ACORN patient participation group Minutes of meeting held on Thursday 20 November South Northumberland Cricket Club 5:30pm 7:30pm Present: Name Initials Gill Clancy (Chair) GC Brunton Park Health Centre Anita Davies AD Gosforth Memorial Health Centre Anne Marie Bailey AMB North of England Commissioning Support Anne Raffle AR Walker Medical Dick Godfrey Brunton Park Health Centre Elizabeth Hammill EH Holly Medical Hilary Bellwood HB Newcastle Gateshead Alliance Ian McCalman IMc Gosforth Memorial Health Centre Ian Nelson IN Grove Medical Group Jackie Cairns JC Newcastle CCG John Smith JS The Grove Medical Group Lisa Dodd LD North of England Commissioning Support Michael Burke MB CCG Lay Member and Chair of Audit Committee Rachel Parsons RP Newcastle Carers Tony Ingoe TI Heaton Road Surgery Tracey Stuchlik TS Business Manager, Thornfield Medical CCG Executive Lead for PPI Alison Thompson AT CCG Patient, Carer and Engagement Lead Apologies: Name Rita Prabhu Susan Musson Paul Woodward Oliver Wood Wendy Hicks Park Medical Group Heaton Road Walker Medical Vice Chair and Lay Member for PPI Regent Medical Group
Action Actionee/s 1. Welcome and Apologies All welcomed and apologies given from Paul Woodward, Rita Prabhu, Susan Musson and Oliver Wood and Wendy Hicks 2. Previous Minutes and Matters Arising The minutes of the meeting held on 25 September were agreed as a true record. 3. Hilary Bellwood, Newcastle Gateshead Alliance CCG Merger update Key highlights from the discussion were: Hilary talked through the revised staff structure and committee structure for the CCG as from 1 April 2015. There is no change in the number of Lay Members which means that Oliver will remain as Lay Member for PPI. Staff within the CCG will know the outcome of the HR process on Monday 24 November. Despite the new structure, there is still a strong focus on PPI. Questions from the group Q. How do the patient groups and their ideas link into the delivery of work? Where do the group give their ideas to? A. Groups like ACORN can and will continue to be involved in engagement work throughout the year. One idea as the new organisation takes shape is to have a representative from the group for each commissioning intention area who can work closely with the Clinical Lead. This would ensure that the group and the patient voice are considered every step of the way. Q. How will the CCG demonstrate the importance of groups like ACORN? Groups aren t involved in key decisions just now but they need to feel and be involved in making bigger decisions. A. In the new structure, groups like ACORN are more important and will have a key role. Groups always have an avenue to give feedback, ask questions and share experiences through the CCG reps for PPI. The CCG want the views and involvement of groups like ACORN to be part of the decision making process whenever possible. When the workstreams have been finalised, the CCG will have more of an idea how things will be structured. There are however, areas of day to day business that the group don t need to be involved in.
The group have been involved in key work so far including the Primary CareStrategy, COPD, Diabetes and Walk in Centre engagement and the CCG would like that to continue and for there to be continuous dialogue. As the group have done previously, inviting Clinical Leads to meetings is a good way to know what work is planned and highlight opportunities to get involved. Hilary ended her discussion with the group by offering to return to a future meeting. post meeting additions: reports to CCG are to have covering sheets on what public consultation has taken place, both in specialised engagement work, and ACORN. It was important to note that ACORN are keen to be involved in any future engagement work that the CCG does over the coming year. 4. Rachel Parsons, Newcastle Carers Rachel wanted to inform the group of the work of Newcastle Carers Centre and the services they offer to carers across the City. Rachel encouraged the group to think carer when carrying out their everyday work and keep in mind that most people don t recognise themselves as carers to close family members and see what they do as part of everyday life. This makes it difficult for GPs, Social Services and other organisations to support carers as much as they would like. There are around 26,000 registered carers in Newcastle but the real figure is a lot more. Services that Newcastle Cares provide include: Carers Opportunities Fund small grants up to 250 to support the carer either taking a break, providing essential household items, driving lessons etc. Advice and information 1-2-1 support Counselling services Complementary Therapy Training Rachel provided leaflets on the services for the group. Questions from the group Q. are funds like the Carers Opportunities Fund available in other areas?
A. There will be local Carers Centres in other areas but the fund, or a similar fund is an area by area initiative. There is also the Carers Trust who also provide funding for carers Q. Who funds the Carers Centre? A. The CCGs and the Local Authority fund the Centre and the Carers Opportunities Fund is funded solely by the Newcastle CCGs. More information on the services of the centre can be found at www.newcastlecarers.org.uk 5. Michael Burke, CCG Lay Member and Chair of Audit Committee Michael outlined his role and responsibilities to the group. These include: Looking at how the CCG decides what it is going to do and how work is going to be achieved. Making sure that decisions made make sense, are good decisions with good outcomes. Good governance structures and committees are in place for reassurance. Michael chairs the Audit Committee which is an independent committee of the CCG, comprising lay members of the CCG. As the committee is independent it can hold the CCG officers to account, ask questions and ask for follow up progress. This gives assurance that good decisions are being made and that they are efficient and effective. The Committee is supported by both internal and external audit colleagues to ensure the right questions are being asked. Because of the complex nature of information, triangulation is used where the information is checked against two other sources to decide whether it is correct or not. Michael also talked to the group about contracting. Main points of the discussion were: All CCG services are now fully focused on patient choice and that patients are more involved with the options for their care. This may mean that to give patients more choice, more than one provider may provide the same service. Where there are lots of providers, e.g. GPs, patients can make their own choice. Where there is one service being provided, the CCG on behalf of the patients, invites tenders from a list of Any Qualified Provider The CCG makes its decision on who will provide the service based on quality, normally at a fixed cost set by the CCG. Desired outcome The service model to achieve it Formalise contract model, including advice from healthcare professionals, other ideas, patient experience, grass roots knowledge,
all to inform the thinking Judgment by quality of bids on preset tariffs outcome-based makes it patient-centred The group raised queries about the awarding of the ABPM contract and how the Hospital trust has subcontracted this to GP practices. Michael explained that to award this contract the CCG used a lead provider contract model for this service which awards the full contract to one provider. If the provider then decides to sub contract, it is their responsibility to do this and they will award this on the basis of quality and value for money. Re the query about the Hospital trust keeping back some of the money, Michael confirmed that the price of the sub contract for this or any service is up to the Hospital trust to negotiate and is not the responsibility or has any involvement from the CCG. JC to provide information about sub-contracting and types of contracts available/awarded. AT to contact procurement colleagues (Trish Hirst) with a view to attending a future ACORN meeting JC AT 6. Lisa Dodd and Anne-Marie Bailey, North of England Commissioning Support Medicines Optimisation Anne-Marie Bailey and Lisa Dodd gave an overview of the medicines optimisation work they are progressing on review of the MO practice pharmacist s contract. Copies of the slides will be sent to the group following the meeting. AT (emailed 21 Nov) Highlights of the discussion were: CCGs want to redesign the practice pharmacist service provided in practices. This is to make sure that the service is fit for the future and fits with the 5 year forward view from the Department of Health, which focuses on developing community services. Details of the practice pharmacist role were highlighted as: Based within practices and review patient medication, working with the GPs. They deal with safety alerts on medications and educate GPs about changes in medications etc. Audit current prescribing practices and benchmark against other practices in Newcastle, the Region and Nationally and work with practice to reduce variation in prescribing, both under and over prescribing.
Work with practices to ensure prescribing is cost-effective and introduce switching processes to address areas which are not cost effective Every practice has a pharmacist but they move between practices so are not there full time. Between now and January, the CCG via colleagues in NECS will be speaking to groups and the public about the role of the practice pharmacist and their ideas about what people would want from this service in the future. This information will feed into the service specification for the future service. Following this a new provider(s) will be identified with the new service starting from April 2016. The group were generally unaware of practice pharmacists and in thinking about what the practice pharmacists could do in the future, some suggestions included: Review medications and discuss changes with patients. Be aware of any physical changes (e.g. weight loss) etc. that patients have and adjust or consider if any adjustments are required to their medications. Annually review medications with patients. All They are keen to see the practice pharmacist service broadened out and it was agreed that members would take the questions on the slides to their individual practice participation groups and feedback any comments. Commissioning Intentions Lisa gave an update on progress and future focus for the commissioning intentions. Questions from the group included: Q. What s happening with the community nursing contract? A. Jackie Cairns updated that on taking this work forward, it was agreed that for the nursing contract to change this would have an effect on all other health services. Because of this, this work has been put on hold and will be looked at next year in line with the progressing primary care strategy work. Lisa highlighted the four areas of work in the coming year. These are: Children and Young People Mental Health Systems Resilience Market Development The group were supportive of the idea of having members of ACORN involved with these groups. 7. Update from Group members on meetings attended Cancer and End of Life Care Anne Raffle gave an update on Cancer and End of Life work. Dr Chris
Tasker had attended the Walker Medical PPG to give an update and advise that his role is changing. His post had previously been partly funded by Macmillan however this had now come to an end. The CCG still fund and support the work on Cancer and End of Life Care but the details of what this will entail next year are still be confirmed. Primary Care Strategy Ian McCalman gave an update on the primary care strategy and specifically the IT systems being discussed. It was important to note that patients need assurance that their information, health medications etc., can be safely and successfully shared between health services. There is also a question around who owns the patient data. The next meeting of the IT group for the primary care strategy is in January 2015. Deciding Together the future of mental health services Elizabeth Hammill gave an update on the launch of the Deciding Together event she attended. A series of events are planned throughout December and January and she encouraged members of the group to attend. Information was circulated about when and where the events are being held. 8. AOB The group were reminded of the Governing Body meeting taking place next Tuesday (25th) November and that members of the group are welcome to attend. Dates of future meetings will be detailed on the agenda of ACORN meetings and the group were reminded to check the Newcastle Gateshead Alliance website to download the papers and venue confirmation. 9. Date of next meeting 22 January 2015, 5.30pm, South Northumberland Cricket Club