Body via its Quality and Governance sub-committee. The collaborative working in these three areas means that this annual report should be read in conjunction with the reports covering CCG activity on Equality and Diversity and Communications. In addition, the CCG s annual report on its activities to enhance the quality of local health services is relevant because it covers CCG activity to improve the patient experience of local health services, as is the CCG s annual complaints report. Finally, the Avon Primary Care Research Collaborative (APCRC), which is hosted by Bristol CCG, has continued to promote and develop PPI in research. For more details of the work of APCRC in this area see (APCRC website details to be added here). 3

6 Setting the scene What are the duties placed on the CCG with respect to PPI? The law places three relevant duties on CCGs. The first relates to public and patient participation in commissioning (s14z2 of the NHS Act 2006). CCGs must make arrangements to ensure that patients and the public are involved throughout the commissioning process and, in particular, when changes to health services that might impact on them are contemplated. (The right of patients to be involved in the planning and development of health services is set out in the NHS Constitution). The second requires the CCG to consult its local Health Overview and Scrutiny Committee if it is planning to make significant variations to local health services. The final one relates to individual participation. CCGs must make arrangements to support individual participation in care and treatment through their commissioning activity. Even if the CCG was not required to do so by law it has, and will continue, to listen and act upon patient and carer feedback at all stages of the commissioning cycle, because of the evident added value of commissioning services that are informed by the experiences and aspirations of local people. Finally, the CCG must ensure that the public are engaged in its governance arrangements by ensuring that the CCG governing body includes at least two lay people. The CCG has two lay members on its Governing Body. In discharging its responsibilities under the relevant legislation, the CCG makes full use of NHS England s guidance, Transforming Participation in Health and Care, when making arrangements to involve patients and the public in the commissioning process. Delivering the public involvement duty three key issues 1. Who to involve? An understanding of Bristol and its changing population is essential to ensure that all groups and communities have the opportunity to have their voice heard. This is particularly important because Bristol is changing the population is growing, and becoming more diverse. This means that the CCG cannot rely on a one size fits all approach to involvement in the commissioning process. Involvement needs to be responsive to, and informed by, the diversity of groups and communities in Bristol. In addition, the public sector equality duties outline how Bristol CCG as a public body must, in the exercise of its functions, have due regard to the need to: 4

7 (a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010; (b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; (c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it. The application of the duties will further strengthen our approach to involving our communities in the work that we do, by ensuring that our involvement practice is inclusive. This means that involvement can range from individual participation to the involvement of groups who are often not well represented in NHS involvement activity. For example, the CCG s cancer steering group has worked closely with a carer of a patient who, since her partner s, death has set up a charity to improve rehabilitation services for cancer patients. As part of the re-commissioning of children s community health services and CAMHS the CCG has made particular efforts to access and create sessions specifically to include members of the public who are seldom heard, such as the gypsy and travelling communities and young people in pupil referral units. There is a large and growing population of children and young people in Bristol with varying needs and opinions, so it has been a priority for the CCG to be inclusive and engage with as many young people as possible. It has been important in the involvement process to identify and work with young people who are often seldom heard. There will be many reasons for this, but one reason may be that a young person is not in mainstream education. A Pupil Referral Unit (PRU) is an establishment maintained by a local authority which is designed to provide education for children who are excluded, sick, or otherwise unable to attend a mainstream or special maintained school. One of these establishments in Bristol is St Matthias Park which supports around 30 students. The CCG worked with these students over three weeks asking for their feedback on children s community health services. 2. How to involve To ensure that everyone has the opportunity to participate, it is important that the CCG, when making arrangements for patients and the public to be involved in its commissioning activity, uses a range of techniques to enable different groups and individuals to be engaged. Therefore, as a matter of course, the CCG should always be ready to offer a range of involvement techniques. The government has made it clear, in the Cabinet Office guidance on consultation, that involvement should be appropriate and proportionate to the issue under discussion. In addition, there is a move to provide a greater range of electronic/digital opportunities for 5

8 involvement than has happened in the past. For example, the CCG uses Twitter to promote involvement activities. There is an additional advantage in making involvement material web based because it is then much easier for participants to view and interact with the material in a language/format that suits them. The CCG does, however, recognise that not everyone is comfortable using web based materials, so it will continue to provide paper copies of involvement materials. There is also a growing expectation on public agencies to co-operate over involvement activities and, in the case of Bristol, this means taking a city wide approach to involvement. The re-designed CCG website has made it easier to offer electronic opportunities for involvement, and the CCG continues to work collaboratively with the Bristol City Council on involvement activity. For example, the CCG was able to contact 11,000 Bristol residents to ask for their views on the development of the CCG s Five Year Plan using the Council s Ask Bristol facility. In addition, a medicines waste survey was uploaded to the Bristol City Council Consultation Hub on its website so that all residents of Bristol could access it to have their say. Increasingly the CCG is working collaboratively with local voluntary and community sector organisations (VCS) to make best use their knowledge, skills and contacts to develop effective involvement. The CCG, along with VOSCUR, played an active role in the delivery of an NHS England funded Building Health Partnerships initiative for Bristol designed to support the development of effective partnership working between CCGs and the voluntary and community sector. In addition, the CCG commissioned VOSCUR to support VCS involvement in the development of the CCG s Five Year Plan and the Care Forum to support VCS involvement in the first phase of the re-commissioning of adult community health services, the development of the CCG s personalisation strategy and its commissioning intentions for 2015/16. The CCG also worked closely with VOSCUR to advertise and promote VCS attendance at a public workshop on the re-commissioning of adult community health services. The CCG continued to develop an effective and productive relationship with councillors and officers responsible for health scrutiny in the city. Following a re-organisation in the city council, the scrutiny function is now delivered by the People Scrutiny Committee. Although the CCG was not required to consult with health scrutiny during the year as a result of a proposal to make a significant change to local health services, considerable effort has been made to ensure that councillors are aware of, and invited to comment on, CCG involvement and commissioning activity. CCG officers attended scrutiny public and planning meetings as well as providing informal briefing sessions for councillors on a number of local issues. In addition, the CCG made sure that members on the people scrutiny committee had an opportunity for early engagement in the development of the CCG s commissioning intentions in the autumn of Healthwatch is an important PPI partner for the CCG and can offer a valuable perspective on the CCG s PPI activity. The CCG met regularly with 6

9 Healthwatch representatives during the year and, as a result, was able to continue or initiate the following activity. The CCG continued to be represented on the Bristol Healthwatch advisory board Quarterly liaison meetings were established Support was offered in the development of Young Healthwatch A joint meeting was held on the development of the CCG s Five Year Plan The CCG participated in a Healthwatch hosted workshop for representatives of BME communities which provided a forum for discussion about experiences of local cancer services, as well as an opportunity for people to comment on the draft of the CCGs commissioning intentions 3. When to involve The diagram below illustrates that involvement can, and should, happen throughout the commissioning process. Using the various stages in the commissioning process or cycle described in the diagram, the following are the arrangements that the CCG has made to involve local people and patients in its commissioning activity during 2014/15. For those interested, further information about how the CCG involves patients and the public can be found on the CCG website under the get involved section, and in the PPI Action Plan for 2014/15 which is attached as appendix 1. 7

10 1. Engaging communities to identify needs and aspirations. The CCG always uses the Joint Strategic Needs Assessment and the Health and Well Being Strategy, both of which are informed by the views of local residents, when commencing any planning or recommissioning projects. The re-commissioning of children s community health services and CAMHS started with the involvement of hundreds of young people and their parents/carers who, in different ways, and in different localities told the CCG about their experiences of current services and their aspirations for service changes and improvements. Member Practices participated in locality meetings aimed at understanding better the concerns of local voluntary and community sector organisations and helping to build partnership working across organisational boundaries The CCG s Clinical Steering Group for Cancer worked with Bristol HealthWatch to understand wider issues around cancer in the community. The group also started work to consider the impact of cancer services on people with protected characteristics to consider how best to build knowledge about how the current and future services impact on these people. 2. Engaging the public in decisions about strategies and priorities 8

11 During April and May, meetings were held with representatives of voluntary and community sector organisations and Bristol Healthwatch to discuss the development of the CCG s Five Year Plan. In addition, public comment was sought through Ask Bristol. The CCG made the following arrangements to involve residents in the development of its commissioning plan for 2015/16. o The draft plan was placed on the CCG website and a special newsletter was published explaining how patients and public could comment on the draft plan. Paper copies were sent to libraries and to the CCG stakeholder mailing list and GP Practices. o Working with Bristol Healthwatch, a public workshop, targeting BME communities, was held in December. The Care Forum was commissioned to organise a workshop targeted at Bristol voluntary and community sector organisations to encourage their involvement, which was also held in December. The CCG s medicines management team ran a project to identify ways to reduce medicines waste across the city. Patient feedback has been crucial to this research and has helped to identify some of the root causes of medicines waste. o Patients across Bristol CCG GP practices were invited to complete a Medicines Waste Survey to share information on how they order their prescription medicines and the service they receive in their pharmacy and GP practice. o This survey was also uploaded to the Bristol City Council Consultation Hub website so that all residents of Bristol could access it to have their say. In total, 1,487 people completed this survey. o Visits were also made to several residential homes, extra care housing units and care homes to hold group discussions with the residents on medicines waste. This has helped the Medicines Management team to identify opportunities to improve pharmaceutical services for more vulnerable members of our population. The Bristol Race Equality Health Partnership (BREHP) was supported to deliver a workshop for community representatives to understand their aspirations for the future of both adult and children s community health services 3. Engaging patients in service design and improvement Children and young people s participation offers an abundance of creativity and honesty in the commissioning process. This is why the Young People s Reference Group (YPRG) was created by Bristol Clinical Commissioning Group (CCG) with Healthwatch Bristol and South Gloucestershire. The group has involved young people in the current re-commissioning process for Children s Community Health Services in Bristol, South Gloucestershire and North Somerset. The 9

12 YPRG meets every six weeks and has offered much to the commissioning process such as helping to design a new service pathway, making suggestions for updating services and making them young people friendly. Bristol Parent Carers were partners throughout the development of the new integrated 0-25 service for children with disabilities. They worked with managers on the vision, configuration, opportunities and challenges in developing the new service. The CCG s cancer steering group ran a day long involvement event with patients, carers, public and other key stakeholders around the development of commissioning plans for future survivorship services in cancer. Mental health service users were involved in the development of a new Bristol Sanctuary service which is an important part of the new crisis service. The year ended with mental health service users and carers joining the programme board which will oversee the two year project to recommission improving access to psychological therapies (IAPT) services. Mental health service users have also been involved in developing a crisis concordat and a street triage service 4. Patient centred procurement and contracting. Service users and carers continued their involvement in the final stages of the procurement of new adult mental health services for the city. They were involved as members of the Project Team and as part of the assurance process for preferred providers 5. Patient centred monitoring and performance management Mental health user representatives have joined the contract and performance management arrangements for the new mental health services in the city. In addition, they will be supported to assist in evaluation and quality assurance of these services The CCG helped to establish an independent mental health forum for the city. Members of the forum will work with commissioners on the monitoring and evaluation of local mental health services Towards the end of the year agreement was reached with University Hospitals Bristol for the Quality sub-group of their integrated quality and performance management structure to have a quarterly focus on patient experience and involvement in this city centre acute trust. The Bristol CCG mental health commissioning evaluation team, which includes service users, undertook an evaluation of North Somerset CCG s primary care mental health liaison service in order to share good practice gained in Bristol. 10

13 4. Delivering the duty on individual participation Since 1 April 2014, the CCG has introduced personal health budgets (PHBs) for those eligible for NHS Continuing Healthcare (CHC) in order to provide patients with more choice and control over the care that they receive. To date, we have set up, or are in the process of developing fifteen PHBs for CHC eligible adults and five for CHC eligible children/young people. Feedback has been sought throughout the first year to understand how this is working for patients, their carers, representatives and staff. This has shaped the development of PHBs going forward. We have asked for feedback at each point of set up of a PHB and the key areas that have impacted on this development have been: Experience and costs involved in using brokerage support services; Access to appropriate training for personal assistants; Length of time it has taken to set up a PHB; Transition from Local Authority personal budget to NHS personal health budget; and Delivery of finance where a person has a direct payment. The CCG has developed a PHB policy and operational guide to provide information and guidance on PHB implementation and maintenance. The CHC team has also commissioned a service on a test and learn basis that is aimed at addressing all of the issues raised by service users, carers and staff involved in the implementation of CHC PHBs. We have had positive feedback from patients, their carers, representatives and staff about the CCG PHB website and patient information documents e.g. PHB Newsletter, patient information leaflet and My PHB Journey. One of our PHB service users has also provided some positive feedback that they were happy for us to share: Having a Personal Health Budget not only gives me the freedom to source care whenever and however I wish [in line with my personalised care and support plan agreed with the NHS] but it has enabled me to plan a holiday for the first time in many years. The confidence and security it brings means that I am entering the next phase of my life with renewed purpose and optimism, with those close to me already noticing an improvement in my general health and well- being We will be continuing to obtain feedback from service users, carers and staff involved in the implementation and development of PHBs through use of a Patient Outcome Evaluation Tool. This questionnaire will be built into the review of all PHBs and will be carried out once a year. We have also consulted Bristol Healthwatch about our three year CHC PHB strategy and gained valuable feedback. Comments that were received in 11

14 relation to areas that it was felt had not been addressed, such as measuring the impact of PHBs on enabling service users to remain in their own homes. This will now be an area that we monitor. Other areas that Healthwatch raised in relation to PHBs are now addressed in PHB policy and operational guidance, in line with National NHS England PHB Guidance, to provide clarity for budget holders and those assisting service users to set up and manage their PHBs. Personalisation and Personal Health Budgets outside of CHC In July 2014 Simon Stevens, Chief Executive of NHS England, announced the Integrated Personal Commissioning (IPC) Programme. The programme is a partnership between NHS England, the Local Government Association (LGA), ADASS Association of Directors of Adult Social Care and Think Local Act Personal. The programme is aimed at groups of individuals, who have high levels of need; who often have both health and social care needs, where a personalised approach would address acknowledged problems in current care provision, help prevent people from becoming more unwell, and enable people to retain their independence. The document Getting Serious about Personalisation in the NHS was also published in September It provides a clear direction, supported by the Five Year Forward View, to change systems and practices to enable the delivery of personalised, integrated care and support. Bristol CCG along with Bristol City Council and a number of local voluntary and community sector partners; Bristol Aging Better, WECIL, Voscur and Healthwatch Bristol formed part of a South West Regional bid for the programme. The idea is that, together, we can make significant strides towards embedding the culture change required to truly deliver person centred and integrated care and support for service users. Being part of this demonstrator site will mean that Bristol will introduce 40 person centred care plans, trial associated personal health budgets/integrated budgets and test out the capitated budget financial model. This work will fall under the Better Care Bristol Programme which shares the key themes of personalisation and integration. The introduction of PHBs, future expansion of PHBs for patients outside of CHC and involvement in the IPC Demonstrator site has led the CCG to consider the wider agenda of personalisation and integration in more detail and look at how this is currently being achieved across the organisation and in partnership with our stakeholders. The CCG has developed a personalisation strategy in recognition of the importance of service user involvement in an individual s care and in the development of services. The overall aim of the strategy is to establish a people powered approach to commissioning that shifts the culture and practice of care to be better co-ordinated and person-centred. This document brings together the strands of work that are currently being undertaken by the 12

15 CCG and its stakeholders to improve service user experience and help to achieve better outcomes for individuals. The Care Forum was commissioned to organise and run a personalisation workshop for representatives of local voluntary and community organisations to explain the purpose of the personalisation strategy and to seek their involvement in developing the actions needed to turn the strategic aspirations into reality. The personalisation strategy is likely to be an evolving document as our understanding and experience of commissioning and shaping services to deliver person centred care increases across the CCG and its stakeholders. The work on these areas, which is a key strand of our Better Care Programme, will continue into 15/16 and beyond in order to increase the opportunities for patient s individual participation in their own care and treatment in Bristol. 5. Summary In this, our second year, the CCG has started to see the tangible outcomes of spending time and energy in ensuring that PPI is central to the work of the organisation. The following three examples demonstrate changes made in response to the views of local Bristol residents and patients and carers. Bristol mental health sanctuary. The need for this new service was first identified by service users and carers in the initial discussions about modernising mental health services in the city. The idea was included in the modernising mental health public consultation. Following that, service users helped to develop a service specification and participated in the procurement process to identify a suitable provider. The service offers a safe, comfortable and welcoming space where people who are experiencing severe emotional distress can go for help out of normal working hours. The service opened in a central location in April 2015 Re-commissioning of children s community health services and Child and Adolescent Mental Health Services (CAMHS). Young people, their parents and carers have been instrumental in helping the CCG draw up some core values for this service, and their experiences of the current service have provided valuable information as the CCG starts the process of developing specifications for the new services. A Young People s Reference Group has been set up to make sure that young people play a central role in the development of these new specifications Re-commissioning adult community health services. The clear message from the public and patients from the first phase of involvement was that they wanted to see both community 13

16 health and social care services work much closer together to deliver an integrated service. In response to this clear feedback, the CCG decided to delay this re-commissioning process to enable joint work to take place with the City Council with a view to developing an integrated approach to the commissioning of adult health and social care services in the city. 6. Next Steps In addition to organising a major public consultation on the re-commissioning of CAMHS and children s community health services in 2015/16, a priority for the CCG will be the work needed to further integrate PPI into the commissioning process. The CCG is developing a detailed action plan to ensure that a wide range of PPI activity is successfully delivered in the coming year, as the CCG continues to work on the aims and objectives set out in its PPI strategy. 14

17 Appendix 1 Bristol CCG Patient and Public Involvement (PPI) Action Plan 2014/15 To be read in conjunction with the CCG Equality and Diversity Action Plan, and Communications Action Plan Strategic Objectives Actions Responsible Officer Develop CCG PPI Action Prepare draft Action Patient and Plan for 2014/15 to Plan to be discussed Public continue to deliver aims at PEC Involvement and objectives set out in Programme CCG PPI Strategy Revised action plan to Manager be discussed at Quality and Governance sub committee Deadline(s) and Progress PEC meeting Quality and Governance meeting Date of Update April 2015 Updates/Issues for PEC Action completed Final draft to be discussed and approved by CCG Governing Body Progress on Action Plan to be reported to Quality and Governance Governing Body meeting Quarterly reports from PEC to Quality and Governance May; July;

18 Produce annual report on CCG PPI activity for 2013/14 Committee Prepare draft Annual Report to be discussed at PEC Revised report to be discussed at Quality and Governance sub committee Patient and Public Involvement Programme Manager November and February 2015 PEC meeting Quality and Governance meeting April 2015 Action completed Final draft to be discussed and approved by CCG Governing Body Governing Body meeting Amend CCG PPI Strategy following legal challenge As required by the terms of a Court Order, the CCG to amend existing PPI strategy and conscientiously consider any public responses to these amendments at PEC, Quality and Governance and Governing Body Patient and Public Involvement Programme Manager and colleagues Governing Body seminar PEC meeting Quality and Governance Governing Body meeting April 2015 Action completed 16

19 To support commissioning colleagues, in both the CCG and the CSU, to develop an approach to commissioning which ensures that the outcomes from the various stages in the commissioning cycle are informed by PPI Continue to develop appropriate training and support for commissioning colleagues designed to develop their capacity and expertise to ensure that PPI informs the whole of the commissioning cycle Training to build on training and support delivered during 2013/14 and informed by staff training needs analysis Support managerial and clinical leads of the Clinical Steering Groups to enable them to have a structured approach to PPI in their work, by building upon initial workshop 25/3/14 to: Support cancer Patient and Public Involvement Programme Manager with PEC colleagues To be delivered throughout 2014/15 Seminar for GB members on involvement and equalities ; PPI input to steering group leads workshop ; training for staff on PPI legal requirements On-going throughout 2014/15 Meetings held with managerial lead group now has user and carer reps on it April 2015 To continue in 2015/16 17

20 steering group in their role as test bed for PPI in CCG Steering Groups Help managerial leads to identify appropriate lay representation on the groups eg Bristol Parent/Carers Group on Children s Steering Group Ensure PPI input in future steering group workshop Develop appropriate paperwork to support selection and involvement of lay representatives Paper with suggested approach discussed and agreed by PEC and input made to steering group workshop Paper with examples discussed by PEC

21 on steering groups where required Ensure that the CCG gets value from NHS E South initiative to provide PPI support and development to CCG s PPI Programme Manager on Advisory Panel overseeing initiative CHC team using initiative as they develop approach to PPI in the development of personal health budgets, including testing out proposals with Healthwatch Initiative funded until end 2014/15 Paper describing CCG s approach to PPI and personal health budgets discussed by Clinical Governance Committee

22 Develop CCG policy on reward and recognition for lay people involved in supporting CCG commissioning Make best use of the contracting/performance management of local mental health providers to maximise opportunities for PPI and improvement in patient experience and developing plans for service user reference group On hold pending publication of NHS E policy on reward and recognition Following publication of NHS E policy, prepare discussion paper for PEC, followed by development of new policy for CCG Service User and carer representatives are part of contract and performance management meetings to provide scrutiny and oversight. Linked to this is quality assurance, evaluation and monitoring carried out by CCG Patient Patient and Public Involvement Programme Manager Bristol CCG mental health commissioning team Implementation delayed by transition to new services/providers, but in place in some services eg Crisis Houses. Agreement reached between commissioners and providers that this will be in April 2015 April 2015 To be actioned during 2015/16 To continue in 2015/16 20

23 monitoring co coordinator and team of evaluators with lived experience. Also linked into System Leader Service User carer board and provider quality assurance Appropriately challenge provider Friends and Family Test (FFT) results and provider feedback and patient experience reports if they give rise to concerns about poor patient experience or are not adequate assurance of patient experience. Develop regular opportunities to invite providers to demonstrate service improvement based on their PPI activities Independent mental health Service User network supported by place for all services for 2015/16 21

24 Make best use of the contracting/performance management of local acute trust providers to maximise opportunities for PPI and improvement in patient experience CCG and carer network also being developed Appropriately challenge provider Friends and Family Test (FFT) results if they give rise to concerns about poor patient experience Develop regular opportunities to invite providers to demonstrate service improvement based on their PPI activities Ensure that results/outcomes from these two actions feed into CCG quality assurance process. Provider management team (CSU) To be actioned at scheduled quarterly meetings with acute providers to start in July 2014 and quarterly thereafter UHB set up quality sub-group reporting to ICQPM Agreed at first meeting of quality sub group ( ) that it would have a quarterly focus on both patient experience and PPI Priority for 2015/16 is to ensure that similar arrangements are in place for NBT April 2015 To continue in 2015/16 Make best use of the Expansion of friends CCG Head of National CQUIN April 2015 To continue in 22

25 contracting/performance management of the local community provider to maximise opportunities for PPI and improvement in patient experience and family test to all clinic based services with a focus on developing written and pictorial feedback (FFT) which is monitored monthly Community Commissioning requirements (October 2014 for all appropriate community services) 2015/16 Expansion of patient and carer involvement by provider in recruitment and service improvement. Expansion of individual service feedback (12 month patient satisfaction survey) Services to be agreed in year PPI survey outlines dates for 12 months of questionnaires. Monthly individual services plan from May/June 2014 March 2015 Internet based patient experience and PPI options being June 2014 (PPI format for end of life care coordination centre activity) During 2014/15, 23

26 evaluated for the end of life test and learn service among other activities, BCH ran focus groups for eg carers, introduced Meridian a real time patient experience feedback tool and reviewed and relaunched their PPI strategy CCG undertakes, and can evidence, effective and consistent PPI in major recommissioning initiatives. First example, recommissioning adult community health services Develop approach and strategy for PPI in the re-commissioning of adult community health services Set up PPI working group, produce detailed involvement plan and deliver engagement events up to end July 2014 for this first phase of PPI. PPI Programme Manager PPI Programme Manager plus members of adults PPI working group PPI work group set up to deliver strategic objectives. Progress on delivery of involvement plan reported regularly to Programme Board from to the end of the first phase of PPI. Programme Board reports to CCG Governing Body April 2015 Action completed. 24

27 CCG undertakes, and can evidence, effective and consistent PPI in major recommissioning initiatives. Second example, recommissioning children s community health services and CAMHS CCG undertakes, and can evidence, effective and consistent PPI in major recommissioning initiatives. Third example, mental health services Develop approach and strategy for PPI in re-commissioning of children s community health services Set up PPI working group, produce detailed involvement plan and deliver engagement events up to start July 2014 for this first phase of PPI Ensure that effective and consistent PPI continues in mental health modernisation programme (MHM) as it moves to PPI Project Support Officer for Children s recommissioning, PPI Programme Manager and members of children s PPI working group MHM Programme Team and PPI Programme Manager PPI working group set up to deliver strategic objectives. Progress on delivery of involvement plan reported regularly to Programme Board from and onwards from Programme Board to CCG GB Feedback from young people and their parents/carers has helped to identify core values for these services as well as being used to inform the development of a new service model By October 2014 for some services and April 2015 for others. (See above for details on how service users and April 2015 April 2015 Action completed Action completed 25

28 modernisation programme implementation and on-going service monitoring carers now part of performance management structures for new services) Working with service users, design and develop evaluation for PPI in MHM programme as part of wider lessons learnt activity from programme Service Improvement Team Lessons learnt workshop Report written following workshop and discussed by MHM Programme Board September 2014 and passed onto community health services commissioning team Ensuring PPI in commissioning of services currently provided at NHS Treatment Centres South Glos CCG leading commissioning process on behalf of five local CCGs. PPI Leads from five participating CCG s plus Comms Leads and CSU PPI plan developed and implemented from Results from PPI will inform April 2015 To be delivered in 2015/16 26

29 Ensure appropriate and effective PPI in recommissioning of Patient Transport Services (PTS) CCG works in partnership with NHS England specialist commissioning colleagues to ensure that there is PPI in their commissioning decisions relevant to Bristol residents CCG develops, and can evidence, increasing PPI in the development of its commissioning intentions Bristol CCG leading re-commissioning on behalf of three local CCGs Joint working with PPI Lead Manager for Specialist commissioning team on commissioning proposals relevant to Bristol residents to ensure that local people have the opportunity to comment on proposals, for example vascular services reconfiguration PPI in development of commissioning intentions 2014/15 delivered via public Programme Manager PPI and Comms Leads from three local CCG s plus CSU Programme Manager PPI Programme Manager and NHS E specialist commissioning PPI Lead Manager PPI Programme Manager plus CSU Communications commissioning intentions for these services Draft PPI plan developed and discussed by PEC in February 2015 Programme Board set up first meeting Specialist commissioning team set timetable April 2015 April 2015 April 2015 To be delivered in 2015/16 To continue in 2015/16 Action completed 27

30 stakeholder workshop and opportunity to comment via CCG website. PPI section included in work plan templates for development of 14/15 commissioning intentions Plan produced for PPI in the development of CCG s Five Year Strategic Plan (including CCG activity on NHS Call To Action) Team PPI Programme Manager and CSU Strategic Planning lead and Comms Team Healthwatch workshop VCS workshop Opportunity for public comment via CCG website and Ask Bristol City Council portal CCG Five Year Plan demonstrates how it has been informed by PP activity PPI Programme Manager and CSU Strategic Planning Lead Public feedback discussed at workshop with steering group leads ( ). Final version of Five Year Plan had section on how PPI was undertaken 28

31 Develop plans for ongoing PPI in development of annual commissioning intentions Develop plans for PPI in development of commissioning intentions for 2015/16 PPI Programme Manager and CSU Strategic Planning Lead PPI Programme Manager and CCG Head of Strategic and how it informed development of Plan. A significant outcome was the inclusion of clear cross cutting priorities eg access to services, in the plan. August CCG GB approved high level approach to PPI in CCG CI as part of an integrated planning process Plan discussed and approved by CCG Planning Group and PEC on Draft CI on CCG website for public comment and discussed with scrutiny committee ; Health 29

32 Deliver PPI in development of commissioning intentions for 2015/16 Planning PPI Programme Manager and Well Being Board , at a Healthwatch workshop targeting BME communities and a VCS workshop on Partnership Objectives Actions Responsible Officer CCG to support the CCG to remain an CCG Governing development of an active member of Body Lay effective Healthwatch for Healthwatch Advisory Member with the city Board responsibility for PPI CCG to support and encourage Health and Develop opportunities for co-working with Healthwatch H+WB Board to be invited to support city PPI Programme Manager and PEC colleagues PPI Programme Manager and PPI feedback collated and used to inform development of CI Deadline(s) and Progress Monthly meetings Date of Update April 2015 Updates/Issues for PEC To continue in 2015/16 Quarterly liaison meetings established Supported Healthwatch in development of Young Healthwatch May 2014 April 2015 Action completed 30

33 Wellbeing Board to take a lead on joining up PPI on city wide involvement activity wide involvement activity on development of CCG Five Year Plan Ensure that PPI on Better Care Fund is integrated with PPI on community health services recommissioning CSU colleagues PPI Programme Manager and PEC representative on H+WB Board Not undertaken because of revised timetable for recommissioning of adult community health services CCG to continue to maintain a constructive and professional relationship with Bristol City Council Health, Wellbeing and Adult Social Care Scrutiny Commission (HOSC) Following Council reorganisation of scrutiny function, health scrutiny now part of People Scrutiny Committee Attend all agenda setting and scrutiny meetings Support colleagues to ensure that CCG responds appropriately to requests for information and agenda items Contribute to the development of the committees work programme for forthcoming year PPI Programme Manager PPI Programme Manager to coordinate PPI Programme Manager CCG colleagues CCG attendance confirmed Throughout the year CCG attends all scrutiny planning meetings where forward work programme agreed and discussed. April 2015 To continue in 2015/16 31

34 Informal briefings provided for Bristol councillors on the work of the CCG, the future of health services on the Frenchay site and possible urgent care developments at Cossham Hospital Discussed by People scrutiny at their meeting on Ensure that the HOSC is offered the opportunity for early engagement in the development of CCG commissioning intentions Ensure that the CCG complies with its statutory duty to PPI Programme Manager CCG colleagues PPI Programme Manager CCG colleagues No proposals for significant variations in service were brought forward in 2014/15 32

35 Contribute to the successful delivery of the NHS E funded Building Health Partnerships Programme (BHP). This is a programme designed to build effective and productive partnership working between CCG s and the voluntary and community sector consult the HOSC on any commissioning proposals that might represent a significant variation in service for Bristol residents Maintain active CCG involvement in both project team and steering groups PPI Programme Manager and PEC member responsible for this initiative Formal programme concluded in September 2014, but local activity continues, led by VOSCUR April 2015 Action completed Involve voluntary and community sector (VCS) in the development of the CCG s personalisation strategy Internal and Practice Objectives Provide specific support and encouragement to Practices to enable them to CCG has commissioned The Care Forum to organise workshop for VCS reps to help CCG develop actions to implement strategy Actions As part of the Memorandum of Agreement (MoA) with PPI Programme Manager Responsible Officer Locality Team plus PPI Programme Workshop held on , outcomes will be fed into strategy implementation Deadline(s) and Progress April 2015 Date of Update April 2015 Action completed Updates/ Issues for PEC Action completed 33

36 use their contacts with patients to gain valuable commissioning insight to inform CCG commissioning intentions, and to build relationships with local voluntary and community organisations member practices (for non-clinical services), Practices have four options for involvement work in 2014/15 Host a focus group for patients who have recently used either children s or adults community health services so that their views can inform the recommissioning process (43 Practices opted in) Attend a locality meeting to promote joint understanding and collaboration with voluntary Manager By September 30 th Three workshops held as follows ICE May 21 st South June 17 th North and West July 2nd 34

37 and community sector organisations (50 Practices opted in) Attend a community or support group local to the Practice to discuss their experiences of a particular health service or issue (38 Practices opted in) Use Practice mechanisms eg waiting room screens to promote opportunities for their patients to get involved in commissioning activities eg the re- By March 2015 By March

38 Ensure that all CCG staff have access to timely and effective specialist advice on PPI and commissioning Ensure that the CCG has access to best practice information and advice on PPI to help to make sure that it fulfils relevant legal duties and good practice obligations commissioning of adult and children s health services (51 Practices opted in) One to one support delivered both as and when needed and through PPI training and support to be offered to staff based upon results of training needs analysis Active participation in the NHS E South of England PPI best practice network attend quarterly meetings Continue to promote joint PPI work across BNSSG where appropriate - meet PPI Programme Manager PPI Programme Manager CCG Locality Team to produce annual report on Practice PPI activity under this section First tranche of structured training delivered w/c , with a focus on the legal duties surrounding PPI One to one support delivered throughout the year Meetings as follows ; ; ; Bi- monthly April 2015 April 2015 To continue in 2015/16 To continue in 2015/16 36

39 with PPI colleagues in neighbouring CCGs every two months. Active participation in the NHS E specialist commissioning Impact Assessment Network attend quarterly meetings Ensure that CCG makes best use of new NHS E South initiative Patient Voice South - to provide PPI support and development to CCG s Meetings as follows ; ; Regular meetings held with Patient Voice South CCG staff have facilitated and participated in Patient Voices South webinars and made use of other opportunities to share good practice eg producing case studies for the Patient Voice website At conclusion of specific initiatives 37

40 Review effectiveness of CCG website as a mechanism for individual members of the public and patients to be involved in the commissioning process Ensure that aims, objectives and outputs from PPI initiatives are clearly identified and evaluated Review to follow conclusion of consultation period for re-commissioning adult community health services PPI Programme Manager Timescales tbc following CCG GB April 2015 Did not take place because of delay in public consultation Results of review to be used in next iteration of CCG website development 38

41 39

42 Appendix 2 Annual Report on Patient and Public (PPI) and community engagement activity undertaken by Practices as part of the Memorandum of Agreement (MOA) for Non Clinical Services Background In 2014/15 building on work undertaken in previous years, practices were offered a list of four PPI and Community Engagement options to sign up to as part of the MOA 2014/15. The options were aligned to two major CCG re-commissioning programmes; The procurement of both Adult and Children s Community Health Services The delivery of the CCG s Self Care Strategy Practices could receive a maximum of 1,500 if they signed up to and completed all four options. Main Findings 1.1 Option 1 Community Services Focus Group The aim of the focus groups were to provide the opportunity for patients and their carer s who have recently used adult/children s community services to feedback to their local GP practice on their experiences (the good and the not so good) and what could be improved to meet their needs better. 44 out of 54 practices signed up to participate in this option and worked together in clusters to deliver and hold the focus groups in September Three out of the eight focus groups planned were successfully held with a total number of 38 patients attending. Focus groups did not go ahead for the following reasons; Difficulty engaging patients in more deprived areas to attend despite practices trying a number of engagement approaches. Adult focus groups inevitably targeted frail and housebound patients, who found it difficult to leave the house without a carer or medical support or use patient transport due to mobility issues. Some practices reported patients take little interest in the bigger picture unless it directly affects them. Their perception was where this did their involvement would not make a lot of difference. However when focus groups did take place they were well attended and well received by patients. The main themes raised by patients who attended the focus groups were; The quality of treatment is of a high standard once received There are long waits for some appointments (physiotherapy)

43 It is difficult to get through on the phone to some services (physiotherapy) Some clinics are poorly organised (catheter and podiatry clinics). Want more capacity and access to physiotherapy Want more coordination and communication between services Want more support on discharge Want more skilled District nurses (expertise in catheters and changing supra pubic catheters) Want more communication with carers by community teams Want a central hub of information which patients/carers can access directly by phone for additional support and a second hub for signposting to community/voluntary resources. All findings from the focus groups were fed back to the Adult and Community Health Services Procurement team. 1.2 Option 2 Connecting Bristol Events This option required GP attendance and participation at a locality based event (one held in each of the three localities) jointly organised by Bristol CCG, Bristol City Council, Healthwatch and Voscur. The aim was to bring together GP practices, the Voluntary and Community sectors and the Area Community Teams (Social Workers), in order to build relationships and understanding of how others work and to give better support to people in the local communities. All three locality events were held over the summer of Each event followed a similar format, with a small number of presentations followed by case studies to promote round table discussion. Each event was chaired by a local organisation. All events were well attended. The broad themes from the group work element of the events were as follows; Need clearer routes to access GP practices and social care Better understanding of the functionality of Well Aware and the availability of services on a weekend A community navigator in practices would be helpful to liaise with voluntary services as well as signpost patients to the most appropriate services How can we encourage patients to self-care, especially when waiting for appointments? 1.3 Option 3 Single practice attending a local group This option required single practices to attend a local group in order to gain their views/experiences of particular service areas

44 such as urgent care, long term conditions, diabetes, community services etc and/or to discuss the specific health needs of the group or their area. Of the 35 practices who signed up to participate in this option nine successfully completed it. The main reason given by practices for non-completion of this option was other practice pressures and commitments taking priority, which meant they ran out of time to complete it before the deadline. The nine practices engaged with the following groups; PEEPs Group (Peer Early Education Partnership) - an hour was spent with a group of postnatal mums discussing first aid, how to manage children s accidents and emergencies, Q&A etc. Henleaze Neighbourhood Partnership Forum representatives from Bristol Aging Better, Wellbeing Board Dementia Champion were also present. Discussed local service provision, focussing on older patients, covering issues with the new hospital at Southmead and Urgent Care including 111 and the GP out of hours service. Ambition Lawrence Weston this is part of an ongoing project looking at health and wellbeing needs in Lawrence Weston, which resulted in formation of a community organisation (Ambition Lawrence Weston). Several meetings attended including with residents, other health providers and a steering group made up of all interested parties to work towards the goal of developing a community Hub. Horfield Health Centre Carers consisted of a group of carers 50+, also present were Carers Centre representatives. Discussions covered Self Care Strategy and Ask Me Three and the self-care resources available. St Christopher s School for children with special needs: severe learning disabilities and complex medical conditions discussed general issues concerning management of prescribing and dispensing medicines. Young Adult Diabetics in the locality purpose of event was to provide the group with skills and knowledge to live a healthy life with Type 1 Diabetes. The opportunity to meet with other diabetics of a similar age and share experiences. Explore lifestyle choices that will help keep them well in the future. Psychosocial skills training alongside diabetes specific education. Information on local support groups etc. Whilst also obtaining feedback as to how local service provision could be improved.

45 Diabetes UK Bristol Branch Discussed diabetic care in GP practices, foot care, retinal screening and access to specialised information and support. International Students at UWE Discussed difficulties students from different countries have when understanding the NHS and the differing perceptions, depending on which country the student came from. Aimed to increase students understanding of the overall NHS structure and what is available to international students. In addition, to decrease inappropriate A&E attendances and/or students attending GP practices where are not yet registered. Health Visitor Mother and Baby Group Discussed the urgent care service for babies and children including own practice in-house service (gaining access to it, the use of telephone triage and the experience once assessed by a clinician), the experience and knowledge of Out of Hours Services, 111 and A&E. 1.4 Option 4 Publishing electronic opportunities to feedback on CCG re-commissioning programmes For this option practices publicised within their practice two surveys which were on the CCG website to support both the Adult and Community Service and Children s Community procurements. Practices were provided with electronic and paper copies of flyers and tear off slips and did the following; Publicised the link via their waiting room screens, on their practices website and printed the link information on prescriptions. Included information and links in general letters sent to particular groups of patients e.g. health checks, flu clinics etc. Displayed information in waiting room and reception areas. 52 practices signed up to and successfully completed this option. More detailed information about the work undertaken by Practices as part of these four options is available from the CCG on request. Next steps Building on the main findings and lessons learnt from the four PPI and Community Engagement options undertaken in the MOA 2014/15 and the self-care section within the Bristol Primary Care Agreement (BPCAg), the following three options have been developed and signed off for the MOA 2015/16. CCG; These options align activity with the following areas to support the

46 Self-Care Strategy Urgent Care The options also further develop and strengthen the Self Care Clinical Lead and Community Resource Lead Contact roles which each practice has committed to through the BPCAg. The three options are; Option 1 Engaging socially isolated and/or vulnerable patients. The Self Care Clinical Lead and the Community Resource Lead contact to hold an event/outreach into an existing group/institution with the aim of ensuring that the voices of these patients are heard and that they are assisted to support their health and wellbeing. 39 practices have signed up to participate in this option. Option 2 Community Resource Lead- Workshop. Community Resource Lead Contact to attend a locality-based workshop to further support the development of this role. 50 practices have signed up to participate in this option. Option 3 Health Champion Training and Embedding Each practice to send a member of the practice team to be trained as a Health Champion. 39 practices have signed up to participate in this option. Practices can be paid a maximum of 1,400 if they sign up to and successfully complete all three options. Rosalind Hussey - Business & Practice Manager, South Locality 16 June 2015

47 Bristol CCG Patient and Public Involvement (PPI) Action Plan 2015/16 To be read in conjunction with the CCG Equality and Diversity Action Plan, and Communications Action Plan Strategic Objectives Actions Responsible Officer Deadline(s) and Progress Date of Update Develop CCG PPI Action Prepare draft Action Patient and First draft June 2015 Plan for 2015/16 to Plan to be discussed Public discussed at PEC continue to deliver aims at PEC Involvement meeting and objectives set out in Programme Revised draft CCG PPI Strategy Manager discussed at May PEC Updates/Issues for PEC Revised action plan to be discussed at Quality and Governance (Q+G) sub committee Quality and Governance meeting tbc Final draft of Action Plan to be discussed and approved by CCG Governing Body Meeting tbc Produce annual report on CCG PPI activity for 2014/15 PEC to monitor progress on Action Plan and report to Q+G as required Prepare draft Annual Report to be discussed at PEC Patient and Public Involvement Discussed and approved with amendments at June 2015

48 Programme Manager PEC meeting Revised report to be discussed at Quality and Governance sub committee Quality and Governance meeting tbc To support commissioning colleagues, in both the CCG and the CSU, to develop an approach to commissioning which ensures that the outcomes from the various stages in the commissioning cycle are informed by PPI Report to be received by CCG Governing Body Continue to develop appropriate training and support for commissioning colleagues designed to develop their capacity and expertise to ensure that PPI informs the whole of the commissioning cycle Patient and Public Involvement Programme Manager with colleagues Governing Body meeting tbc To be delivered throughout 2015/16 June 2015 Support managerial and clinical leads of the Clinical Steering Groups to develop PPI in their work. Options paper to June PEC on proposals for further integrating PPI into day to day commissioning Work with Patient Voice South to design 2 Specific proposal discussed and

49 and run training for CCG and CSU commissioners in improving PPI in commissioning approved at PEC First training workshop to be held on Discuss potential future support from possible successor resource to Patient Voice South following report on conclusion of that project and possible future developments Evaluation report on Patient Voice South Project expected mid- June Review CCG policy on reward and recognition for lay people involved in supporting CCG commissioning Encourage greater ownership of PPI agenda by commissioners as a result of them preparing and presenting at proposed you said, we did sessions at GB meetings Following publication of NHS E policy, produce paper summarising it and key principles for Patient and Public Involvement Programme Manager 3 Paper outlining proposal discussed and approved at Quality and Governance meeting First presentation made by commissioners to Governing Body Summary of NHS E policy and key principles discussed at PEC meeting on June 2015

50 Continue to make best use of the contracting/performance management of local mental health providers to maximise opportunities for PPI and improvement in patient experience discussion at PEC. To be followed by PEC discussion and agreement of new draft reward and recognition policy for CCG Service User and carer representatives are part of contract and performance management meetings to provide scrutiny and oversight. Linked to this is the quality assurance, evaluation and monitoring carried out by CCG Patient monitoring co coordinator and a team of evaluators with lived experience of services. Also linked into System Leader Service User Carer Board and provider quality assurance Appropriately challenge provider Friends and Family Test (FFT) results and Bristol CCG mental health commissioning team Draft CCG reward and recognition to be discussed at July PEC To be actioned at contract and performance meetings with providers June 2015

51 Continue to make best use of the contracting/performance management of local acute trust providers to maximise opportunities for PPI and improvement in patient experience provider feedback and patient experience reports if they give rise to concerns about poor patient experience or are not adequate assurance of patient experience. Develop regular opportunities to invite providers to demonstrate service improvement based on their PPI activities Independent mental health Service User network supported by CCG and carer network also being developed Appropriately challenge provider Friends and Family Test (FFT) results if they give rise to concerns about poor patient experience Develop regular opportunities to invite providers to demonstrate service improvement based Provider management team (CSU) 5 UHB have set up quality sub-group reporting to ICQPM meeting. Agreed at first meeting of quality sub group ( ) that it would have a quarterly focus on both patient experience and PPI. First meeting June 2015

52 Make best use of the contracting/performance management of the local community provider to maximise opportunities for PPI and improvement in patient experience on their PPI activities Ensure that results/outcomes from these two actions feed into CCG quality assurance process. A key focus for 2015/16 will be for services to produce action plans based on feedback to drive further improvements to patient experience Also ensure that PPI including friends and family test results, compliments and complaints continue to be a standing item on the IQPM agenda and are discussed every month as part of the overall contract management for each service. CCG Head of Community Commissioning 6 with a focus on PPI took place on Priority for 2015/16 is to ensure that similar arrangements are in place for NBT Number of focus groups planned during the year. BCH will be able to report separately on whether feedback from experience surveys is from patients or carers. CCG has recently received the feedback from the carers focus groups undertaken earlier which we will be analysing and translating in to actions for the organisation as a whole and/or specific services June 2015

53 to take. BCH have a CQUIN on engaging with different communities within Bristol, including accessibility and language access CCG undertakes, and can evidence, effective and consistent PPI in major recommissioning initiatives, in this case the recommissioning children s community health services and CAMHS Ensure that all necessary preparations for public consultation are in place including reality check on service specifications to ensure that they have been informed by PPI outcomes to date Ensure that CCG and partners develop a clear and concise public consultation document which sets out the options for change and explains how these have been informed by PPI and is designed to suit the PPI Project Support Officer for Children s recommissioning, PPI Programme Manager and members of children s PPI working group and Project Team 7 As part of reality check process, Equality and PPI Leads met to review specs on PPI working group met to start planning for public consultation which will start on and run for 12 weeks Agreed that public consultation document will be produced in digital format. CSU Comms asked by Project Team to June 2015

54 Work with partners to ensure arrangements are made for appropriate and proportionate PPI in commissioning of services currently provided at NHS Treatment Centres Ensure appropriate and effective PPI in recommissioning of Patient Transport Services (PTS) Ensure arrangements are made for appropriate and proportionate PPI in the recommissioning of IAPT target audience young people, their parents and carers South Glos CCG leading commissioning process on behalf of five local CCGs. Bristol CCG leading re-commissioning on behalf of three local CCGs Recruit service users and carer representatives to the IAPT recommissioning PPI Leads from five participating CCG s plus Comms Leads and CSU Programme Manager PPI and Comms Leads from three local CCG s plus CSU Programme Manager MHM Programme Team with support from PPI programme Manager 8 provide plan to deliver this Ensure that milestones in PPI plan are met. Results of survey of patient experience of current services published on CCG websites Draft PPI plan developed and discussed by PEC in February Delivery of PPI activity to commence following first meeting of Programme Board held on Initial request for user feedback placed on all CCG websites by mid- May Recruitment completed by end of May June 2015 June 2015 June 2015

55 services Programme Board Ensure arrangements are made for appropriate and proportionate PPI in the actions required to deliver the objectives in the CCG s Urgent Care Strategy Involve service users and VCS representatives in developing proposals for service development Prepare proposals for public consultation Actions to be agreed Urgent Care commissioners and PPI Programme Manager To take place May to August. Care Forum commissioned to run workshop for VCS representatives Public consultation scheduled for autumn Timescales to be agreed June 2015 Ensure arrangements are made for any necessary PPI arising from the development of cocommissioning of primary care services with NHS England Ensure arrangements are made for appropriate PPI in the activity required prior to Actions to be agreed following the establishment of a Joint Committee. Governing Body lay member with responsibility for PPI will be an important member of this committee Detailed actions to be agreed Commissioning staff supporting the work of the Joint Committee and PPI Programme Manager PPI Programme Manager, and recommissioning Timescales to be agreed June 2015 To be agreed June

56 the resumption of the recommissioning of adult community health services in September 2016 project team CCG works in partnership with NHS England specialist commissioning colleagues to ensure that there is PPI in their commissioning decisions relevant to Bristol residents CCG develops, and can evidence, increasing PPI in the development of its annual commissioning plan Joint working with specialist commissioning team colleagues on proposals relevant to Bristol residents to ensure that local people have the opportunity to comment. Outcome of PPI in development of 2015/16 plan to be fed back via stakeholders and through CCG website PPI to be integral to the development of 2016/17 plan PPI Programme Manager NHS E specialist commissioning colleagues PPI Programme Manager and Head of Strategic Planning PPI Manager and Head of Strategic Planning Partnership Objectives Actions Responsible Officer CCG to continue to support CCG to remain an CCG Governing the development of an active member of Body Lay effective Healthwatch for Healthwatch Advisory Member with the city Board responsibility for PPI Specialist commissioning team set involvement timetable To follow completion and approval of 2015/16 plan Actions to be developed through new CCG planning group. Deadline(s) and progress Meeting schedule set by Healthwatch June 2015 June 2015 Date of Update June 2015 Updates/Issues for PEC 10

57 CCG to continue to maintain a constructive and professional relationship with Bristol City Council People Scrutiny Committee which delivers the health scrutiny function for the Council Develop opportunities for co-working with Healthwatch Attend agenda planning and scrutiny meetings Support colleagues to ensure that CCG responds appropriately to requests for information and agenda items PPI Programme Manager and PEC colleagues PPI Programme Manager PPI Programme Manager to coordinate To be discussed at quarterly liaison meetings which will take place ; ; ; CCG attendance confirmed Throughout the year June 2015 Contribute to the development of the committees work programme for forthcoming municipal year Ensure that the People scrutiny committee is offered PPI Programme Manager CCG colleagues PPI Programme Manager CCG colleagues 11 CCG attends all planning meetings where forward work programme discussed and agreed. Meeting dates for the year tbc following first meeting of the new post local election committee on Autumn 2015

58 the opportunity for early engagement in the development of CCG commissioning plans To discuss and develop the CCG s approach to building and supporting patient leadership in the city Ensure that the CCG complies with its statutory duty to consult the health scrutiny committee on any commissioning proposals that might represent a significant variation in service for Bristol residents To initiate a discussion at PEC to develop CCG thinking in this area PPI Programme Manager CCG colleagues PPI Programme Manager Discussion held at April PEC June 2015 Internal and Practice Objectives Provide specific support and encouragement to Practices to enable them to To respond to an initiative from Bristol Community Health covering this issue Actions Delivered as part of the Memorandum of Agreement (MoA) with Responsible Officer Locality Team plus support from PPI Programme 12 Following discussion at PEC and Directors meeting CCG reps attended initial meeting to discuss initiative Deadline(s) and progress Options for Practice PPI activity for Date of Update June 2015 Update/Issues for PEC

59 use their contacts with patients to gain valuable commissioning insight to inform CCG commissioning intentions, and to build relationships with local voluntary and community organisations member practices (for non-clinical services). Options for Practice activity in 2015/16 developed. Manager 2015/16 offered to Practices in April. Three options available designed support delivery of CCG self - care strategy and urgent care commissioning. The options are: engaging socially isolated/vulnerable patients; workshop for Practice community resource leads; training a Practice rep as a health champion Ensure that all CCG staff have access to timely and effective specialist advice on PPI and commissioning One to one support delivered both as and when needed and through PPI training PPI Programme Manager Throughout the year June 2015 Work with CSU to deliver PPI and commissioning training to commissioners based in CSU and in CCG 13 Proposal discussed and agreed at April PEC and first workshop to be delivered on Ensure that the CCG has Work with PPI PPI Programme Proposal in June 2015

60 access to best practice information and advice on PPI to help to make sure that it fulfils relevant legal duties and good practice obligations colleagues to develop proposal for a new PPI best practice network following NHS E re-organisation and decision to no longer have Regional PPI Lead. (There is a proposal for NHS E South to continue to offer admin support to the best practice network) Continue to promote joint PPI work across BNSSG where appropriate - meet with PPI colleagues in neighbouring CCGs every two months. Manager and PPI colleagues development Bi- monthly Active participation in the NHS E specialist commissioning Impact Assessment Network attend meetings as necessary Meeting schedule for 2015/16 tbc Investigate potential additional PPI support from any successor initiative following end To follow production of evaluation report on Patient Voice 14

61 of NHS E South initiative Patient Voice South South Project expected in mid- June 15

62 Equality & Diversity Annual Report Equality & Diversity Annual Report 1

63 Bristol CCG Equality & Diversity Annual Report Introduction: This is the second equality & diversity annual report for Bristol Clinical Commissioning Group since its inception in April The report outlines our equality & diversity achievements in our second year of operation through our equality & diversity action plan and gives us an opportunity to examine our actions and assess how well we, as a new organisation are meeting our statutory, social and moral obligations as a lead organisation in Bristol. This second year also allowed us to build on the good foundations we put in place in , and to take active steps towards being a lead organisation for promoting good equality and diversity practice in Bristol. The report also outlines our aspirations to continue to build on our successes and solidify our position as a lead public sector organisation over the upcoming 12 months. 2. Organisational context: We are responsible for the commissioning of the majority of secondary, community and mental health services for the population of Bristol. We are a statutory body and are also a membership organisation. Each of the 54 GP practices in the city is a member. The governing body includes, elected representatives from our member practices, a specialist doctor, a nurse, and two lay members. The CCG is formed from three strong and vibrant localities that cover the whole geographical area of Bristol. The localities are the building blocks of the CCG and ensure that all of the member practices can be effectively involved in local decision making and collaborate on development with community partners. Each locality has its own Locality Executive Group (LEG) with an elected membership. Other larger CCGs in the country have also adopted a locality structure. The LEGs are represented on the CCG s Governing Body. Individual CCG and LEG members play lead roles on an agreed area of clinical commissioning. They engage with stakeholders and patient groups across the city, through both structured events and more informal visits and meetings. These active and personal contacts are an important component of our communications to involve our public and patients in commissioning decisions. GP members also play a key role in bringing feedback Equality & Diversity Annual Report 2

64 from their individual patients and their own experiences as local clinicians into the commissioning process. On relevant areas of commissioning Bristol CCG works in collaboration with CCG neighbours in North Somerset and South Gloucestershire. The three CCGs have set out a Memorandum of Understanding to guide the development of their partnership working. 3. Legislative context: Implementation of the public sector equality duty 2011 (PSED) forms the foundation of equality and diversity activities in Bristol CCG. The PSED applies to the CCG as a public authority, and therefore requires that the CCG, in the exercise of its functions, have due regard to the need to: (a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act; (b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it; (c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it These are known as the three sections of the general duty The CCG intends to utilise the NHS equality delivery system (EDS) as the principle means of fulfilling our commitments under the PSED. In compliance with the CCG s statutory requirements under the specific equality duty, we are required to: (a) Set specific, measurable equality objectives; (b) Analyse the effect of our policies and practises on equality and consider how they further the equality aims; (c) Publish sufficient information to demonstrate that we have complied with the general duty on an annual basis. Equality & Diversity Annual Report 3

65 4. The communities we serve: According to the Joint Strategic Needs Assessment (JSNA) Bristol has an estimated resident population of 441,300. It is the largest city in the South West, and currently the 8 th largest city in England. Since 2001, the population of Bristol is estimated to have increased by 13.2%. This growth is double the average estimated increase for England. Age: Bristol s Joint Strategic Needs Assessment shows that Bristol has a relatively young age profile compared to the national average with higher proportions of people aged years and lower proportions of people aged 45 and over. Ethnicity: BME communities in Bristol make up 16% of the total population, with 28% of all school pupils coming from BME backgrounds. Religion & Belief: There are at least 45 religions represented in Bristol, whilst 37% of people have no religion compared to the national average of 25%. Disability: The proportion of people with life limiting long term illness or disability in the city make up 16.7% of the total population. 5. Structures and processes: We recognised in our first few months of operation that we needed a dedicated resource to help shape our equality and diversity agenda and lead on the implementation on the development and implementation of our equality & diversity strategy going forward. The CCG was successful in appointing an equality and diversity lead in august The current reporting arrangements are for the monitoring of progress against the equality and diversity action plan to be monitored through the PEC (PPI, Equality & Communications) group. The PEC group is a strategic meeting that brings together the 3 enablers to good commissioning (PPI, Equality & Communications) and is chaired by the governing body lay member for PPI (Patient & Public Involvement). The PEC reports to the Quality & Governance Board which reports in turn to the governing body. Equality & Diversity Annual Report 4

66 6. Workforce: Bristol CCG employs 107 staff, and a breakdown of our work force profile compared with Bristol population can be found in table 1 Profiles are available for the following areas: Age Disability. Race. Sex. Sexual Orientation. Religion & Belief. Characteristic Group description Table 1 Total Workforce or Population Analysis of workforce as at 31 March % (112 employees) Bristol population (figures for 2011) 100% Ethnic origin White British Ethnic Origin 74% (83) 78% Black or Minority Ethnic Origin 11% (12) 15% (excluding White Irish and Other White groups) White Irish or Other White Ethnic Origin 8% (9) 5% Unknown Ethnic Origin 7% (8) 2% Equality & Diversity Annual Report 5

67 Disability Group description People with a limiting long term illness on Electronic Staff Record Analysis of workforce as at 31 March % (3) Bristol population (figures for 2011) 12.4% Sex Gender identity Sexual Orientation Unknown All population, all ages Transgender population Lesbian, Gay or Bisexual 6% (7) 18% male (20) 82% female (92) Information not available 5% (5) 50% male 50% female Information not available 6.0*% Heterosexual 79% (89) 94*% Religion or Belief Unknown Christian Other religion or belief 16% (18) 35% (39) 18% (20) % 7.7% No religion or belief 21% (24) 37.4% Unknown Age Aged Aged 65+ (Aged 85+) 25% (28) 99% (111) 1% (1) 8.1% 62.2% 37.8% *2005 Treasury estimate for the UK population, reported on Stonewall s website (2013) Detailed analysis of our workforce report indicates the following trends: Equality & Diversity Annual Report 6

68 Disability: With a decrease from 4% representation in to a 3% representation in , this is the one area of representation that the CCG has not made improvements on over the past 12 months. It must however be noted that the small numbers and the changes in overall staff numbers mean that these figures should be interpreted with caution. A further breakdown of our recruitment and selection figures for disabled applicants is shown in table 2. In order to focus on this area the CCG has: 1) Developed a Recruitment & Positive Action strategy and associated action plan. 2) Renewed our two ticks disability symbol user status through undergoing an assessment by Job Centre Plus. 3) Worked with Job Centre Plus on developing our work experience programme. 4) Dedicated resources to support the development and launch of the Bristol Deaf Health Charter. 5) Continued to engage with disabled service users, their parents/ carers through commissioning activity to gauge a better understanding of their needs. 6) Developed a staff support network policy, and continue to take proactive steps to encourage the reformation of the Disability Forum. Table 2 Disability Number of applications Shortlisted applicants Appointed applicants Physical Impairment Sensory Impairment Mental Health Condition Learning Disability Long standing illness Other Sexual Orientation: Representation of LGB&T individuals within the CCG workforce saw an increase over the last 12 months from 2% in to 5% in Again the small and changing numbers of staff mean that these figures should be viewed with Equality & Diversity Annual Report 7

69 caution. It is however evident from recruitment and selection figures in table 3 that the CCG will need to ensure that it continues to build on achievements in the past 12 months by: 1) Continue to build its reputation amongst LGB&T grass root organisations to ensure that it LGB&T people are aware of the CCG s ongoing commitment to increasing its representation of the communities it serves. 2) Actively encourage the LGBT forum (staff support network) to act as a critical friend to the organisation and to become involved in key activity to support the implementation of the recruitment and positive action strategy. Table 3 Sexual Number of Shortlisted Appointed Orientation applications applicants applicants Lesbian Gay Bisexual Heterosexual Race: Representation of BME individuals within the CCG workforce saw an increase over the last 12 months from 5.6 in to 11% in It is however evident from recruitment and selection figures in table 4 that the CCG will need to ensure that it continues to build on achievements in the past 12 months by: 1) Implement key activities in the recruitment and positive action strategy. 2) Work with partner agencies and grass root organisations on developing a multi agency approach to improving the representation of BME individuals across public sector organisations in Bristol through the Manifesto for Race Equality. Table 4 Ethnicity Number of applications Shortlisted applicants Appointed applicants Equality & Diversity Annual Report 8

70 White-British White-Irish White-Any other white background Asian or Asian British-Indian Asian or Asian British-Pakistani Asian or Asian Bristish- Bangladeshi Asian or Asian British-Any other Asian background Mixed-White & Black Caribbean Mixed-White & Black African Mixed-White & Black African Mixed-White and Asian Mixed-any other background Black or Black Caribbean Black or Black British African Black or Black British-Any other black background Other Ethnic Group-Chinese Other Ethnic Group-Any other ethnic group Undisclosed Sex: Representation of Male members of staff has increased to 18% representation , from 15% representation in Equality & Diversity Annual Report 9

71 7. The Equality Delivery System: The EDS is a framework for NHS organisations to understand their equality performance and main challenges and to plan a way forward towards improvement. Implementing the EDS can also help the CCG to: i) demonstrate compliance with the general and specific equality duties and with human rights obligations ii) deliver on the NHS Outcomes Framework and the NHS Constitution iii) improve the services provided for local communities iv) consider health inequalities in the locality v) provide better working environments, free of discrimination The EDS is also a way to identify and shape the equality objectives which all public authorities are required to publish. Grading performance using the EDS Implementing the system will involve an evidence-based assessment of performance against 18 nationally-specified outcomes in relation to 4 goals. Each of the 18 outcomes relates to the 9 characteristics protected by the Equality Act Evidence against each outcome is used to allocate one of four grades as shown below in figure 1: Figure 1 Grades for each goal are then aggregated to give an overall grade for each of the four outcomes. These are then further aggregated to give an overall grade for the organisation. To assist us in achieving this, we have worked with our partners to develop an expert panel, made up of local stakeholders. The expert panel shall grade our performance against the EDS outcomes following a robust training programme designed to familiarise members with the EDS, and to ensure consistency of approach to the grading process. Equality & Diversity Annual Report 10

72 The expert panel shall grade our performance against the EDS outcomes following a robust training programme designed to familiarise members with the EDS, and to ensure consistency of approach to the grading process. To assist us in integrating the EDS outcomes into our core business, we have mapped these and aligned them to our equality and diversity objectives and our action plan appendix 1. In September 2014, the expert panel agreed the following: 1) The following 13 outcomes were applicable to the CCG: Table 5 Objective 1. Better health outcomes 2. Improved patient access and experience. Outcome 1.1 Services are commissioned, designed and procured to meet the health needs of local communities 2.2 People are informed and supported to be as involved as they wish to be in decisions about their care 2.3 People report positive experiences of the NHS 2.4 People s complaints about services are handled respectfully and efficiently 3. A representative and supported workforce 3.1 Fair NHS recruitment and selection processes lead to a more representative workforce at all levels 3.2 The NHS is committed to equal pay for work of equal value and expects employers to use equal pay audits to help fulfil their legal obligations 3.3 Training and development opportunities are taken up and positively evaluated by all staff 3.4 When at work, staff are free from abuse, harassment, bullying and violence from any source 3.5 Flexible working options are available to all staff consistent with the needs of the service and the way people lead their lives 3.6 Staff report positive experiences of their membership of the workforce Equality & Diversity Annual Report 11

73 Objective 4. Inclusive leadership at all levels Outcome 4.1 Boards and senior leaders routinely demonstrate their commitment to promoting equality within and beyond their organisations 4.2 Papers that come before the Board and other major Committees identify equality-related impacts including risks, and say how these risks are to be managed 4.3 Middle managers and other line managers support their staff to work in culturally competent ways within a work environment free from discrimination 2) That the CCG s strategy was a good starting point for the CCG, and it would be appropriate to agree an implementation plan for summer 2015, which would allow the CCG to make progress on the strategy objectives. 3) That the CCG Equality & Diversity Strategy and our revised Equality Objectives were fit for purpose. 4) That developing a Positive Action and Recruitment strategy would be a positive step forward. In addition, two meetings were organised with staff to ensure that they are familiar with the EDS and how it can assist in integrating Equality activity into core CCG business. In line with NHS England 2015 guidelines table 6 outlines the EDS2 grading and implementation time line to be presented to the Expert Panel in May 2015 : Table 6 Activity May June July August September October Confirm Governance arrangements and Leadership commitment. Assemble Equality & Diversity Annual Report 12

74 Evidence. Staff Briefing and Involvement Setting up URL Internal Grading Grading by expert panel EDS2 Report submitted to NHS England 8. Equality & Diversity Strategy and Equality Objectives: Our equality objectives which are aligned with the EDS outcomes and developed to fulfil our legal requirements under PSED Our objectives are: Objective 1: Improve the use of equality analysis data in our commissioning cycle. Objective 2: Build strong relationships with protected groups and communities to better understand their needs and improve our equality data. Objective 3: Promote workforce equality and improve representation through effective employment practices. Objective 4: Develop inclusive leadership at governing body level. 9. Equality Impact Assessments: Equality Impact Assessment (EIA) is an analysis of a proposed organisational policy/ procedure/ practise, or a change to an existing one, which assesses whether the policy/ procedure/ practise has a disparate impact on persons with protected characteristics. We have taken proactive steps to embed equality impact assessments into our commissioning cycle. We have developed a new EIA screening template to assist in integrating good practice into our commissioning processes. Equality & Diversity Annual Report 13

75 During the past 12 months, whilst some improvements have been achieved in establishing EIAs to be undertaken as part of policy development and commissioning activities, we recognise that integrating this into our culture will take some time, and to assist CCG staff in this, we have: 1) Delivered bespoke training sessions to staff on how to initiate and develop an EIA. 2) Supported the development of EIA activity for areas such as the Personalisation agenda. 3) Requested EIA to accompany key policy development such as HR policies. We have also supported key recommissioning projects such as the Children and Adult Community Health Recommissioning projects. Both these projects have been supported in with robust EIA activity with the CCG taking a lead role in developing and initiating this work. The focus of the activity for both EIAs has been during phase one of the projects has been to ensure that the involvement activity mirrors our local demographics and ensures that our approach is inclusive. This also forms the scoping part of the equality impact assessment, and allows us to undertake a gap analysis on the communities that we have yet to consult with and ensure that we have the appropriate mechanisms in place to actively involve them in our consultation process. Inclusive involvement: We have varied our methods of involving our communities in phase 1 of both projects, and this was done to ensure that we enable as many people as possible to participate in the process. It was also designed to cater for the diversity of our communities and taken into account its local demographics. Targeted focus groups: BME: A number of bespoke focus groups (gender sensitive where appropriate) were organised to ascertain the needs of BME communities in Bristol. A specific consultation event was organised to involve BME people in phase 1, and the forum of choice was the annual BREHP (Bristol Race Equality Health Partnership) conference on the 19 th June, along with targeted media interviews with local radio stations (Ujima radio, BBC radio Bristol) in the build up to the event. LGB&T: Equality & Diversity Annual Report 14

76 A focus group was organised with the LGBT Bristol Youth Forum to ascertain feedback from LGB&T young people on their experiences accessing community health services to date. In addition, the CCG liased with LGBT Bristol to organise a consultation event with a focus on adult community health services. Disability: Our involvement activity targeted the following groups to ensure views were ascertained on both current services and suggestions for services going forward: Parents and carers of children with complex needs Parents and carers of children with learning difficulties Parents and carers of children who use mental health services Parents of children who use universal services (school nurses and health visitors) Young people with complex needs Young people with learning difficulties Young people who use mental health services Young people who use universal service (school nursing) Parents, carers and young people who may use community health services in the future In addition, the Bristol Deaf Health Promotion Group was approached to organise a customised focus group for deaf, deafblind, heard of hearing and blind people. Surveys: Recognising that we needed to reach as many people as possible to ensure their involvement an online survey was designed to capitalise fact that access to IT is more prominent today than ever. It is however recognised that not all of our communities have access to an electronic device ( phone, tablet, laptop, computer) and our website. It is also noted that the survey was developed in English only which may have restricted access to it to those that: a) have access to a device, internet, are IT literate; and b) speak English. The online survey did however provide a useful tool to access a wide range of communities, this was evident form analysing the equality monitoring questionnaire which was attached to the survey. The survey was particularly helpful in reaching the LGB&T communities. We utilised our links with LGBT Bristol to publicise the survey. Equality & Diversity Annual Report 15

77 For Bristol, paper surveys were also available, and we targeted BME communities through recruiting a community activist and ensuring that this was part of our wider approach to ensuring that we involved a wide cross section of our communities. Social media and radio: We utilised the CCG twitter and facebook page to publicise and invite involvement with the EIA activity. In addition, we were able to secure a number of interviews with local radio stations (BBC Radio Bristol, Radio Ujima), which proved an opportunity to further discuss the work undertaken to date and invite listeners to get involved. 10. Developing our organisation: We recognise the value of learning and development in assisting us in promoting equality and valuing diversity. Over the past 12 months, we have: 1) Continued to deliver class room based equality and diversity sessions as part of our induction programme. 2) Delivered EIA specific training on request to CCG staff and to the Children s Community Health Services Recommissioning programme board. 3) Delivered an equality and diversity seminar to governing body members. 4) Delivered bite sized equality and diversity sessions as part of the NHS change day sessions. 5) Continued to deliver online equality and diversity refresher training. 6) Delivered class room based equality and diversity training sessions. In order to compliment our equality and diversity strategy , we have also developed our recruitment and positive action strategy as we: Recognise the value of being an organisation that is diverse and representative of the communities that we serve. Aim to be a public sector employer of choice, attracting the best candidates to be part of our organisation. Aim to build on existing good practise in our recruitment processes by ensuring that we have systems in place that enable us to be proactive about attracting and retaining talent from under represented groups in our communities. Aim to create a workforce environment where staff are supported in their career progression. The key objectives of the recruitment and positive action strategy are to: Equality & Diversity Annual Report 16

78 Raise the profile of the CCG as a positive place to work in Bristol, targeting community organisations and groups with direct links to BME, Disabled & LGB&T communities. Monitor recruitment activity and outcomes, and produce management information to illustrate such activity in partnership with the Human Resources team. Develop opportunities for work experience and shadowing for potential external candidates to gain insight into the work of the CCG. Utilise existing processes such as secondment opportunities and the performance development framework to improve overall job satisfaction for our staff and identify progression opportunities to improve representation at leadership levels. In order to continue to support our diverse workforce, we have developed a staff support network policy. In addition, the CCG has worked with job centre plus on the following initiatives: 1) Renewed its status as a two ticks positive about disability organisation through completing its annual assessment. 2) Attended and supported two BME recruitment fairs in October 2014 and February ) Supported a BME VOICE event through governing body member attendance. 4) Develop a work experience aimed at offering shadowing and mentoring opportunities for people living with disabilities to support them in their journey towards securing employment. 11. Key initiatives: Supporting the development and the launch of the Bristol Deaf Health Charter: Bristol has become a significant cultural centre for the Deaf community in the UK (predominantly British Sign Language users). It is estimated that the Deaf population in Bristol is at least three times higher than the national average, and is second only to London s Deaf population. The CCG has worked with the Bristol Deaf Health Promotion Group on developing both the Bristol Deaf Health Charter and the associated guidance. The Charter sets out a number of pledges to improve the access and rights of Deaf, hard of hearing, deafened and deafblind people. It highlights good practice and will build the capacity to eliminate unlawful discrimination (both direct and indirect), advance equality of Equality & Diversity Annual Report 17

79 opportunity and build good relations with Bristol's Deaf, hard of hearing, deafened and deafblind communities. The CCG has supported to coordination of the launch event for the Charter in May To date this has included: 1) Organising a social media campaign and press release to generate interest in the launch and the charter. 2) Organise interviews with relevant media outlets to publicise the launch event. 3) Support the event through attendance of a governing body member. The Bristol Manifesto for Race Equality: The Bristol Manifesto for Race Equality has been developed by a number of Race Equality Champions in Bristol a basis to tackle Race Inequality across a number of themes. These themes range from the under representation of BME people in the work place to access to services and involvement in public life. The Manifesto sets out a series of expectations from the public sector, including Bristol CCG as a public sector organisation. The CCG is to support the Leaders event organised for April 2015, and to support the implementation plan for the Manifesto to be published in summer of Support for prevention and eradication of Female Genital Mutilation: The CCG has championed initiatives aimed at ending FGM including: 1) Signing the Charter to end FGM and child, early and forced marriage at the Girls Summit in London. 2) Jointly hosting a national conference on female genital mutilation was held in Bristol on Thursday 2 October The event shared the successful Bristol Model with professionals working in the FGM field. The conference was the first opportunity for FGM professionals from health, social care, police and community groups to meet and share their experiences and ideas. It looked at The Bristol Model, a diverse approach recognised as the UK s model of best practice. It was organised by local agencies working in FGM including Bristol Clinical Commissioning Group. In addition, the Bristol Community Rose Clinic (commissioned by the CCG in 2013/14) continues to offer support for women who are experiencing problems as a result of FGM. The Clinic won the Primary Care and Community Service Redesign category at the 2014 Health Service Journal (HSJ) Awards. Equality & Diversity Annual Report 18

80 Setting up the CCG Health Inequality Group: The group was set up to oversee the discharge of the CCG s statutory responsibilities to tackling health inequalities. The Group is led by a CCG Governing Body member and to date has discussed the CCG s approach to a number of strategic initiatives such as supporting the development of a Bristol wide Migrant Health Strategy, and also agreeing key objectives for the CCG in the context of Health Inequality. 12. Summary and highlights: 1) Bristol CCG has taken positive steps towards implementing its Equality & Diversity Strategy and Objectives. 2) Workforce data indicates an increase in the representation of BME, LGB&T staff and male members of staff compared to data. To continue to build on this, initiatives such as the Positive Action and Recruitment Strategy have been developed. 3) Workforce data indicates a decrease in the representation of people living with a disability in the workplace compared to data. Mitigating action has included developing the Positive Action and Recruitment Strategy, the Staff Support Network Police and a work experience programme to be piloted in conjunction with Job Centre Plus in May/ June ) Bristol CCG has taken a lead role in supporting the development and launch of the Bristol Deaf Health Charter. 5) Bristol CCG has taken active steps to support the Bristol Manifesto for Race Equality, and will continue to support this initiative into implementation in ) Bristol CCG has secured its positive about disability two ticks status for the second year in a row. 7) Bristol CCG has led the multi agency work on developing a robust Equality Impact Assessment for both the Children and Adult Community Health Services Recommissioning projects. 13. Next Steps: A action plan has been developed to capture key activities and allocated time frames for implementation. This will be updated and maintained by the Equality & Diversity Lead and reviewed at the PEC Group on an on-going basis. Equality & Diversity Annual Report 19

81 Equality & Diversity Action Plan for delivering the Equality and Diversity Objectives in : 1. Improve the use of equality analysis data in our commissioning cycle 2. Build strong relationships with protected groups and communities to better understand their needs and improve our equality data 3. Promote workforce equality and improve representation through effective employment practices 4. Develop inclusive leadership at governing body level Objective EDS Outcome Action Required RO Deadline Date of Update &1.2 Embed equality impact assessments into core steering group activities and programme boards: Update Publish completed EIA s on website Niema Burns Ongoing April 2015 EIA for children s community health services-v19 to be shared with programme board, and published on CCG website. Spec evaluation meeting 1

82 May 2015 June 2015 organised for the 12 th May. Part of the EIA activity to ensure that CCHS activity to date reflects the needs of communities. Report produced and forward to CCHS Programme Team. Meeting with Comms team organised for the 15 th June Establish EIA library to host current and ongoing EIA s Niema Burns Sept 2015 EIA cycle formally reviewed on a quarterly basis by Governing Body Niema Burns Sept 2015 June 2015 Discussion took place at PEC about viability of this. Equality & Diversity Lead advised that this would support the Governing Body in discharging their responsibilities under the PSED Suggested approach to 2

83 Work with public health partners to ensure that equality data is relevant and available to steering groups leads and programme directors Niema Burns Ongoing June 2015 raise at Q&G and then discuss as part of the seminar in August CCG considering being a partner to support VOICE HIT, which will focus on developing CCG s understanding of how best to utilise data ascertained from BME communities to address Health Inequalities. Written proposal by local authority expected to be received end of May Equality & Diversity Lead chased up Lead Commissioner. No updates as of June

84 Objective EDS Outcome , 2.2, 2.3 & 2.4 Action Required RO Deadline Date of Update Age: Support the development of advocacy services with Age UK Continue to support the development of appropriate methods to involve and engage children and young people through the recommissioning of children community health services. Disability: Niema Burns Ongoing April 2015 Niema Burns Ongoing June 2015 Update Meeting took place on the 8 th April to discuss how the CCG can further develop existing services to ensure that the needs of communities can be further strengthened. Next steps: Further discussions to take place. Equality & Diversity Lead forward named contact to the CCHS team for consideration to incorporate this contact into consultation activity planned for September/ November Support the launch of the Bristol Deaf Health Charter. Niema Burns Ongoing June 2015 Invites sent out for event on 20th May using eventbrite. Section developed on the events area of the 4

85 website. Social media plan to prepared to promote the event: 4 week countdown to commence on the website W/C 27 th April. Other social media activity has included linking with the Bristol Deaf Health Reference. Charter launched on the 20 th May. Equality & Diversity Lead developing the first assessment against the Charter action plan. This will include: -Undertaking a base line assessment on current activity against the Charter Action Plan. -Compare the baseline 5

86 Recruitment and Positive Action Strategy action plan. Develop work experience programme in conjunction with Job Centre Plus Niema Burns Ongoing April 2015 Niema Burns Ongoing June 2015 with positive about disability two ticks activity pledges. -Share draft baseline assessment with August PEC for initial feedback. Strategy in draft and presented at PEC (March 2015) & HOT (April 2015). To be presented at Directors May 2015, Q&G and GB June Programme developed in draft and pilot to commence on the 5 th May Feedback meeting between Equality & Diversity Lead, Work Pilot participant and Job Centre Plus Placement Coordinator organised for the 12 th June Evaluation paper to be 6

87 Renew the CCG Two Ticks Positive about Disability User Symbol as per annual cycle. Sex: Review the support required by the Men s Health Group. Niema Burns Mar 2016 June 2015 Niema Burns Ongoing June 2015 written W/C 15 th June and presented at the August PEC. Job Centre Plus approved the CCG status as a two ticks organisation following E&D Lead completing robust process. Confirmation letter forwarded to Operations Director for record/ information. Paper on this to be presented at the August PEC and August Quality & Governance. Internal discussions on how best support the group s needs led by the Equality & Diversity Lead and the Patient Monitoring Coordinator to be held on the 11 th June

88 Sexual Orientation (inc Transgender): Review Diversity Trust evaluation of LGB&T survey of Bristol population. Plan for LGB&T awareness month February 2016 Race: Niema Burns Niema Burns October Ongoing April 2015 April 2015 Sustainable engagement strategy organised as part of the PEC seminar May 2015 Survey is being undertaken at present, outcomes to be shared October Work with Comms on developing activity. Support the Bristol Manifesto for Race Equality. Niema Burns Mar 2015 June 2015 Launch event attended by CCG Leaders, with pledges being discussed. These pledges will feature as a key part of our recruitment and positive action strategy. E&D Lead invited to contribute to the next phase of development for the manifesto. CCG Chair developed 8

89 local pledges. Equality & Diversity Lead attended a Planning meeting on the 5 th June to discuss next steps. Manifesto Group will communicate next steps later in June Plan for Black History Month 2015 Niema Burns October 2015 April 2015 Work with Comms on developing activity. Religion & Belief : Scope opportunities for involvement in local religious events Community involvement in EDS2 implementation. Niema Burns Ongoing April 2015 Niema Burns Ongoing April 2015 May 2015 First meeting organised for the 21st June Expert panel actively engaged in implementation of EDS2 activity. Meeting organised for 19 th May 2015 to discuss overall approach and new NHS requirements. Paper written and 9

90 June 2015 presented to PEC on the 9 th June Paper outlines approach and timelines for implementation. Seminar to be organised for PEC to support achievement of sustainable engagement with communities. Niema Burns Ongoing June 2015 Paper to be presented to Quality & Governance for approval and endorsement 23 rd June Organised for May PEC. Seminar took place on May 2015, and a summary paper was produced. A further two papers are to be developed to explore main themes further at future PEC meetings. Additionally, main themes to be discussed ay GB seminar August

91 Objective EDS Outcome , 3.2, 3.3, 3.4, 3.5 & 3.6 Action Required RO Deadline Date of Update Renew Disability Symbol Niema Burns Mar 2015 April User for Update CCG continues to adhere to Disability Standard User Symbol and is allowed to display the symbol on its official communications, stationary etc. Job Centre Plus approved the CCG status as a two ticks organisation following E&D Lead completing robust process. Confirmation letter forwarded to Operations Director for record/ information. Deliver training to managers on fair selection processes including our commitments as a Niema Burns Sep 2015 April 2015 Paper on this to be presented at the August PEC and August Quality & Governance. 11

92 Disability Symbol User. Deliver disability awareness training. Develop Staff Support Network Policy Deliver awareness training on sexual orientation Review staff survey to identify key themes experienced by staff with a focus on equality themes as part of the working group Deliver equality and diversity refresher training. Deliver equality & diversity training as part of our induction training programme. Niema Burns Dec 2015 April 2015 Niema Burns June April Niema Burns Niema Burns, HR March 2016 Oct 2015 May 2015 April 2015 May 2015 Niema Burns Ongoing April 2015 SCWCSU Ongoing April 2015 Training to be planned Policy has been developed and shared at HOT meeting 20 th April Policy discussed at Directors 14 th May Policy to be shared at Quality & Governance June Training to be planned. Staff Experience Group has met (28 th May 2015), and these are to be shared with the HOT group. New dates for 2015/ 2016 to be published and training to be planned. Currently delivered through our SLA with CSU. 12

93 Objective EDS Outcome Action Required RO Deadline Date of Update , 4.2 & 4.3 Support the launch of the May 2015 June Bristol Deaf Health 2015 Charter. Support the Bristol April June Manifesto for Race Equality Update Operations Director present at launch event on the 20 th May 2015 CCG Senior Leaders attended the launch event for the Bristol Manifesto for Race Equality. CCG Chair set a number of Pledges during the launch event. RO-Responsible Officer PEC- Patient Public Involvement, Equalities & Communication Group 13

94 Equality & Diversity Action Plan Objective Objective 1: Improve the use of equality analysis data in our commissioning cycle. 1.1Embed equality impact assessments into core steering group activities and programme boards. EDS Outcome Action Required RO Deadline Date of Update 1.1 & 1.2 Success measure: Ongoing Equality data routinely used in commissioning work and equality impact assessment library populated accordingly. Deliver relevant EIA Niema Burns February Jan training sessions Update Training session designed delivered to CHS programme board members Jan Training delivered to staff as part of lunch time sessions. March and September EIA cycle formally reviewed on a quarterly basis by Governing Body Publish completed EIA s on website Niema Burns Ongoing June 2014 Governing Body seminar on EIA s delivered in June

95 Niema Burns Ongoing March 2015 EIA for children s community health services-v20 complete. For further details on this work see CCHS Equality plan. Activity around this has included E&D Lead completing:talks on local: BCFM, BBC radio Bristol. Items in stake holder newsletter. Work shops & Focus Groups aimed at BME, & LGB&T communities. Approach on EIA has led to E&D Lead being invited to speak at regional conference Autumn 2015.Equality and Diversity section of specification for CCHS developed. 2

96 Ongoing support to CCG staff to complete EIA s. Ongoing March 2015 EIA s supported to date have included: Safeguarding Policy, Ongoing support to care home project, Personalised budgets, CCHS (see above) and ACHS EIA library to host current and ongoing EIA s. Ongoing March 2015 Carried over to action plan. 1.2 Work with public health partners to ensure that equality data is relevant and available to steering groups leads and programme directors. Discussions with public health partners as part of core offer to provide relevant equality data. Niema Burns June 2014 Jan 2015 Community Health services scope for EIA has been an opportunity to further enhance our data collation. Information collated on: LGB&T communities via surveys and workshops. BME communities via surveys, events and workshops. See 1.1 CCG Equality & Diversity Lead is full 3

97 member of Health Inequality Group. Develope a form that outlines our approach to E&D and requires providers to complete equality monitoring data to assist us in developing our understanding of who accesses the services we commission. Meet with Lead commissioner and discuss requirements June Niema Burns Sep 2014 August 2014 Form completed and in use by commissioners. 1.3 Develop appropriate tools to assist in the development of robust equality impact assessments. Develop an Equality Impact Assessment screening template. Niema Burns Sep 2014 April 2014 Form available on S Drive. 4

98 Support the implementation of the Bristol Safeguarding Board s Equality & Diversity Action Plan. Niema Burns Dec 2015 Jan 2015 Meeting took place with Fiona Tudge from the BSGB to discuss the requirements of the Action Plan. Action Plan presented. Complete Objective 2: Build strong relationships with protected groups and communities to better understand their needs and improve our equality data. 2.1, 2.2, 2.3, & 2.4 Success measure: Improved engagement with protected groups through PPI and visibility of the CCG at key community events. 2.1 Age Recommissioning of adult community health services consultation events. Niema Burns Ongoing June 2014 March 2015 Complete. See Phase 1 report. Events held: BREHP July LGB&T Focus Group February Project suspended to September

99 2.2 Disability Sign up to Bristol Deaf Charter Niema Burns PEC May 2014 August 2014 Discussed at PEC in February, March, April, May, August, October, November 2014 meetings. Discussed at Q&G August meeting. Discussed at GB meeting in August GB sign up on the 24 th February Confirmation of sign up on CCG website announced via CCG twitter account. 6

100 Develop the Action Plan and Guidance to support the implementation of the Charter. Niema Burns Feb 2015 Jan 2015 As part of the build up to the launch of the Charter in May 2015, the Equality & Diversity Lead is assisting the Deaf Health Steering Group in developing the action plan and guidance for the implementation of the Charter to align it with current NHS initiative: EDS2 (Equality Delivery System 2). Feedback from providers incorporated into the action plan. 7

101 Recruitment and Positive Action Strategy developed. Niema Burns March 2015 March 2015 Draft strategy completed and action plan draft completed and presented at: -HOT meeting February and April 2015 & PEC meeting February Amendments made to the strategy and action plan, and this to be presented at Directors, Q&G and GB meetings. Carry over to Meeting organised with Job centre October 2014, December 2014 & February 2015 to discuss work experience programme. Work experience programme being developed as part of the Recruitment and PA Strategy Action Plan. 8

102 Support integrating Equality and Diversity principles into the work of Mental Health Bristol Niema Burns Ongoing March 2015 Coached the Devon Mental Health Partnership team on developing a fit for purpose approach for Bristol. Continue to support the system leader to develop an integrated approach to Equality & Diversity. 2.3 Sex Review the support required by the Mens Health Group. Niema Burns Ongoing March 2015 Internal discussions on how best support the group s needs October Discussions to continue through engaging 9

103 Patient Monitoring Coordinator. 2.4 Sexual Orientation Proactively ascertain how best to involve LGB&T communities in the recommissioning of adult community health services consultation. Niema Burns June 2014 July 2014 Sustainable engagement seminar organised for May 2015 to discuss best ways to carry this through action plans. Survey results for recommissioning of adult community health services indicate that 10% of the 122 responses received are LGB Surveys and focus group organised June 2014, with outcomes fed into the CCHS and ACHS projects. Niema Burns August 2014 August 2014 Feedback collated as part of the CCHS and ACHS Equality Impact Assessment. 2.5 Race Utilising the BREHP conference 2014 to involve BME communities in the recomissioning of adult community health services. Niema Burns Tony Jones June 2015 July 2014 Event organised by CCG, and findings to be carried forward via sustainable engagement seminar May

104 Put in place mechanisms to implement the NHS Workforce Race Equality Standard through discussion at the October 2014 meeting Niema Burns Feb 2015 March 2015 Complete-Action carried through Recruitment and Positive Action Strategy and the Equality & Diversity Strategy. 2.6 Religion & Belief Scope opportunities for involvement in local religious events Ongoing April 2015 Contact made (May 2014, July 2014 & August 2014) local organisations (Dhek Bal, Al Baseera Centre) to ascertain how the CCG can continue to engage them in the work that we do. Continue to engage as part of our sustainable engagement initiative. 2.7 Transgender See 1.4 Survey results for recommissioning of adult community health services indicate that 7% of the 122 responses received are a gender different to the one they were assigned at birth 11

105 2.8 Community feedback on Equality & Diversity strategy and to discuss approach to implementing EDS2 Expert panel currently set up and receiving training input. Niema Burns March 2015 March 2015 Sessions organised 20 th August 2014 and 9 th September 2014 for community feedback. In light of changes to EDS2 reporting scheduled from March 2015, the following was agreed: -Panel supported the E&D strategy and action plan. -Panel agreed that they would evaluate and grade performance in 2015/ Time frame for implementation to be agreed with panel in Spring Carry forward to Complaints are analysed per protected Quarterly reports on breakdown of complaints Kat Tucker Sep 2014 Jan 2015 Meeting with Complaints and FOI manager to 12

106 characteristic. per protected characteristic. discuss the logistics of producing a quarterly report and EDS2 implementation time line took place in September Objective 3: Promote workforce equality and improve representation through effective employment practices. 3.1 Review recruitment practice to incorporate positive action initiatives that reflect the CCG s status as a Disability Symbol User EDS 3.1, 3.2, 3.3, 3.4, 3.5 & 3.6 Success measure: Better representation of protected groups in the workplace as a result of inclusive recruitment & retention practices and better staff engagement and good employment practices. We attract the right people for the right posts at the right time. Develop recruitment and positive action strategy. Niema Burns Ongoing Mar 2015 March 2015 Action carried forward to 2015, following implementation of EDS2. Recruitment and positive action strategy-see

107 Targeted recruitment initiatives to ensure that perspective disabled applicants and staff can access employment opportunities. Niema Burns Mar 2015 Jan 2015 Meeting with Job Centre January 2015 organised to discuss the recruitment and positive action strategy, and how this can translate into meaningful initiatives. Complete-This action is to be implemented through the CCG Recruitment and Positive Action Strategy Attended a job fair 20 th October 2014 organised by job centre plus. During this event, a training session was delivered on completing an application form on NHS jobs. 3.2 Deliver training to managers on fair selection processes including our commitments as a Disability Symbol User. This has been incorporated into recruitment and selection training for managers. Niema Burns June 2014 March 2015 This has been discussed with HR during a meeting on the 12 th May 2014 and incorporated by HR into relevant training. 14

108 3.3 Deliver disability awareness training. 3.4 Reforming the Disability Forum 3.5 Deliver awareness training on sexual orientation. 3.6 Develop annual staff survey to evaluate effectiveness of people management approaches (access to flexible working, development opportunities) in promoting a fair and inclusive work environment. 3.7 Review the effectiveness of current workforce data arrangements. Training to be planned. Niema Burns Sep 2014 Ascertain interest in the Niema Burns March reforming of the Disability 2015 Forum Training to be planned. Niema Burns Sep 2014 Survey to be developed. Publish our workforce data through our equality & diversity annual report. Niema Burns, HR, Communicati ons. Niema Burns Complet e. April 2014 March 2015 July 2014 April 2015 Jan 2015 July 2014 To be planned. See 3.8 No sufficient interest received at this stage. Carried through action plan via our staff support network policy. To be planned. See 3.8 Complete as part of the staff survey This has been done through our Equality & Diversity Strategy Published May

109 3.8 Deliver equality & diversity training as part of our induction training programme. Currently core training delivered through our SLA with CSU, however bespoke training has been delivered to CCG staff. Niema Burns March 2015 March 2015 Refresher training delivered to cover the online update sessions on the 31 st March Two sessions (9 th and 12 th July 2014) organised as part of NHS change week. Objective 4: Develop inclusive leadership at governing body level. 4.1 Governing body members ensure that papers and initiatives presented at governing 4.1, 4.2 & 4.3 Success measure: Governing Body proactive about the integration of equality into core business. A governing body seminar on equality planned for June 2014 Niema Burns Ongoing June 2014 April 2014 Bespoke training delivered to CCHS 6 th January 2015 programme board members. Seminar delivered 26 th June

110 body contain appropriate equality impact information to assist them in determining how they shall manage any identified risks. 4.2 Governing body members approve revised equality objectives To be discussed during governing body seminar Niema Burns June 2014 August 2014 Presented to Governing Body members on the 29 th July 2015 and agreed. Publish the Equality & Diversity Objectives in the work place. Niema Burns/ Governing Body June 2014 Sep 2014 Publicised via information board. 4.3 Oversee the compliance with PSED through annual reporting Report to governing body scheduled for May 2014 Governing body members May 2014 April 2014 Discussed as part of the Governing Body Seminar. Further work required. RO-Responsible Officer PEC- PPI, Equalities & Communication Group 17

111 Communications Annual Report April 2014 March

112 Bristol CCG Communications Annual Report 2014/ Introduction This report outlines the key activities undertaken by the Communications Team to support Bristol Clinical Commissioning Group throughout the year from April 2014 to March The PPI, Equalities and Communications Group (PEC) is used to oversee the work of these three work areas and subsequently supports the effective commissioning of healthcare services. All three of these work areas are key enablers in supporting effective dialogue with key audiences and ensuring that the patient and public voice can be heard throughout the organisation. From a communications perspective this involves leading proactive media relations and responding to media enquiries reactively; managing the website and social media channels for the CCG; producing leaflets, flyers and other communications materials; responding to Parliamentary Hub requests for briefings and information; producing and distributing newsletters and ad-hoc news updates; offering strategic communications advice and guidance regarding issues and operational resilience. A detailed Action Plan highlighting our key communications achievements and actions over the past 12 months is in Appendix 1 however information on the key achievements is outlined in the following pages. Notably this year, the Communications Team s efforts were recognised with two award nominations for the Think ABC campaign work undertaken by the team on behalf of the CCG. The team also won the silver award at the Chartered Institute of Public Relations (CIPR) awards for Outstanding In-House Public Relations Team for 2014; which is testament in part to the work undertaken for Bristol CCG. 2.0 Background Bristol Clinical Commissioning Group (CCG) has now been in operation for two years, following its formal establishment in April When the CCG was first formed in 2013, a basic communications strategy was developed as a guide to communications for the new organisation. In 2014 this communications strategy was comprehensively refreshed and updated to align with the aims, objectives and priorities set out in the CCG s five year strategic plan. The strategy was approved via PEC and the Quality and Governance Committee before being discussed and signed off by the Governing Body at its December 2014 meeting. The communications strategy and appending action plan now set out the objectives that the communications activity is focused on achieving i.e. the activities to be undertaken to ensure realisation of these goals the channels and tactics used. 2

113 In its five year strategic plan, Bristol CCG outlines seven priorities, 11 delivery themes and seven cross-cutting priorities. It is these areas where the communications team has focused its activity over the last year. Throughout 2014/2015 all communications activity for the CCG has been led by the SWCS Communications Team. A dedicated communications manager and communications officer have led the day-to-day operational communications activity with support on specialist tasks, such as digital communications and graphic design, from the Digital Project Manager, Digital Content Coordinator and the Publications Manager. Campaign management and discrete projects requiring communications support have been undertaken by the team s project communications managers, while strategic communications advice and guidance was offered by the Head of External Communications and Programme Director for Communications. Bristol CCG s vision and purpose are as follows: The vision is: Better health and sustainable healthcare for Bristol. The purpose is to: Improve the health of people in Bristol Improve the patient experience and access to care Work with Bristol City Council to reduce health inequalities across Bristol Work with our partners to ensure that there is a sustainable and affordable healthcare system in Bristol. There are five values that lie at the heart of the way they work with patients, the public, partners and staff. Communications will support the CCG values which are: 3

114 It is these five values that provide the basis of the communications messages that run throughout any materials for the CCG. 3.0 Key Objectives The key communication objectives as highlighted in the communications strategy, for this year were: To raise the profile of Bristol CCG in the South West and increase understanding of its role in the local health economy. Build confidence in the CCG and its ability to make health decisions on behalf of the population of Bristol. Improve signposting and access to services through effective and regular communications, in partnership with provider organisations. To create two-way communications processes, allowing the CCG to enter into a dialogue with local people. Increase numbers actively engaging with the CCG through promotion of patient and public involvement activity. To support the CCG to achieve its strategic priorities, as established in its five year plan, through effective communications and engagement. To gain support for the CCG s five year plan and overall strategic direction, with patients, staff, partners, stakeholders and the public. 4