1 st Annual Leeds Citywide Patient Participation Group Event Friday - - PowerPoint PPT Presentation

1st Annual Leeds Citywide Patient Participation Group Event

Friday 20th October 2017

NHS Leeds CCG Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Welcome

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Housekeeping

• Agenda
• Questions
• Delegate packs
• Toilets
• Drinks
• Fire alarm
• #3things
• Evaluations
• Social media

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Acronym buster

• PPG/PRG – Patient Participation Group/Patient

Representative Group

• LTHT – Leeds Teaching Hospitals Trust
• LYPFT – Leeds and York Partnership Foundation Trust
• PAG – Patient Assurance Group
• CCG – Clinical Commissioning Group
• CQC – Care Quality Commission

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Social Media

Twitter - @nhsinleeds #PPGsinLeeds Facebook - https://www.facebook.com/nhsleedssouthandeastccg/ #PPGsinLeeds Instagram - https://www.instagram.com/nhsleeds/ #PPGsinLeeds Scribble Live - https://www.leedssouthandeastccg.nhs.uk/leeds-citywide-ppg-

event-20-october-2017/ #PPGsinLeeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Aims & Objectives

‘To bring people together to openly discuss PPGs; how they are doing, what support is out there and where we are going in the future’

• To better understand the current status and plans for health and social care in

Leeds

• To better understand the current status of PPGs in Leeds
• To understand what is expected of a PPG and its members
• To better understand some of the barriers, and solutions, to making PPGs

works

• To share and learn of good PPG practice across the city
• To understand different ways to get involved as part of a PPG
• To discuss the formation of ‘The Leeds PPG Network’

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Spend five minutes discussing on your table the following question:

“What are PPGs to you?”

• Jot down your discussions on a piece of the flipchart paper
• Pick a couple of key points to feedback

What are PPGs to you?

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Opening Remarks Simon Stockill

Medical Director NHS Leeds Clinical Commissioning Group Partnership

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Leeds Engagement Hub: working together to strengthen citizen voice

Why are we here? Rebecca Barwick

Head of Programme Delivery – System Integration

NHS Leeds Clinical Commissioning Group Partnership

Nigel Gray

Chief Officer – System Integration

NHS Leeds Clinical Commissioning Group Partnership

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Leeds Engagement Hub: working together to strengthen citizen voice

System integration and ‘one voice’

20th October 2017

Nigel Gray, Chief Officer - System Integration Becky Barwick, Head of Programme Delivery - System Integration

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Why do we need to change?

I want to be able to plan my care with people who work together to understand me and my carer(s) I want services that work together to achieve the

• utcomes important to me

When I use a new part of the service, my care plan is known in advance and respected. The professionals involved with my care talk to each other. We all work as a team Taken together, my care and support help me live the life I want to the best of my ability.

Source: National Voices, A Narrative for Integrated Care

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Leeds Engagement Hub: working together to strengthen citizen voice

The Leeds CCGs

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Leeds Engagement Hub: working together to strengthen citizen voice

NHS Clinical Commissioners: September 2017

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Leeds Engagement Hub: working together to strengthen citizen voice

How will providers change?

Accountable Care System

Alliance of providers Outcomes based contract Whole budget for defined population

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Leeds Neighbourhood Teams

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Single integrated teams General Practice teams working in localities Some hospital specialists

New Extended Primary Care Team

Local Care Partnerships

Population

• c. 30-70k

UNDERPINNING ACCOUNATBLE CARE SYSTEM?

City wide services and functions

Neighbourhood teams Other community services Primary care mental health workers /CMHT Third Sector

GP

GP GP GP

Consultants and specialist nurses

What could community care look like in the future?

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Why are we doing this? - The three gaps

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Leeds Engagement Hub: working together to strengthen citizen voice

National and international direction of travel

Leeds Engagement Hub: working together to strengthen citizen voice

What are we trying to do? - recap

A new model of provision:

Integrated care based around registered list An extended primary care team Fewer steps to access specialist support Joint responsibility for outcomes Joint responsibility for money

Integrated commissioning for population level health and wellbeing

• utcomes

A new model of commissioning:

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Looking Forward… Paul Bollom

Interim Executive Lead for the Leeds Plan

Leeds City Council

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Partnership Executive Group

Leeds Health and Care Plan

Connecting our initiatives, connecting with the public

Paul Bollom

11 October 2017 Member Development Session

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• “Leeds will be a healthy and caring city for all ages, where people who are the poorest

improve their health the fastest”

• Turning the curve:
• Health and wellbeing
• Care quality
• Finance and efficiency
• Not just another plan – a ‘social movement’
• Change our conversation and how we connect
• A plan for every citizen and member of

staff in Leeds that they:

• Understand and inspires them
• Can relate to
• Can see what their contribution as an individual, family, community and city is.

What are we trying to achieve?

Secondary Care Primary Care Self Care Secondary Care Primary Care Self Care

Leeds Left Shift

Healthy Episodic illness Healthy at higher risk of developing health and social care needs Living with frailty Living at end of life

Stages of health and wellbeing people tend to be within at a point in time Current emphasis of resources and focus

Prevention

Future emphasis of resources and focus

Prevention

Shift as a society we need to make

#PPGsinLeeds

Leeds Health and Care Plan

By 2021, Leeds will be a healthy and caring city for all ages, where people who are the poorest improve their health the fastest

A plan that will improve health and wellbeing for all ages and for all of Leeds which will… Protect the vulnerable and reduce inequalities Improve quality and reduce inconsistency Build a sustainable system within the reduced resources available Our community health and care service providers, GPs, local authority, hospitals and commissioning organisations will work with citizens, elected members, volunteer, community and faith sector and our workforce to design solutions bottom up that… Have citizens at the centre of all decisions and change the conversation around health and care Build on the strengths in ourselves, our families and our community; working with people, actively listening to what matters most to people, with a focus on what’s strong rather than what’s wrong Invest more in prevention and early intervention, targeting those areas that will make the greatest impact for citizens Use neighbourhoods as a starting point to further integrate our social care, hospital and volunteer, community and faith sector around GP practices providing care closer to home and a rapid response in times of crisis Takes a holistic approach working with people to improve their physical, mental and social outcomes in everything we do Use the strength of our hospital in specialist care to support the sustainability of services for citizens of Leeds and wider across West Yorkshire What this means for me… “Living a healthy life to keep myself well” “Health and care services working with me in my community” “Hospital care only when I need it” “I get rapid help when needed to allow me to return to managing my own health in a planned way” Key actions that will be undertaken…

• 1. We will promote awareness and develop services

to ensure the Best Start (conception to age 2) for every baby, with early identification and targeted support early in the life of the child.

• 2. We will promote the benefits of physical activity

and improve the environments that encourage physical activity to become part of everyday life.

• 3. We will maximise every opportunity to reduce the

harm from tobacco and alcohol, including enhancing the contribution by health and care staff.

• 4. We will have new accessible, integrated services

that support people to live healthier lifestyles and promote emotional health and wellbeing for all ages, with a specific focus on those at high risk of developing respiratory, cardio-vascular conditions.

• 5. We will have a new, locally-based community

service, ‘Better Together’, that can better build everyday resilience and skills in our most vulnerable populations.

• 1. People living with severe breathing difficulties will

know how to manage anxiety issues due to their illness and have a supportive plan about what’s important to them by December 2017.

• 2. People living with severe frailty will be supported to

live independently at home whenever possible, instead of having to go in and out of hospital.

• 3. People at high risk of developing diabetes and

those living with diabetes will have access to support programmes to give them the confidence and skills to manage their condition by December 2017.

• 4. We will take the best examples where health and

care services are working together outside of hospital and make them available across Leeds, for example muscle and joint services.

• 1. Patients will stay the right time in hospital.
• 2. Patients with a mental health need will have

their needs met in Leeds more often rather than being sent elsewhere to receive help.

• 3. We will meet more of patients’ needs locally by

ensuring their GPs can easily get advice from the right hospital specialist.

• 4. We will ensure that patients get the right tests

for their conditions.

• 5. We will reduce the visits patients need to take

to hospital before and after treatment.

• 6. We will ensure that patients get the best value

medicines.

• 1. We will review the ways that people currently

access urgent health and social care services including the range of single points of access. The aim will be to make the system less confusing allowing a more timely and consistent response and when necessary appropriate referral into other services.

• 2. We will look at where and how people’s needs are

assessed and how emergency care planning is delivered (including end of life) with the aim to join up services, focus on the needs of people and where possible maintain their independence.

• 3. We will make sure that when people require urgent

care, their journey through urgent care services is smooth and that services can respond to increases in demand as seen in winter.

• 4. We will change the way we organise services by

connecting all urgent health and care services together to meet the mental, physical and social needs of people to help ensure people are using the right services at the right time. Together these actions will deliver a new vision for community services and primary care in every neighbourhood. These will be supported by… Working as if we are one organisation, growing our own workforce from our diverse communities, supported by leading and innovative workforce education, training and technology Having the best connected city using digital technology to improve health and wellbeing in innovative ways Using existing buildings more effectively, ensuring that they are right for the job Using our collective buying power to get the best value for our ‘Leeds £’ Making Leeds a centre for good growth becoming the place of choice in the UK to live, to study, for businesses to invest in, for people to come and work Draft version 2.2 | Date 03/07/17

• Maintain balance of recognising the very significant funding challenges – no

sugar-coating – alongside what we can change to improve.

• Talk simply together about resilience / winter, our Leeds Plan and our

ambitions for new accountable models.

• Update communities and the public with progress and create the appetite for

change.

Continuing the conversation with public, workforce and elected members

• Citizens Trust members, Citizens Panel, NHS engagement panels, Third Sector networks,

businesses, universities

• Carers Those registered as carers and those who aren’t
• Third Sector partners and the clients / citizens they support
• Working adults reached through the workplace
• Elected Member engagement: Scrutiny, Community Committees
• Health and care colleagues: Council, Primary Care and Trust employees, both as citizens

but also as workforce;

• Statutory Partners
• Universities, colleges, schools
• Partnership with Leeds City Council’s Intelligence and Policy Service and Digital Access

Teams

• ‘Toolkit’ to enable discussions to take place autonomously

What do we mean by a citizen conversation?

Changes brought to life through stories

Margaret, 86, Middleton

Present Day 2017 - “What is the reality now?” Fast Forward to 2027 - “What can be done to make it better?”

I struggle to get out and about as much as I used to. It’s hard to plan days out as I never know when I’ll have a good or bad day and so sometimes I can go weeks without leaving the house. I do get visits from people, family and carers, but they’re often just short visits and I can understand that they’ve got busy lives and haven’t always got the time to take me out. As soon as I spoke with my doctor about the difficulty I was having breathing and getting out as much, he sent me for tests but also allocated a well-being coordinator to me. The wellbeing coordinator is great, he conducted an initial assessment and asked me lots of questions to understand my social situation, my daily lifestyle, and the support I was getting at home and in the community. This helped him to work with me and my son-in-law to prepare my care plan. My plan is tailored to what I need and it brings together information about the help I get from the Council as well as information about what we plan to do together to make sure I get involved with lots of community activities. I’ve had numerous spells in hospital and I receive daily care from the community nursing team. The hospital care I’ve had has always been really good, although I’d rather not have to go into hospital unless I absolutely have to. I’m not flexible enough to be able to change my dressings so I need help from people who come and do this 2 or 3 times a day. The help I’ve had at home in the community hasn’t been as good though. It just hasn’t been joined up at all. People don’t seem to speak to each other the professionals are just not speaking. There have been a lot of times when nurses have turned up without bandages. My family have said how easy things have been for them to link in with the joined up team of people who provide me with help at home. My son-in-law spoke with the doctors who looked after me in hospital about something that they call a ‘virtual ward’. This means an urgent care team is available to help him look after me if things aren’t going well. They’ve got tele-video kit that they can use to find out what’s wrong with me and offer support remotely. Ever since I first started receiving help at home, my family and I have had a single community nurse allocated to us as our first point of contact. This gives us really good access to the staff who help to look after me. There are lots of people who have to work as a team to make sure I get my visits at the right time, and that they come with the right equipment and information. I’ve had lots of infections in my legs. I get really upset sometimes when nurses don’t even treat it. Sometimes they just strap it up instead of cleaning my infected legs properly. On one occasion my daughter asked why a doctor hadn’t been asked by the nurses to come and look at my leg. She was very upset when the nurses responded that it wasn’t their job to call doctor, and they were just supposed to dress my leg. It’s very rare that anything goes wrong, but at least if there is any confusion I can go straight to my main point of contact and she knows my circumstances really well. She’s got to know me over the year and she’ll always pick up the phone to the rest of the team and get things sorted quickly if anything is wrong. This is a huge help and means that me and my son-in-law don’t have to go through the details

• f my case with new staff all the time. If she’s busy then my son just drops her a quick email and she’ll always come back to him as soon as she can.

I’ve been very poorly for 2-3 years and it’s been a real frustration trying to fight the system the whole time. My daughter and son-in-law have spent hours every week speaking with the different departments and organisations just to get the basics right. Whenever I need to visit the doctor or the nurse I’m always given plenty of time with to be able to talk about needs. My son gets an email sent to him a couple of weeks before an appointment and he has the login details so he can look at all my notes before we go in. He says he finds that helpful so that he has time to think about what questions he wants to ask for me. It’s also helpful to be able to look at my notes from time to time to check details that I might have forgotten. My Doctor holds a clinic once every couple of months to review all of his older patients who are in similar circumstances as me. It’s really nice as they put on activities at the community hub so that we all have the opportunity to spend some time with each other on the day that the clinic takes place. They have things like a hairdresser who visits, as well as talks and lunches on the day. After each of my reviews with the doctor at the community clinic there is a meeting where they get together to discuss all of the patients who they’ve reviewed that day and a management plan is made. At the meeting they have the GPs, the district nurses, an occupational therapist, a physiotherapist, and a social worker. Some of the people I’ve got to know through the clinic sessions are in care homes as they need a bit more help than me. Where my friends are in homes their nursing home managers and staff also go along for the review. My son-in-law said I have a prescription list as long as my arm. The pharmacy keeps sending out medicines, but I don’t need many of them. I’ve now been taken off lots of them by my doctor and I find it confusing to keep getting so many delivered to my house. My son in law keeps taking them back and the pharmacy says they can’t use them then even though they’ve not been opened. It’s all really confusing and I don’t want to be responsible for wasting the NHS’s money. At one point I was able to have a look, with the help of my son-in-law, and quickly fix a problem with the pharmacy who had got my prescription mixed up and kept sending me medicines that I no longer

• need. This has been sorted now after we took a copy of my current prescriptions from my online record and emailed it over to them.

People coming to look after me at home always seem to be rushed. It’s usually different people each time they visit and it sometimes seems that some are much better trained than others. A lot of the time I don’t know who to expect as there are temporary staff who come to see me if the permanent team are sick. I have to leave a key in a special key box outside because I’m not mobile enough to get to the door and I sometimes don’t hear it. Because it’s different staff each time I feel a bit nervous about leaving keys out for strangers to let themselves in. It’s really nice to know in advance about who is coming to visit me. More often than not it’s someone I know, but from time to time I’ll get one of the new one’s coming. Before each visit I get a quick phone call to let me know who it is and when they’ll be arriving. That means I can relax and not have to worry about who is coming and when. I’ve not really been involved but I know it’s been confusing for my family trying to deal with the costs of care and the split between the health and care elements of residential homes. I don’t really understand it all but I think it would be good if it was clearer for people and their families. When I was in hospital after my heart attack the staff there told my son-in-law that he had 3 days to find a home. He and my daughter had to visit 7 homes in a weekend. During that time when they were racing around to view the homes and asking lots of questions they said they found it difficult to get a straight answer about how much the cost would be. The care home, websites and the council kept telling them different things. They’ve said they just wanted a single person to speak with so they could get all the facts straight. I wish I’d thought years ago about what I would do when the time came that I’d need more help. I’m not really happy in the home I’ve ended up in. The people are polite and nice enough, but I don’t often see a familiar face except the odd visit from busy family members. I’ve been getting my care at home for a couple of years and it has been great. I’m probably at the stage now though where I’m starting to think about the future and other options. Within the next couple of years I think I’d like the peace of mind of knowing there was always someone nearby if I need them. I’ve spoken about this with my family and they’ve had lots of information about options from the council. As it happens there are a few of my friends in a similar situation, we’re all okay for now but are beginning to think about our plans for a few years’ time. When I was younger I’d have shuddered at the thought of leaving the place where I raised a family and ‘moving into a home’, but things are very different now than they were when I was trying to sort care

• ut for my parents thirty years ago. One of the options that my friends and I are looking at together is something called Co-Housing. There are lots of organisations who can offer support and advice and

help to work with us on solving some of the difficult but important problems around costs and agreements that need to be sorted between my friends and I so that we all fully understand what we’re signing up to if we do decide to go down the co-housing route and live together. I really like the idea as not only are we all friends but I know most of their kids and have seen them grown up. It would be lovely to have all their kids and grandkids visiting as well as my own. We don’t have to decide just yet, but I’m leaning toward this idea as it would be lovely to live with people I know rather than complete strangers.

Hi, my name is Margaret. I’m 86 and I live in Middleton. I’m getting on a bit and I’ve been living alone since my husband died four years ago. I’m often at the doctor’s and I need a lot of help at

• home. I’ve not been in great health for a while now which is part of getting old I guess. I have what the doctors say is exacerbated COPD (Chronic Obstructive Pulmonary Disease) and I even

suffered a heart attack earlier this year. I struggle with Lymphedema in my legs. This gives me an aching, heavy feeling, difficulty moving and repeated skin infections and sores on my legs.

DRAFT 09/10/2017

Leeds Engagement Hub: working together to strengthen citizen voice

Setting the Scene Chris Bridle

Engagement Lead

NHS Leeds Clinical Commissioning Group Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

A history of patient involvement

1950’s – cancer research and treatment 1960’s – patient empowerment grew with the rise of

the women’s movement

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

A history of patient involvement

1970’s - consumer-friendly hospital complaints

procedures

1972 – First PPG set up by a GP 1978 – NAPP set up

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

A history of patient involvement

Late 2000’s - Mid-Staffordshire 2010 – Winterbourne View 2011 – Patient Participation DES 2015 – PPGs become a contractual requirement for

practice

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Engagement works! ‘There is clear evidence that PPI can make real, constructive changes to the provision of services, aiding the responsiveness of practices and providing services that truly reflect what patients want and need.’

British Medical Association, 2015 https://www.bma.org.uk/about-us/how-we-work/professional-activities/patient-liaison-group/resources

We have to do it anyway! ‘We must put citizen and patient voice absolutely at the heart of every decision we take in purchasing, commissioning and providing services.’

Tim Kelsey, National Director of Patients and Information, NHS England, Transforming Participation in Health and Social Care, 2013 https://www.england.nhs.uk/wp-content/uploads/2013/09/trans-part-hc-guid1.pdf

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The Health and Social Care Act 2012 outlines two legal duties, requiring Clinical Commissioning Groups (CCGs) and commissioners in NHS England to enable:

1. patients and carers to participate in planning, managing and making decisions about their care and treatment. 2. the effective participation of the public in the commissioning process itself, so that services provided reflect the needs of local people.

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The Leeds context

• 104 practices in Leeds
• Serving different communities
• In a period of change
• Increased demand
• Move towards partnership working
• More focus on prevention
• Patient empowerment
• Different ways of commissioning and providing

care

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Leeds PPG audit

• Only one practice say they have no PPG
• Between 0 and 300 members
• 4 practices say they only have a virtual group
• Some PPGs are ‘active’ but haven’t met since March 2015
• Many PPGs do not publish their minutes on the website

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Key points

• Patients are a key stakeholder
• Primary care under pressure
• Variation between practices
• Some great examples of PPGs in Leeds
• Lack of clarity about the role of PPGs
• Tools and resources are available (Engagement Hub)

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of PPGs, practices and PPG members Consider:

• What is a reasonable expectation?
• What are ‘must do’s’ and ‘nice-to-do’s’
• How does your practice measure up?
• How can you support your practice?
• What can your practice do to support you?

Setting the Scene

The status of PPGs in Leeds

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Helen Wilkinson

Primary Care Locality Manager

NHS Leeds Clinical Commissioning Group Partnership

Trevor Thewlis

Patient Participation Group Member

Ireland Wood/New Croft Surgery

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Leeds Engagement Hub: working together to strengthen citizen voice

The role of the PPG

‘……to ensure that patients are involved in decisions about the range and quality of services provided and, over time, commissioned by their practice.’ BMA, 2011

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The characteristics of a good PPG

Organisation and structure

• Have a clear terms of reference, ground rules and action plan
• Well chaired and meet regularly

Membership

• Is reasonably accessible
• Have members who are objective
• Work in partnership with staff and the voluntary care sector
• Consider the views of people not represented on the group
• Are regularly attended by a range of staff

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The characteristics of a good PPG

Making a difference

• Are valued by the practice
• Have access to patient feedback/experience about the practice
• Focus on improvement of quality of care and patient experience
• Have the opportunity to explore solutions in a safe and transparent

environment

• Can see how their contributions have impacted on patients

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Hello my Name is…

Trevor Thewlis

• PPG member for 7 years at Ireland Wood/New Croft

Surgery

• 20+ active PPG members at face to face meetings who

meet quarterly

• Over 200 members connected virtually
• Run, twice yearly, ‘patient survey week’

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG

“What it is NOT is as important as what it is.”

Trevor Thewlis (2017)

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG

Purpose:

• To work with the practice to improve the experience of the patient

population for that practice Expectation:

• Mutual respect between patients and staff working with a common

purpose Method:

• Practice staff medical professionals, not public relations or

marketing experts…PPG members can provide vital links

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG – What is it NOT about?

• A “talking shop”
• A coffee morning/lunch club/social evening
• A vehicle for a personal NHS crusade

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Something else to consider…

It’s not going to happen overnight…

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG – For your consideration

• PPG Guidance

– Document for consultation – To assist in making a PPG work – Feel free to write on the guidance with feedback – Take it away and feedback electronically

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Co-produced PPG Quality Indicator Checklist

• This checklist provides an opportunity for Patient Participation Groups to

review their progress and identify areas for development.

• The tool is not monitored by the CCG or linked to the GP practice

contract.

• It simply aims to support PPGs to improve and should be filled in jointly with

PPG members and staff.

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Examples of good practice

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Leeds Engagement Hub: working together to strengthen citizen voice

Thank you

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a Practice Kirsty Turner

Head of Primary Care Transformation

NHS Leeds Clinical Commissioning Group Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a Practice

Practices were incentivised to develop Patient Participation Groups through an ‘enhanced service’ which ceased on 31 March 2015. From April 2015 it became a formal requirement of the GP contract for all practices to:

• establish (if it has not already done so)
• maintain a patient participation group (PPG)
• make reasonable efforts during each year for this to be

representative of the practice population.

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

What is in the Contract?

• The practice must engage with the PPG throughout each

year, at a frequency and in a manner as agreed with its PPG

• review patient and carer feedback
• identify improvements
• Where the practice and PPG agree, the practice must act on

suggestions for improvement using reasonable endeavors to implement these.

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

How are we assured?

• Practices have to complete an annual declaration
• Specific questions relating to PPG include:
• The practice can evidence that they have acted on

suggestions for improvement.

• The practice is able to show that the PPG is properly

representative of its practice population

Leeds Engagement Hub: working together to strengthen citizen voice

Benefits to Practices

CQC Case Study

How are people who use the service, the public and staff engaged and involved? The practice had an active patient participation group (PPG), carer support group and friends of the practice group. They influenced changes and improved services for patients at the practice by offering services to all patients or carers - especially those who were lonely or isolated. For example, the groups offered lunch clubs for housebound patients, a telephone support service, sitting and befriending services, weekly social events and supported carers. The Friends of the practice group was also involved in raising funds for the practice. They were able to buy a gas cylinder, which patients could use for pain relief during complex wound dressings, and they paid for patient transport and other maintenance at the practice

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

How are we assured?

• Practices have to complete an annual declaration
• Specific questions relating to PPG include:
• The practice can evidence that they have acted on

suggestions for improvement.

• The practice is able to show that the PPG is properly

representative of its practice population

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Our Vision

• Ensure that any contractual proposal is discussed with the

PPG prior to submission

• PPG influence and support quality improvements in practices
• Support the development of locality PPGs

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Member – “The Critical Friend”

Chris Bridle

Engagement Lead

NHS Leeds Clinical Commissioning Group Partnership

Suzie Shepherd

Patient Participation Group Member

Manor Park Surgery

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The role of a PPG is.. ‘……to ensure that patients are involved in decisions about the range and quality of services provided and, over time, commissioned by their practice.’ BMA, 2011

Expectations of a PPG Members

The critical friend

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

Critical friend

Supporting engagement activities Interviewing new staff

Developing and delivering peer support groups

Contribute to a practice newsletter

Help people to get

• nline

Use skills to improve practice facilities (gardening)

Fundraising

Champion the needs of vulnerable groups

Evaluate interventions Supporting the practice during closures and merges

What can they do?

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

As an individual (sharing your personal opinion)

• Friends and family test
• Filling in surveys about service change
• Filling in surveys about your GP practice
• Patient Opinion/NHS Choices (Complaints or

compliments)

• Attending focus groups
• Patient Participation Groups (PPG)?

Both are valid & important engagement roles As a ‘patient champion’ (championing the needs of the wider community)

• Patient Participation Groups (PPG)?
• Patient Assurance Groups (PAG)
• ‘Patient champion’ on a steering group

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

It isn’t to:

• Promote a personal campaign
• Criticise existing services/processes

It is to:

• Contribute to improving services
• Ensure that we consider feedback from patients
• Be open-minded
• Understand the health needs of the wider public
• Champion the needs of the wider public
• Ensure that we act of the feedback of patients/public
• Share the responsibility for difficult decisions
• Focus on improving patient experience
• Support the engagement

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

Essential understanding, values and behaviours

• the practice serves a diverse community
• the PPG represents the whole community
• the PPG is not a place for personal complaints or campaigns
• commitment to partnership working
• commitment to improvement
• show respect to other members and staff
• penness and transparency
• respect for confidentiality

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

Other helpful qualities

• 1. Honesty
• 2. Ability to Delegate
• 3. Communication
• 4. Sense of Humour
• 5. Confidence
• 6. Commitment
• 7. Positive Attitude
• 8. Creativity

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Expectations of a PPG Members

The critical friend

Clarifying expectations

• Develop a terms of reference for your group
• Develop a role description
• Develop a code of conduct

All these resources are available on our website: https://www.leedswestccg.nhs.uk/get-involved/how/patient- participation-group/

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The PPG Panel

• Trevor Thewlis – PPG Member

Ireland Wood Surgery

• Kath Newton – PPG Member

The Gables Surgery

• Chris Bridle – Engagement Lead

NHS Leeds CCG Partnership

• Gloria Hartley – Locality Manager

NHS Leeds CCG Partnership

• Kirsty Turner – Associate Director of Primary Care

NHS Leeds CCG Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

It’s nearly lunch time!

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Breaking Down Barriers

But first…

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Breaking Down Barriers

• Using the post it notes on the tables think about the barriers there are to

making a PPG work.

• Write them down on a post it note and stick the post it to one of the

flipchart boards around the room.

• Then go have lunch…

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Lunch

Visit the stalls, network, meet new people

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Gibson Lane Patient Participation Group

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Group Set Up

Virtual group- established 2014 Actual Group- established 2009

• Practice Manager Lead/ Lead GP/ Lead Nurse
• Meet bi-annually
• 2 of our members are members of Locality PPG
• Practice chair is locality chair
• 1 Patient Champion Member
• Speakers organised for meetings

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Challenges

• Mix of patient demographic
• Characters of members
• Expectations
• Recruitment

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

PPG Achievements

• On going surveys & questionnaires/action plans from results
• Involvement in CCSP (Collaborative Care & Support Planning in Primary

Care.)

• Discussion & implementation of Pharmacy Services
• Involvement in Level 3 Practice services
• Champions in Pilot of Leeds Care Records
• Communication Issues/phone system
• Appointment system/on line services
• Health Station
• Customer Service
• Reception Environment
• CQC visits

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Forward View

• Patient Champions in Practice
• Increase variation of demographics in the group
• Independent Meetings without Practice Staff
• Increase Patient satisfaction
• EPS/ On line access services
• Level 3 Services

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

PPGs in Practice – Caring Hands Beverley Kite

Patient Participation Group Chair

North Leeds Medical Practice

Michelle Whitaker

Caring Hands Project Co-ordinator

North Leeds Medical Practice

#PPGsinLeeds

Promoting GP online services at you Practice

20 October 2017

Mariam Manneh m.manneh@nhs.net James Blanchard jamesblanchard@nhs.net Patient Online team

GP online services delivered by Patient Online

The programme is called patient online. All information for GP practices, CCGs, CSUs and NHS trusts will be labelled this way.

#PatientOnline http://www.england.nhs.uk/ourwork/pe/patient-online/ http://elearning.rcgp.org.uk/patientonline

When we communicate with patients we use ‘GP

• nline services’. This is because a large survey

revealed that people don’t think of themselves as patients, unless they are in a hospital.

#GPOnlineServices www.nhs.uk/gponlineservices

What is GP online services?

Three key online services offered to patients:

Appointment Booking Repeat Prescriptions Access to Records

97.4% of practices offering the service 4% of all repeat prescriptions requested online 9 million patients signed up

Repeat Prescriptions

2.9 million patients signed up for summary information (information about allergies and medicines history) 97% of practices offering access to a detailed coded record (DCR)

Access to Records Appointment Booking

98.7% of practices offering the service 12% of all appointments are made available online 9.2 million patients signed up

What is Patient Online?

Key challenges facing General Practice

Increase in GP consultations from 260 million to 360 million per year in last 10 years Increase in clinical workload in general practice of over 40% since 2008

Changing user expectations Variations in outcomes Ageing population Increasingly complex patient diagnosis Slower than required growth in numbers of health professionals

Reduce Practice Visits Online Status Check Access From Home Reduce Prescription Errors EPS Availability

Benefits for patients

Better Audit Trails Fewer Calls Fewer Transcript Errors Fewer F2F Transactions Saves Time

Benefits for practices

1

• Tell your GP surgery that you’d like to use GP online services

2

• Complete a short form and prove your identity

3

• You will get a letter with your username, password

and information on where you can log in

How to get started

Available to:

• CCGs
• CSUs
• GP Surgeries
• PPGs
• Partners
• Local Council
• Local Healthwatch

www.england.nhs.uk/materialsforpatient/

Promotional Materials for Patients

Posters and leaflets Appointment cards Balloons and bunting Digital material PPG Toolkit

What best practice looks like

Website

Inspiration

• Bradford Districts CCG
• Greater Huddersfield CCG
• Sunderland CCG
• Hall Green Health – Birmingham
• Swan Practice – Buckingham
• Sheringham Medical Practice – Norwich

Dedicated page Link through to national Videos – YouTube channel Guidance for patients and public Guidance for GPs – link through Top tips and more information

Get proper training for staff (especially the reception staff) Ask every patient at reception Create ‘how to guides’ for staff and patients as support mechanism Attend the Patient Online team workshops Offer support with set up (invite patients at none peak times)

Brief all staff at the practice (medical staff can signpost to the reception team)

What practices can do to reach the 20% target

Did you know you can get test results online?

Did you know you can find

• ut what immunisations

you’ve had online?

Would you like to do your repeat prescriptions online? Do you know anyone using GP online services? Would you benefit from using online services? Do you use the internet? Do you have a smart phone? Would you like to book your appointment

• nline?

Do you have someone that can help you get

• nline?

What volunteers can ask patients

Thank you!

Please come and see us at our stand! england.patient-online@nhs.net

Leeds Engagement Hub: working together to strengthen citizen voice

Breaking Down Barriers

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Breaking Down Barriers

• How can we overcome the barriers identified?
• Work together on your table to come up with some ideas
• Use the post it notes on the table to write down some

solutions to each barrier

• Table facilitators will add the suggestions to the flipcharts

around the room

• Pick your best suggestions to feedback

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Relaunching a PPG Adam Stewart

Engagement Officer

NHS Leeds CCG Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

The first step is admitting there is a problem…

#PPGsinLeeds

Your PPG

Your GP is

Patient Participation Group

Leeds Engagement Hub: working together to strengthen citizen voice

Taking a step back

• Have a look at why it wasn’t working:
• Recruitment?
• Retention?
• Representation?
• Focus?
• Productive?

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Daunting task

• It’s ok if a PPG stops working/needs re-tooling – these things

happen

• Better to do something about it and make a change than let it

be a source of stress/apathy

• Don’t want to lose the good work PPGs can do
• But…

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

How to go about it (perhaps?)

• 1. Set a date for an initial meeting – give yourself enough time
• 2. Awareness raising/recruitment
• 3. Work with Engagement team at the CCG
• 4. Use first meeting to inform interested patients about the PPG
• 5. Set a date for first formal meeting with signed up patients
• 6. Use resources already available to develop PPG

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Need some help?

Get in touch:

Tel: 0113 843 5475 Email: adam.stewart1@nhs.net Resources: https://www.leedswestccg.nhs.uk/get-involved/how/patient-participation-group/

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

PPGs in Practice – Supporting local NHS Campaigns

Shak Rafiq

Communications Lead

NHS Leeds CCG Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

PPGs in Practice – Supporting local NHS Campaigns

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Local Care Partnerships

• Dr. Chris Mills

Clinical Lead for New Models of Care

NHS Leeds CCG Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

How do we improve care in communities?

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Brian

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Local Care Partnerships

Leeds Engagement Hub: working together to strengthen citizen voice

Provision of care to a defined, registered population of between 30,000 and 50,000 An integrated workforce, with a strong focus on partnerships spanning primary, secondary, social care and the third sector A combined focus on personalisation of care with improvements in population health outcomes Aligned clinical and financial drivers through the management of whole population budgets with appropriate shared risks and rewards Key features of Local Care Partnerships

Leeds Engagement Hub: working together to strengthen citizen voice

People involved in Brian’s care

Carers Consultant(s) Physiotherapy GP Care co-ordinator Cardiac nurse District nurse Mental health worker On-call GP Practice nurse A&E staff Occupational therapy Pharmacist Ward staff 3rd sector Community Matron Macmillan nurse Social worker

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

A different approach

Working on problems / deficits Working on ability / assets Responding to crisis Building resilience Service processes and boundaries What's important for patients Fragmented and difficult to navigate Coordinated and easy to access Episodic intervention and assessment Lasting relationships and conversations

From To

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Leeds Neighbourhood Teams

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Local Care Partnership

• Leadership
• Citizen involvement
• Social movement

Leeds Engagement Hub: working together to strengthen citizen voice

The Leeds PPG Network John Curtin

Project Group Member

Leeds Citywide PPG Event Project Group

Helen Wilkinson

Primary Care Locality Manager

NHS Leeds Clinical Commissioning Group Partnership

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

• I’m new to all this PPG stuff.
• Looks like a good idea.
• Great potential for improving the “going to the doctor” experience:-
• Make sure that the practise hears the patients’ viewpoint(s)
• Look at ways to make life easier for both the patient and practise
• Reach out to the full range of practise users
• Give patients a stake in their GP practise
• Will need support to achieve all this
• How about a Leeds PPG Network?

#PPGsinLeeds

The Leeds PPG Network – A Novice View…

Leeds Engagement Hub: working together to strengthen citizen voice

Help support PPGs to be active, effective and productive!

• A means to encourage good practice
• A platform to share successes and help solve problems
• A gateway to sources of support / advice / training
• Promote better links with practises and the CCG
• Improve communication – between Leeds PPGs and others

#PPGsinLeeds

The Leeds PPG Network – What it might do

Leeds Engagement Hub: working together to strengthen citizen voice

Open to all practice staff and PPGs Supported via Slack (a messaging platform available on computers and smartphones)

• Administered by the CCG via single platform, easily managed.
• Safe, secure and easy to use
• Easy to share documents without bombarding people with emails

#PPGsinLeeds

The Leeds PPG Network

Leeds Engagement Hub: working together to strengthen citizen voice

Also supported via a central Leeds PPG Network group:

• Made up of members from the 13 different neighbourhood localities
• Meet regularly to offer support to PPGs, look at and review possible engagement
• pportunities
• Link in with PPGs to cascade information, ideas and good practice
• Help support and promote PPGs
• Link in with the patient assurance group (PAG) and other relevant bodies as needed
• Other tasks as to be decided by the group

#PPGsinLeeds

The Leeds PPG Network

Leeds Engagement Hub: working together to strengthen citizen voice

Discuss on your tables the following points:

• Any immediate benefits to your practice/PPG
• Benefits of the group
• Potential issues
• Anything that’s missing

#PPGsinLeeds

The Leeds PPG Network – What do you think?

Leeds Engagement Hub: working together to strengthen citizen voice

Close

#PPGsinLeeds

Leeds Engagement Hub: working together to strengthen citizen voice

Please take five minutes to fill in an evaluation, it’ll help us develop our session for next year…

#PPGsinLeeds

Evaluations

Leeds Engagement Hub: working together to strengthen citizen voice

Please feel free to use the last 30 minutes to:

• Network
• Swap contact details
• Sign up to our community network (blue, square form)
• Share ideas and good practice
• Invite people to your PPGs
• Visit the stalls
• Complete your evaluation
• Take a #3thingsNHS selfie

#PPGsinLeeds

Any Questions?

Leeds Engagement Hub: working together to strengthen citizen voice

We will be writing up an evaluation and report of this event which we will use to help inform what we do next time

#PPGsinLeeds

See you next year…

Feel free to get in touch: adam.stewart1@nhs.net 0113 843 5475