Embed Size (px)
Citation preview
1
Enfield CCG’s Annual Report
on its Legal Duty to involve Patients and
Public in Commissioning for
1 April 2015-31 March 2016
Appendices
Contents Appendix A ............................................................................................................................................. 2
Appendix B ............................................................................................................................................. 3
Appendix C ........................................................................................................................................... 11
Appendix C1 ......................................................................................................................................... 27
Appendix D ........................................................................................................................................... 29
Appendix E ........................................................................................................................................... 31
Appendix F ........................................................................................................................................... 37
Appendix G ........................................................................................................................................... 43
Appendix H ........................................................................................................................................... 48
Appendix I ............................................................................................................................................. 35
Appendix J ............................................................................................................................................ 37
Appendix K ........................................................................................................................................... 35
Appendix L ........................................................................................................................................... 40
Appendix M .......................................................................................................................................... 61
Appendix N ........................................................................................................................................... 78
Appendix O ............................................................................................................................................. 80
Appendix P ........................................................................................................................................... 85
Appendix Q ........................................................................................................................................... 88
2
Appendix A: Commissioning Engagement Cycle
The Engagement Cycle shows clearly how we plan to engage with patients and the
public, explaining where and how people and groups can contribute and how their
views will be used by the CCG to improve services and make commissioning
decisions. Each box on the engagement cycle shows the ways we will involve the
public at every stage of the commissioning process.
3
Appendix B
Agenda Item: Paper Ref:
MEETING: NHS Enfield Clinical Commissioning Group
DATE: 20.04.16
TITLE: Evaluation of the NHS Enfield Clinical Commissioning Group Primary Care Safeguarding Children and Adults at Risk Symposium
LEAD BOARD MEMBER:
Aimee Fairbairns, Director of Service Quality and Integrated Governance
AUTHOR: Carole Bruce-Gordon, Assistant Director of Safeguarding & Christina Keating, Designated Nurse for Safeguarding Children
CONTACT DETAILS:
SUMMARY:
On Wednesday, 23rd of March, 2016, 80 Enfield primary care delegates attended
the NHS Enfield CCG Primary Care Safeguarding Children and Adults at Risk
Symposium in the Lee Valley Athletic Centre. The delegates held a variety of
roles within primary care. This report summarises the delegate’s evaluations of
the presentations delivered on a number of topics pertinent to child and adult
safeguarding.
The Safeguarding team in the CCG invited a number of local and nationally
recognised speakers to deliver presentations on the key areas of safeguarding
both in children and adults at risk.
The symposium was chaired by Dr Peter Green, Chairman of the National
Network Designated Health Professionals.
61 evaluation forms were returned from the total number of 80 delegates. The
delegates evaluated the day positive with 99 respondents reporting they would
4
use the learning in their delivery of patient care.
Participants were also asked to rate the overall conference from 1 to 6. 102 out of
the 114 respondents evaluated the conference above 4 on the scale of 1 being
poor to 6 being excellent.
Next steps
CCG Safeguarding team will develop a series of updates on safeguarding
children and adults at risk for 2016/17.
SUPPORTING PAPERS:
Summary of the symposium presentations and agenda
RECOMMENDED ACTION:
The Governing Body members are requested to note the evaluation of the NHS Enfield CCG Primary Care Safeguarding Children and Adults at Risk Symposium
Objective(s) / Plans supported by this paper:
This paper is supported by the CCG Commissioning Strategic Plan to ensure quality
services and improve patient safety.
Patient & Public Involvement (PPI): N/A Equality Impact Analysis: Impact to be determined
Risks: All quality risks are reflected on the CCG Corporate Risk Register
Resource Implications: None identified at present
Audit Trail: 1st paper
5
Evaluation of the NHS Enfield CCG Primary Care Safeguarding Children and Adults at Risk Symposium
Overview
On Thursday, 23rd of March, 2016 80 Enfield primary care delegates attended the NHS
Enfield CCG Primary Care Safeguarding Children and Adults at Risk Symposium in the Lee
Valley Athletic Centre. The delegates were a mixture of reception staff, practice managers,
practice nurses and GPs across Enfield.
This report summarises the evaluations of the presentations delivered on a number of key
topics pertinent to child and adult safeguarding.
The Safeguarding team in the CCG invited a number of local and nationally recognised
speakers to deliver presentations on the key areas of safeguarding both in children and
adults at risk.
The symposium was chaired by Dr Peter Green, Chairman of the National Network
Designated Health Professionals. Dr Green introduced the CCG safeguarding team and set
the scene for the day.
The symposium began with a presentation on Building responses to peer-on-peer abuse:
The work of the MsUnderstood Partnership delivered by Dr Carlene Firmin, MBE. Dr Firmin
included in her presentation the voice of girls and boys affected and involved in peer on
peer abuse. She also included a challenge to the delegate’s understanding of terminology
commonly used when describing young people.
Georgina Diba, the Development Manager for the Safeguarding Adult Board delivered a
presentation on the Adults Multi-Agency Safeguarding Hub process. She included details of
the referral pathway when a primary care professional has a safeguarding alert is raised. Her
presentation was followed by an overview of the Safeguarding Adults Board (SAB) by Marian
Harrington, Independent Chair of the SAB.
The next section included training on the Mental Capacity Act (MCA) and Deprivation of
Liberty Safeguards (DoLS). Liana Kotze, the MCA and DoLS Manager for Enfield Local
Authority included a case study demonstrating how practitioners assess for Mental Capacity
and the process involved when a decision is made to deprive a person of their liberty. The
presentation generated discussion within the group with delegates referring to patients
they were managing currently. This session was positively evaluated in the feedback with a
number of the delegates stating they would use this learning in their practice.
The first session after the lunch break focussed on Female Genital Mutilation (FGM)with two
presentations on the topic. The first session heard from Alimatu Dimonekene from Project
Acei, a survivor of FGM. Alimatu replayed her story and experience of FGM and included a
DVD on a young girl who had recently been taken back to her home country to be cut. This
powerful presentation was followed by a presentation by Ms Frances Evans. Ms Evans is the
Lead Obs & Gynae Consultant from the North Middlesex University Hospital for Iris clinic.
The Iris clinic is a newly formed clinic with a team of a midwife, health psychologist and
gynaecologist/obstetrician to support women who have undergone FGM. The aim of the
clinic is to be able to address the social, physical and psychological issues for the women
booking in.
The next session was delivered by Mandy Jones from the National Society for the Prevention
of Cruelty to Children (NSPCC). Mandy spoke about Serious Case Reviews from a health
perspective and gave a general overview of the lessons learned for health.
Geraldine Gavin, the Independent Chair of the Local Safeguarding Children Board gave an
overview of the position of safeguarding boards. She highlighted the potential changes to
the functions of children’s boards in light of recent reviews undertaken by the Government.
The final presentation was on Domestic Violence and the Identification, Referral to Improve
Safety project in Enfield. Dr Sandu and Jeasmin Chowdhury included in their presentation
the difficulties around broaching the subject of domestic abuse and violence in a clinical
setting. The presentation referred to the success of the IRIS project in the East of the
Borough with lots of interest from the delegates to consider introducing the project within
their practices.
Summary of evaluations:
61 evaluation forms were completed from the total number of 80 delegates. The majority of
evaluations were positive with 99 respondents reporting they would use the learning in
their delivery of patient care. The other responses included using the learning for personal
or professional development and in the training of others.
In addition, participants were asked to rate the presentations from poor to excellent with
the presentations on FGM and the MsUnderstood project being the most positively scored
by the respondents.
Presentations rated above 4
8 86
95
110
106
77 110
MsUnderstood
MSP
FGM
Faith Linked Abuse
MCA & DoLS
Prevent
No response
Participants were also asked to rate the overall conference from 1 to 6. 102 out of the 114
respondents evaluated the conference above 4 on the scale of 1 being poor to 6 being
excellent.
In addition, many positive comments were received back in the comments sections.
Examples included:
“Very good – lots of new knowledge learnt and I will take this back to train others”
“Generally very welcoming a big thank you to all the speakers interesting
presentation – awareness on FGM and faith linked abuse”
“A real mix well done”
“An extremely useful conference”
“Really good and covered my level 3 safeguarding”
“The misunderstood programme and FGM local referral pathway was very
informative. Faith Varied and interesting”
“Interesting informative and thought provoking conference”
“Brilliant conference more of these please. Well done to the organisers
Linked abuse sad and worrying. Overall a great educational programme”
Overall conference assessment
8 4
19 Poor
2
30 3
4
5
Excellent
No response
44
Next steps
Using the feedback evaluations from the conference, the CCG Safeguarding team are developing a rolling programme of bespoke training for the health economy.
Each session will focus on one key area. The session will include greater detail of the role of the health professional in the referral process and assessments. This will ensure front line health
6
9
professionals embed the learning from the conference and have the opportunity for a greater discussion on the expectations of them in practice.
The CCG safeguarding team will also target staff in specialist roles within their organisations and tailor the training sessions to meet their needs. The sessions will also be linked with the Local Safeguarding Children Board and the Safeguarding Adult Board multi-agency priorities. The long- term aim of these training sessions is to ensure greater awareness of the overall safeguarding agenda amongst front line health practitioners in the Enfield health economy.
Authors
Carole Bruce-Gordon, Assistant Director of Safeguarding
Christina Keating, Designated Nurse for Safeguarding Children
7
10
Agenda
Welcome – Aimee Fairbairns, Director of Quality & Governance
0915 Introduction and scene setting - Dr Peter Green, Chairman, National Network Designated Health Professionals
0930 MsUnderstood programme – Dr Carlene Firmin, Head of MsUnderstood Project
1030 Referral pathways Multi-Agency Safeguarding Hub (Adults) - Carole Galloway, Team Manager & Georgina Diba, Development Manager
1045 Safeguarding Adult Board – Marian Harrington,
Independent Chair
1100 Coffee
1120 Mental Capacity Act & Deprivation of Liberty Safeguards - Liana Kotze, Manager Mental Capacity Act & Deprivation of Liberty Safeguards
1220 Lunch
1320 Female Genital Mutilation - Alimatu Dimonekene, Project Acei
1350 Female Genital Mutilation-Definitions and Decisions-Ms Frances Evans, Obs & Gynae Consultant
1430 Coffee
1445 Serious case reviews – Mandy Jones, Service Manager, National Society for the Prevention of Cruelty to Children (NSPCC)
1545 Local Safeguarding Children Board – Geraldine Gavin, Independent Chair
1600 Domestic Violence & Identification, Referral to Improve Safety project – Jeasmin Chowdhury, Advocate Educator & Dr Punit Sandhu,
Clinical Lead
1630 Close and questions – Dr Peter Green
11
Appendix C
EMU SERVICE USER ENGAGEMENT CONFERENCE REPORT
Friday 4 September Dugdale Centre, Enfield
12
BACKGROUND AND AIMS
The Enfield health commissioners (the CCG), Barnet Enfield and Haringey Mental Health NHS Trust (BEH-MHT) and London Borough of Enfield have been working together on developments to support an enablement approach in mental health services. This builds on the recovery approach with the aim of working in partnership with service users to enable them to best achieve their goals. The phrase ‘Live, Love, Do’ has been coined to describe the various important areas these goals usually fall into, which are: employment, relationships and housing. To test Enfield service-user support for the approach (in general) and to gather their views as to whether or not our services provide an enabling experience for people in crisis, the CCG commissioned EMU (as a respected local service user representative organisation) to hold a service user engagement event on September 4, 2015. This report describes that event, and outlines the findings, plans and actions that will be taken forward as a result.
Partners
EMU
CCG Barnet, Enfield and Haringey Mental Health NHS Trust
HHASC Speakers
Sara Litchfield Brown – CEO EMU
Kathryn O’Donnell – Enfield Clinical Director, BEH-MHT
Keith Dean – Interim Mental Health Commissioner, Enfield CCG
Graham McDougall – Director of Strategy and Partnerships, Enfield CCG
Venue Dugdale Centre Thomas Hardy House Enfield EN2 6DS
13
ABOUT EMU
EMU is the Enfield Mental Health User Group. It is a long-established and widely-recognised registered charity providing peer support for people using Mental Health Services in the London Borough of Enfield. The charity is led by mental health service users.
EMU’s Vision
To challenge stigma within the London Borough of Enfield community, to promote social integration and work towards more positive images of people with mental health problems/illness.
To be an independent user group led by service users for all adult service users to promote personal development with all their different needs and with all their diversity.
To improve communications between service users and service providers so to influence improvements. This will involve representation on as many committees and recruitment panels held by service providers as possible. It will also involve monitoring of service providers.
To be the voice of mental health service users in the London Borough of Enfield working in a constructive spirit.
14
PLANNING When planning the conference, CCG, BEH-MHT, HHASC and EMU all felt strongly that it needed to include as wide a representation as possible from mental health service users in Enfield, and that service users needed to feel their contribution was valued. It was also agreed that there needed to be a fun element to the day to ensure that people left feeling upbeat and commit to further consultation.
The partners felt it was very important this was not “just” another conference with no outcomes, no feedback and no commitment to further partnership work.
We agreed on these non-negotiables:
1. Services users must lead in the facilitation. 2. There must be a commitment from the statutory services to take part in the
conference and make clear where information would be going. 3. All the groups who have an interest in mental health must be invited and
information must be cascaded across the borough. 4. Personal information must be confidential. 5. The venue and resources must be of a high standard. 6. There must be a fun element.
After consultation with service users at EMU, these were addressed by:
1. EMU recruited service users to facilitate and gave them training and expenses to do
this on the day. 2. EMU discussed with statutory services their involvement and the workshops were
co-facilitated, everyone signed up to be in a workshop and there was a presentation and next steps from statutory service representatives.
3. We sent invitations to all the groups via the distribution lists for meetings. We made personal contacts with groups and sent information out across the borough.
4. We introduced the conference and made it clear personal information was confidential. We set up anonymous feedback and had a generic box for all questionnaires, feedback and comment. We put facilitators on reception to take feedback where people felt this was difficult.
5. We booked a central venue that is used for staff training for the local authority and booked a catered for lunch and teas and coffees.
6. We ran Poetry/Music workshops after the main event and we gave people ‘goody’ bags we filled these with information, mindfulness activities and treats. This had the added benefit of ensuring that people took information away with them.
15
THE CONFERENCE
AGENDA
11-11.30am Sign in
11.30-11.45am Introduction and ground rules
11.45-12.15pm Kathryn O’Donnell, Enfield Clinical Director
12.15-12.45pm Workshops:
Crisis Experience What does Enablement and Recovery mean to you?
What makes a good life when living with mental illness? What is a mental health friendly GP?
12.45-1pm Facilitators Feedback
1-1.45pm Lunch
1.45-2pm Response and Next Steps
Graham McDougall, Director Strategy and Partnerships, Enfield CCG
2pm-3pm Music/Poetry workshops
THE EVENT
118 people signed into the conference, however it is estimated that approximately 125 people attended. There were 109 attendees identified as service users.
There was representation from:
EMU
MIND Saheli
Ebony
Individual service users
CCG
BEH-MHT
Healthwatch Enfield
LB Enfield
LB Enfield Quality Checkers Labour Party – Kate Osamor MP
16
SPEAKERS
Sara Litchfield Brown, CEO EMU
EMU thanked the CCG, BEHT and HHASC for the opportunity to host the conference and for their commitment to consultation.
Sara thanked all the service users who had attended on the day, and thanked those who were willing to share their experiences to ensure that Enfield had the best mental health support possible.
Sara went through the agenda and explained that this was not the forum for individual issues to be dealt with but there were staff available on reception or around the room who would be able to take forward issues.
She then explained that if people were sharing information this should be treated with respect and confidentiality. Sara thanked the other groups who were represented.
Kathryn O’Donnell, Enfield Clinical Director
Kathryn thanked everyone for attending and gave a PowerPoint presentation (see attached) outlining the BEH-MHT plans.
She took questions from the floor these included:
Are you saying you don’t want criticism?
Answer: Not at all – we welcome comments and suggestions and will be working hard to have a dialogue with service users. I would like anyone who wants to stay in touch to pass me their details so I can include them in consultation.
Comment: Without my psychiatrist I would be dead.
Comment: I was let down by the Crisis team, as a carer. Keith Dean, Interim Commissioner Mental Health CCG:
Keith thanked everyone for attending and EMU for arranging the Conference. He said he was very pleased to be involved in such a well-attended event.
WORKSHOPS
There were four working groups, with each one focusing on a separate theme or question. These were:
Crisis Experience What does enablement and recovery mean to you?
What makes a good life when living with mental illness?
What is a mental health friendly GP?
17
We offered people the opportunity to choose their own workshop, depending on what they were most interested in.
17 people chose Crisis 13 people chose what does Enablement and recovery mean to you?
33 people chose what makes a good life when living with mental illness?
16 people chose what makes a mental health friendly GP? Others chose as the groups were formed
FEEDBACK FOLLOWING DISCUSSION
Group 1 – Crisis Experience
Team don’t know your background
Responsiveness
In crisis need to know someone who knows you
Care plans that continue through crisis
Crisis team need to listen to carers and clients
How they communicate with family and patients who are suicidal
Home crisis team not understanding/misunderstanding behaviour
Calls to police – yes/no. No opportunity to explain context When mistakes happen how do we put them right and quickly
Recording info – info learning are they recording right info
Lack of communication within team Crisis team not helping when caller not suicidal not helpful in to complex cases
Lack of contact with care coordinators
Comms don’t hear
Not listening need helpful first contact getting it right first time
More prevention Need to understand what the client feels is serious
4 hour wait for crisis is too long Same targets as health
Interagency issues are difficulty
Duplication need to share info One stop shop Better training for staff so they can signpost
No supporting for users if they are not demonstrating suicidal ideation
Active listening
Timelines of response
Support for carers
Empathy
Need to direct to right service
More options for people in crisis not just hospital Patients want privacy non clinical space to recover
Prefer to use Samaritans not crisis team Would like response to feedback from users
Next steps info on feedback on web sites
18
Not good signposting
Unclear pathways
Group 2 – What does enablement and recovery mean to you?
Value
Contribute Work voluntary
Financial freedom Creating a paid post
To be valued
Independent Organisations and services should liaise with each other more
Communication needs improvement Central team offering advice
Education and training police and local organisations
Awareness for service users and services Raise awareness of community services
Psychiatric dept should be more active with service users
Psychiatric dept should get more training from service user perspective Group 3 – What makes a good life when living with mental illness?
Drop-ins EMU/Park Ave
Well being groups
Walking groups
Voluntary work
Training
Having chase farm for emergencies
Dating groups
Quality housing
Budgeting Day trips
Ongoing assessment of medication
Having fun Swimming
Being able to share and talking
Gardening
All forms of exercise
Yoga Shopping
Cinema
Tea parties Pampering
Resting and sleep Reflexology
19
Overcome isolation
Motivation Planning ahead
Playing games Keeping up with obligations
Good friends to listen to
Story writing Poetry
Music therapy English course
Developing new skills
Recovery College Trekking
Dance groups
Evening meals Xmas parties
Learning a foreign language
Helping other people
Good nutrition
Drama/acting Doing things you feel good about
Manage stress levels Stop worrying
Reward yourself often
Get a pet Dental hygiene
Grooming Motivation
Plan ahead
Have a routine Debating on different issues
Socialising Cooking
Hobbies
Listening to music Housework
Keeping up with bills Attend church functions
Be honest and law abiding
Need for a Recovery college in Enfield Anger management
20
Group 4 – What is a mental health friendly GP?
Someone to talk to openly and has good contacts to refer Understanding open-minded and flexible to opportunities re mental health.
Treated equally
Holistic approach Someone willing to take time to understand
GP who is educated in MH and has a better understanding
Offers alternatives local services etc for interim Offer alternatives not just drugs but services
Training and research educated in mental health courses involving service users increase understanding
Good helpful supportive experience from phone call – receptionist –GP whole experience
GPs knowing what’s out there offer alternatives community groups services etc Better interpersonal skills/communicate openly/don’t just prescribe something
explain why
Integrated mental health specialists/GP in one place
Shorter waits for appointments What is support like now from GPs?
General misconceptions
Lack of interpersonal skills Lack of empathy
Don’t offer support or alternatives
If the GP is good or supportive so you need to keep them
If whole practise reception etc is good makes a big difference
SUMMARY
Crisis Experience Service users sent a clear message that they consider there is a major problem with crisis management in Enfield.
There were issues regarding response times, appropriateness of response, communication both with service users and carers and with other teams and the judgement of levels of seriousness.
There were concerns that support for service users who were not deemed in need of the CHRT was lacking and there was no knowledge or clear pathways for community or alternative support.
There was a lack of innovation in providing support and service users identified safe spaces as needed during crisis, a One Stop Shop for information and greater training across services
21
involved in Crisis management led by service users to develop empathy and appropriate response and support.
What does enablement and recovery mean to you? Service users clearly identified their aspirations for recovery in their needs for opportunities for productive role, social activity and supportive relationships. They want to be valued and independent.
There was recognition that there was a need for support, information and opportunity to facilitate this and that clear pathways and information and services that were working in a joined up manner and making the most of partnership provision were best served to deliver this successfully.
The need for all services to be mental health aware was clear.
What makes a good life when living with mental illness? This workshop was the most popular workshop and was split into 2 slots.
Service users explored a variety of “things” that they felt added meaning to their lives and they reflected the diversity of the workshop attendees.
There were main themes identified, these were that service users valued safe and facilitated spaces such as drop-in or support groups talk with peers in a non judgemental setting.
The positive value of social activities was discussed, the social capital, and the need for these to be provided in a setting where service users were at ease or for support to be provided to access them by people who understood.
Service users identified meaningful occupation either in paid employment or voluntary roles and helping other people which in turn increased a feeling of self-worth.
Financial stability, housing and the knowledge there was help in a crisis or support in daily life was important.
The link between good physical health and good mental health and recovery was identified.
The need to support life skills such as budgeting and to develop new skills was identified as was the need for a Recovery College in Enfield.
What is a mental health friendly GP? Service users identified the issues in finding a mental health friendly GP and highlighted the lack of consistency across GP practises, they felt strongly that if you had a MH friendly GP you needed to keep hold of them since it was not the norm.
Areas identified as being MH friendly were listening skills, empathy, communication skills, mental health knowledge and awareness of other support in the community.
22
Service users felt strongly that they wanted other options offered to them – not just medication. But, when medication was offered, they wanted clear information about it.
They wanted to be treated as equals in their recovery.
An issue with support staff in GP practices needing to be mental health aware and friendly was identified and training led by service user was suggested.
The issue of joined up working and lengthy waits for appointments was fed back.
23
NEXT STEPS We would like to thank Graham MacDougall from Enfield CCG for addressing the conference after the feedback.
He made clear that the input from service users was extremely valuable and that he valued their individual responses.
He stated a clear commitment to:
Address issues in the Crisis Team and work in partnership to make improvements.
To continue the dialogue with service users in a variety of formats including holding two conferences a year. The next one would be on suicide, as suggested from the floor.
To ensure the feedback from the conference and the actions taken were clearly shared on the Trust website and other forums.
FEEDBACK FOLLOWING THE SESSION
We received 47 feedback forms (see attached). This represented 40% of participants who signed in.
The overwhelming majority felt the conference was a successful and enjoyable event. The format of the conference was inclusive and that the service user-led facilitation allowed everyone a chance to speak. The downtime at the end with music and poetry allowed people time to calm down from discussing some difficult issues.
The venue was accessible and welcoming and the lunch was nice.
We had verbal feedback that thegoodie bags were fun and appreciated in particular the information packs and well-being exercises.
There was some feedback for improvements. These included having two roving microphones for questions from the floor, having breakout space for the workshops, having a longer day for more content and plating up the lunch.
THANK YOU
CCG Barnet, Enfield and Haringey Mental Health NHS Trust LB Enfield Mind in Enfield Saheli Ebony Naree Shratki Healthwatch Enfield Quality Checkers LB Enfield Kate Osamor MP And the amazing Peer Support Team at EMU
24
INFORMATION AND CONTACTS
Enfield Mental Health User Group The Lancaster centre 53 Lancaster Rd Enfield Middx. EN2 0BU
0208 366 6560 Email: [email protected] Website:http://www.emugroup.org.uk
Peer support, group sessions Complementary therapy, counselling, social events, free membership
Mind Enfield 275 Fore St Edmonton London N9 0PD 0208 887 1480
Website:http://www.mind-in- enfield.org.uk.index.html
Enfield Saheli Community House 311 Fore Street Edmonton N9 0PZ
Project Coordinator 020 8373 6218 Mental Health 020 8373 6220 Fax No 020 8373 6219 Email: [email protected] www.enfieldsaheli.org
Ebony Peoples Association (Wellbeing Connect Services) 215 Fore Street EdmontonN18 2TZ Telephone: 020 88032200 mailto:[email protected]
BEH-MHT Patient Experience Advisors Barnet, Enfield and Haringey Mental Health NHS Trust Ivy house, Chase Farm Hospital The Ridgeway, Enfield EN2 8JL Tel: 0208 702 6705
London Borough Enfield Civic Centre Silver Street Enfield EN1 3XA
020 8379 1000 www.enfield.gov.uk/adultsocialcare
Quality Checkers Park Ave 65c Park Avenue, Enfield, Middlesex, EN1 2HL. 020 8379 8035
Email. [email protected]
Healthwatch
Call us on 020 8373 6283, email us at [email protected]
Or write to us at: FREEPOST RTGT-SRCL-ABRS Healthwatch Enfield Room 11, Community House 311 Fore Street, London N9 0PZ
25
BARNET 0208 702 4040 ENFIELD 0208 702 3800 HARINGEY 0208 702 6700
CRISIS RESOLUTION AND HOME TREATMENT TEAM
www.beh-mht.nhs.ukNO PANIC Support for people who experience panic attacks, phobias, obsessive compulsive disorder.
08088 808 0545 Email: [email protected] www.nopanic.org.uk
SAMARITANS Feeling low need someone to talk to line open 24/7 they can ring you back 08457 909090
ENFIELD ADULT ABUSE LINE 0208 379 5212
BTC BREAK THE CYCLE Support group and ex drug and alcohol users
Community House 311 Fore St. N9 0PZ 0208 373 6307 Email: BTC @ggcce.org.uk
BIPOLAR UK Supports people with bipolar and family 0207 931 6480 [email protected] www.bipolar.uk
DEPRESSION ALLIANCE Provides info and support for people with depression through local self help groups 0845 123 2320 Email:[email protected] www.depressionalliance.org
26
BIG WHITE WALL Feeling low or stressed, Habits you want to kick? Feeling lost or out of control? Support Available 24/7 www.bigwhitewall.com
SANE Saneline is the National out-of-hours helpline that offers emotional and crisis support to people coping with mental illness, their, families and friends. 1st floor, Cityside House, London E1 1EE SANELINE : 0845 767 8000 Directline: 0207 247 6647 www.sane.org.uk
Cruse Bereavement Care 0845 758 5565
Shelterline 24hours 0808 800 4444 Housing and Homelessness Advice App Moodscope , or pocket Moodtracker for smart phones to monitor moods
27
Appendix C1
Tips and strategies to protect your mental and physical
well-being.
10th October 2016 11am – 3pm
Dugdale Centre
Thomas Hardy House
39 London Road
Enfield
EN2 6DS
NO NEED TO BOOK but it helps us cater if you let us know you
are coming!
0208 366 6560
FREE BUFFET LUNCH WORKSHOPS GOODIE BAG FOR ALL
28
Hosted by emu Enfield Mental Health User Group, Barnet Enfield and Haringey
Mental Health Trust, Enfield Council, and Enfield Clinical Commissioning Group
29
Appendix D
Enfield CCG Contracts list for Voluntary and Community groups- December 2015
Service Summary Target Age UK Footcare
Age UK (footcare Service) delivers foot care treatment to vulnerable residents who are 50 or over (Excluding type 1 diabetes or high risk customers).
Minimum treatment per annum: 650. Positive outcome 100%
Catch 22 Catch 22 provides a support scheme for vulnerable adults with Learning Disabilities or Mental Health conditions who have been taken into police custody.
Positive outcome 100%
Crossroad Crossroads care provides home based and respite care enabling full time carers to take a break away from their usual caring responsibilities.
Hours per quarter: 4 hrs per client per week (minimum 80 clients) = 4160 hours. Client:80. Positive outcome 100%
Ebony Ebony Peoples Association is an advocacy, information and support service for people in Enfield from Black Minority Ethnic Community Needs.
1000 Hours per annum or 250 per quarter. Positive outcome 100%.
EMHC Enfield Mental Health Carers provide support, advice a& information for relatives and carers of people sufferring with mental health.
See 5 carers per day. 325 per quarter. Positive outcome 100%.
EMU EMU promotes the views of service users with mental health conditions.
Service meetings 20 hours per month/60 per quarter. Representation at meetings 40 hours per month 120 per quarter.
GGCCE – Hospitality
Greek and Greek Cypriot Community of Enfield provides a Hospitality and Home comfort service that supports older people (50+) who have not been given or do not require a full social care package.
Positive Outcome 100%
GGCCE - lets talk
Lets talk is a therapy and counselling service delivered by the Greek and Greek Cypriot Community of Enfield for Greek speaking people with mental health needs.
Hours per month: 26 or 78 per qrtr
Mind in Enfield Mind in Enfield provides a psychological therapy service, delivering a counselling service for people and their families who are experiencing distress or mental health difficulties.
Total clients: 450 per annum/112 clients per qrtr. 2500 Sessions per annum/625 per quarter
30
NAFSIYAT NAFSIYAT provides an intercultural therapy centre that assists the recovery of people with mental health needs by providing intercultural psychotherapy and counselling.
Positive outcome 100%.
Enfield Saheli Saheli provides drop-in support for Asian women who have or are recovering from a mental health condition.
Service Users per day: 3 = 195 per quarter. Positive outcome 100%
Attend Attend aims to deliver a community stroke navigator service to support reintegration into the community, volunteering, return to work and support stroke survivors, their families and carers to navigate health and social care systems in Enfield. This Service adds value to the existing community services and build capacity of local organisations to be better able to support people affected by stroke.
31
Appendix E
YoungMinds Training
Training Offer for Children and Young People’s Workforce/Volunteers in
Enfield
YoungMinds is the UK’s leading charity committed to improving the emotional
well being and mental health of children and young people and empowering their
parents and carers. We provide expert knowledge to professionals, parents and
young people through our parents helpline, online resources, training and
consultancy, outreach work and publications.
YoungMinds, in partnership with Enfield Council and NHS Enfield Clinical
Commissioning Group, are offering a fully funded training programme consisting
of one day courses on:
12th Feb 2016: Self Harm
32
Open to nurses, GPs, voluntary sector, volunteers, faith communities, youth
workers, social workers, school nurses and others within schools. This course is
for all practitioners working with young people who want to increase their
understanding of why young people self harm, and how best to support those
who do.
By the end of this course you will be able to:
Understand common myths surrounding self harm, as well as issues
regarding stigma.
Understand and appreciate the perspectives of other professionals, parents and young people.
Assess and manage risk, understand the concept of harm minimisation, and be better able to explore alternatives to self harm within the context of your role.
Apply proven strategies aimed at developing the resilience of those vulnerable to self harm.
Develop a self harm policy tailored to your needs, designed to provide clear information and guidance.
Explore and reflect upon your own feelings towards self harm, and consider how such views influence your practice.
Trainer: Charlotte Levene
23rd Feb 2016: Introduction to Children and Young People’s
Mental Health Open to nurses, voluntary sector, volunteers, faith
communities, youth workers, social workers, school nurses and others within
schools. This multidisciplinary course will enable participants from a wide range of
backgrounds to consider how, through their role:
They can promote the mental health and wellbeing of children and young people.
Identify early mental health problems and work together with others to improve access to services and support.
By the end of this course you will be able to:
Apply current conceptual models for thinking about mental health, mental health problems and disorders in children and teenagers.
Briefly apply and describe current theories and research relating to: attachment, brain development, risk and resilience in order to deepen your understanding and develop your practice.
Explore and develop your own perspective on children and young people’s mental health, alongside the perspectives of others including the voices of young people, in order to establish a foundation for further learning.
Trainer: Joanna Watson
8th April 2016: Eating Disorders
Open to nurses, GPs, voluntary sector, volunteers, faith communities, youth workers, social workers, school nurses and others within schools.
What the course will cover:
Types of eating disorder and prevalence
Self esteem and body image
Screening and working with risk
NICE guidance
Preventive approaches
36
By the end of this course you will be able to:
Describe different types of eating disorder
Reflect on risk and causal factors
Identify children and young people who are particularly vulnerable
Develop strategies to increase resilience
Trainer: Damian Hart
How to book:
There is no charge for participation in any of the above training. If people do not attend, then a
£50 charge will be levied.
To book a place, or to register your interest/ask any questions please email Marcella Verdi at YoungMinds:
Tel: 020 7089 5057
All courses take place from 10am to 4pm at The Dugdale Centre, Enfield EN2 6DS. Refreshments will be served.
37
Appendix F
NHS Enfield Clinical Commissioning Group
Voluntary and Community Stakeholder Reference Group
Terms of Reference
1. GENERAL
These terms of reference set out the membership, remit responsibilities and reporting arrangements of the Stakeholder Reference Group.
2. PURPOSE
2.1 The group’s purpose is to provide the patient, service users and public perspective, as articulated by voluntary and community sector representatives on the development, planning, implementation and evaluation (success and challenges) of health services commissioned by Enfield Clinical Commissioning Group (Enfield CCG).
3. RESPONSIBILITIES
3.1 To raise the profile and importance of patients, service users, carers and other stakeholder’s opinion in influencing local healthcare developments, such as service redesign, commissioning intentions and procurement.
38
3.2 To enable the voluntary and community sector perspective to be expressed and used to influence proposals and decisions.
3.3 For Enfield CCG to share knowledge and fully inform about local NHS services and commissioning plans for the
future at local level and across the North Central London Sector
3.4 To work with Enfield CCG to address areas of concern and improvement
3.5 Members will assist in communicating information to voluntary and community groups within Enfield
3.6 To promote formal consultations and other engagement activities that will potentially have an impact on local health services as and when these arise.
3.7 To provide strategic and accurate feedback on voluntary and community organisations, residents, service users and
patients’ needs, concerns and interests.
3.8 To develop, promote and scrutinise plans, projects and services that would benefit the residents of Enfield.
3.9 To assist Enfield CCG to develop mechanisms to communicate feedback and achievements to the wider community including patients, the public and across all stakeholders.
3.10 To ensure all interested parties are kept informed about the work of the Group and how it influences the work of
Enfield CCG.
4. MEMBERSHIP AND QUORACY
4.1 The group comprises maximum of 20 members with a quorum of 8 members of which there must be representation from Enfield CCG, London Borough of Enfield and 6 other voluntary and community stakeholder members.
4.2 The core membership is:
39
Enfield CCG Head of Communications and Engagement – Chair of Group Patient and Public Engagement Manager NHS North and East London Commissioning Support Unit Equality and Diversity Manager Elected Enfield Patient Participation Groups’ Representative London Borough of Enfield Representatives Third Sector Development Manager
One Representative from 15 voluntary organisations/community groups to include: Age UK Enfield Carers
Enfield Disability Action Enfield Faith Forum
Enfield Lesbian Gay Bisexual and Transgender Network Enfield Parents and Children Enfield Racial Equality Council
Enfield Voluntary Action Enfield Women’s Centre Healthwatch Enfield Mind in Enfield One-to-One Enfield Our Voice Over 50s Forum Youth Parliament
40
4.3 The minutes of the meeting will normally be taken by Enfield CCG’s Communications and Engagement Assistant.
5. ATTENDANCE
5.1 Other CCG Managers will be invited to attend when the group is discussing areas that are their responsibility. If they are unable to attend in person, then they will nominate a suitable deputy to attend in their place. Other individuals will be invited to attend if specific specialist advice is required.
5.2 Other colleagues from supporting organisations including Commissioning Support Unit will be invited to attend where appropriate and with their agreement.
5.3 Guest speakers will be invited when specific challenges or items of interest are being discussed.
6. FREQUENCY OF MEETINGS
6.1 The Group will meet at least four times a year. The chair may call additional meetings as necessary.
6.2 If a designated member is unable to attend, they should endeavour to send a representative in their place.
6.3 Members may be contacted via the Chair or Enfield CCG colleagues in-between the formal meetings, if there are urgent matters to discuss.
6.4 Meetings to be interactive and last no longer than two hours.
7. REPORTING
7.1 The group will report to the Patient and Public Engagement Committee.
41
8. GROUND RULES
8.1 Requests for Agenda items should be sent to the Communications and Engagement Assistant a minimum of two
weeks in advance. The Chair will decide when and if items can be added, depending on previous commitments and
time restraints.
8.2 An approved agenda and papers will be circulated by email to all members five working days in advance of meetings
taking place. Paper copies of meeting papers will be available on request from the Communications and Engagement
Assistant
8.3 Minutes from the previous meeting will be circulated to all members no later than 15 working days after the meeting.
8.4 From time to time it may be necessary for the Chair to make an urgent decision at short notice. Members will be
advised of this at the next available meeting, or by other means, such as email.
8.5 Membership is on the understanding that this Group is not the mechanism to raise or deal with individual complaints or
to lobby in relation to funding for individual voluntary and community sector organisations or other organisations.
Complaints or concerns of any nature should be directed through appropriate channels in the usual manner.
8.6 To ensure that meetings run smoothly and effectively, members will be expected to adhere to the following rules:
42
Members will read circulated reports and other materials in advance of meetings
Discussions should follow planned agendas
Show respect by listening to others and not interrupting
Operate on a consensus; seek general agreements
Identify actions that result from discussions and commit to following through those actions
Address items through the Chair of the meeting
Talk one at time; wait to be recognised by the Chair
Turn mobile phones off, to silent or on vibrate
Be respectful of other members ideas, views and cultures
9. CONFIDENTIALITY
9.1 Documents circulated by Enfield CCG, London Borough of Enfield or voluntary or community organisations, and the
notes from the meetings, can be shared externally unless expressly stated as confidential or in draft form.
9.2 Members are required to respect confidentiality of specific topics discussed at the meeting as requested by other
members, CCG staff, Local Authority staff or guest speakers.
10. REVIEW DATE
Membership and chairing arrangements will be reviewed annually. Next Review date will be September 2016.
Approval date: 21 September 2015
43
Appendix G
Voluntary Sector Strategy Group Terms of Reference
Mission Statement
The Voluntary Sector Strategy Group (VSSG) provides the mechanism for strategic consultation and partnership working between the
London Borough of Enfield, the Enfield Strategic Partnership (ESP) and the Enfield voluntary and community sector (VCS). The VSSG will
form the Council’s main strategic interface with the voluntary sector.
Aims and Objectives
The VSSG members are committed to the principles of the Enfield Compact. This is a local agreement that sets out the principles for positive partnership working, across the statutory, voluntary and community sectors within a spirit of mutual respect and partnership. The aim of the Enfield Compact is to help create new ways of working together for the benefit of those who live, work, study and do business in Enfield.
44
On matters relating to strategic partnerships or Compact related issues, the VSSG shall make appropriate reference to the
- Enfield Compact Review Board (ECRB) or - other relevant body.
That the principles contained in the strategic documentation produced by the Council and ESP relating to the VCS are adhered to
A presence on the ESP Board is created to create the formal link between that body and the VSSG
The opportunity for meaningful consultation between LBE and the VCS so that all the implications of funding decisions can be taken into account.
The opportunity for clear and constructive communication between VCS representatives, LBE elected Members, and Officers
The opportunity for debating issues of mutual concern and devising solutions to strategic problems.
Maintain a strategic overview and input into the work of key Enfield partnerships including the ESP and area based regeneration partnerships
Sustain linkages and connections with other statutory authorities
Review progress of issues raised by partners
Explore and collaborate on joint funding opportunities
45
Membership – please see attached
Representatives to feedback to their organisations
Representatives can nominate a Deputy
Non attendance will elicit a letter from the Chair of the VSSG (unless prior notification has been given)
Failure to attend on 3 consecutive occasions will result in the organisation being removed from the Group
Other officers as well as statutory and commercial partners will be asked to attend as and when appropriate
The elected element of the Group will be revisited every 3 years and an election for those seats enacted accordingly (the next elections will take place in 2016)
Resources
The facilitation and support provided by Enfield Council to the VSSG forms part of its overall approach to supporting partnership working
with the VCS and is incorporated into the remit of the Strategy, Partnerships, Engagement & Consultation Team accordingly.
Any additional requests for resources will be based upon discussions arising from Group business on an exceptions basis.
Frequency of Meetings
The Voluntary Sector Strategy Group will meet at least quarterly with provision set aside for the option of two additional meetings in any
operational year (up to 6 times per year).
46
Voluntary Sector Strategy Group – Membership
Chief Executive (Co-chair)
Cabinet Member for Voluntary Sector (Co-chair)
Voluntary Organisations (to provide one representative each)
Age UK Enfield
Enfield Carers Centre
Enfield Children & Young Persons’ Services
Enfield Citizens Advice Bureau
Enfield Disability Action
Voluntary Sector Strategy Group
47
Enfield LGBT Network (inc Faith)
Enfield Racial Equality Council
Enfield Voluntary Action
Enfield Women’s Centre
Elected Representatives
Micro organisation (No paid workers)
Small organisation (2 or less full-time paid or equivalent workers – income less than £80,000)
Medium organisation (income between £80,000-£500,000)
Large organisation (income over £500,000)
Officers Serving VSSG
Head of Strategy, Partnerships, Engagement & Consultation
Third Sector Development Manager
Director of Health Housing & Adult Social Care (inc CCG Business) (or nominee)
Director of Schools & Children’s Services (or nominee)
Director, Regeneration & Environment (inc area based partnerships business) (or nominee)
Administrator (Third Sector Development Team)
48
Appendix H Co-Chairs
Cabinet Member for Community Organisations &
Culture Cllr Yasemin Brett [email protected]
LBE Chief Executive Rob Leak
Voluntary Organisations
Age UK Enfield Tony Seagroatt [email protected]
Enfield Carers Centre Pamela Burke [email protected]
Enfield Children & Young Persons’ Services Claire Whetstone [email protected]
Enfield Citizens Advice Bureau Services Jill Harrison [email protected]
Enfield Disability Action Liane Burn [email protected]
Enfield Lesbian, Gay, Bisexual and Transgender
Network Tim Fellows [email protected]
Enfield Racial Equality Council Chandra Bhatia [email protected]
Enfield Voluntary Action Paula Jeffery [email protected]
Enfield Women’s Centre Ginnie Landon
Elected Representatives
Crossroads Care
(representing Large VCS Groups)
Jill Raines [email protected]
49
One to One (Enfield)
(representing Medium VCS Groups)
Lesley Walls [email protected]
Stroke Action
(representing Small VCS Groups)
Rita Melifonwu [email protected]
Vacant
(representing Micro VCS Groups)
Vacant
Enfield Clinical Commissioning Group
Director of Strategy & Partnerships Graham MacDougall
LBE Officers serving VSSG
Chief Executive's Unit
Head of Strategy, Partnerships, Engagement &
Consultation Shaun Rogan [email protected]
Third Sector Development Manager Niki Nicolaou [email protected]
Consultation & Resident Engagement Manager Ilhan Basharan [email protected]
Third Sector Development Team Officer
(Administration) Debbie Gibbs [email protected]
Health, Housing and Adult Social Care
Director of Public Health Dr Shahed Ahmad [email protected]
Assistant Director Strategy & Resources Bindi Nagra [email protected]
50
Head of Strategy Policy & Performance Doug Wilson
Schools and Children's Services
Assistant Director – Strategic Commissioning Eve Stickler [email protected]
Regeneration and Environment
Senior Project Manager Mary O’Sullivan [email protected]
Appendix I
36
37
Appendix J
NHS Enfield Clinical Commissioning Group
Voluntary and Community Stakeholder Reference Group
Terms of Reference
11. GENERAL
These terms of reference set out the membership, remit responsibilities and reporting arrangements of the Stakeholder Reference Group.
12. PURPOSE
12.1 The group’s purpose is to provide the patient, service users and public perspective, as articulated by voluntary and community sector representatives on the development, planning, implementation and evaluation (success and challenges) of health services commissioned by Enfield Clinical Commissioning Group (Enfield CCG).
13. RESPONSIBILITIES
13.1 To raise the profile and importance of patients, service users, carers and other stakeholder’s opinion in influencing local healthcare developments, such as service redesign, commissioning intentions and procurement.
13.2 To enable the voluntary and community sector perspective to be expressed and used to influence proposals and decisions.
13.3 For Enfield CCG to share knowledge and fully inform about local NHS
services and commissioning plans for the future at local level and across the North Central London Sector
13.4 To work with Enfield CCG to address areas of concern and
improvement
13.5 Members will assist in communicating information to voluntary and community groups within Enfield
13.6 To promote formal consultations and other engagement activities that
will potentially have an impact on local health services as and when these arise.
38
13.7 To provide strategic and accurate feedback on voluntary and community organisations, residents, service users and patients’ needs, concerns and interests.
13.8 To develop, promote and scrutinise plans, projects and services that would benefit the residents of Enfield.
13.9 To assist Enfield CCG to develop mechanisms to communicate
feedback and achievements to the wider community including patients, the public and across all stakeholders.
13.10 To ensure all interested parties are kept informed about the work of the
Group and how it influences the work of Enfield CCG.
14. MEMBERSHIP AND QUORACY
14.1 The group comprises maximum of 20 members with a quorum of 8 members of which there must be representation from Enfield CCG, London Borough of Enfield and 6 other voluntary and community stakeholder members.
14.2 The core membership is:
Enfield CCG Head of Communications and Engagement – Chair of Group Patient and Public Engagement Manager NHS North and East London Commissioning Support Unit Equality and Diversity Manager Elected Enfield Patient Participation Groups’ Representative London Borough of Enfield Representatives
Third Sector Development Manager
One Representative from 15 voluntary organisations/community groups to include: Age UK
Enfield Carers
Enfield Disability Action
Enfield Faith Forum
Enfield Lesbian Gay Bisexual and Transgender Network Enfield Parents and Children
Enfield Racial Equality Council
39
Enfield Voluntary Action Enfield Women’s Centre Healthwatch Enfield Mind in Enfield One-to-One Enfield Our Voice Over 50s Forum Youth Parliament
4.3 The minutes of the meeting will normally be taken by Enfield CCG’s Communications and Engagement Assistant.
15. ATTENDANCE
15.1 Other CCG Managers will be invited to attend when the group is discussing areas that are their responsibility. If they are unable to attend in person, then they will nominate a suitable deputy to attend in their place. Other individuals will be invited to attend if specific specialist advice is required.
15.2 Other colleagues from supporting organisations including Commissioning Support Unit will be invited to attend where appropriate and with their agreement.
15.3 Guest speakers will be invited when specific challenges or items of interest are being discussed.
16. FREQUENCY OF MEETINGS
16.1 The Group will meet at least four times a year. The chair may call additional meetings as necessary.
16.2 If a designated member is unable to attend, they should endeavour to send a representative in their place.
16.3 Members may be contacted via the Chair or Enfield CCG colleagues in-between the formal meetings, if there are urgent matters to discuss.
16.4 Meetings to be interactive and last no longer than two hours.
17. REPORTING
17.1 The group will report to the Patient and Public Engagement Committee.
18. GROUND RULES
18.1 Requests for Agenda items should be sent to the Communications and
Engagement Assistant a minimum of two weeks in advance. The Chair
40
will decide when and if items can be added, depending on previous
commitments and time restraints.
8.2 An approved agenda and papers will be circulated by email to all
members five working days in advance of meetings taking place. Paper
copies of meeting papers will be available on request from the
Communications and Engagement Assistant
8.3 Minutes from the previous meeting will be circulated to all members no
later than 15 working days after the meeting.
8.4 From time to time it may be necessary for the Chair to make an urgent
decision at short notice. Members will be advised of this at the next
available meeting, or by other means, such as email.
8.5 Membership is on the understanding that this Group is not the
mechanism to raise or deal with individual complaints or to lobby in
relation to funding for individual voluntary and community sector
organisations or other organisations. Complaints or concerns of any
nature should be directed through appropriate channels in the usual
manner.
8.6 To ensure that meetings run smoothly and effectively, members will be
expected to adhere to the following rules:
Members will read circulated reports and other materials in advance of meetings
Discussions should follow planned agendas
Show respect by listening to others and not interrupting
Operate on a consensus; seek general agreements
Identify actions that result from discussions and commit to following through those actions
Address items through the Chair of the meeting
Talk one at time; wait to be recognised by the Chair
Turn mobile phones off, to silent or on vibrate
Be respectful of other members ideas, views and cultures
41
19. CONFIDENTIALITY
19.1 Documents circulated by Enfield CCG, London Borough of Enfield or
voluntary or community organisations, and the notes from the
meetings, can be shared externally unless expressly stated as
confidential or in draft form.
19.2 Members are required to respect confidentiality of specific topics
discussed at the meeting as requested by other members, CCG staff,
Local Authority staff or guest speakers.
20. REVIEW DATE
Membership and chairing arrangements will be reviewed annually. Next
Review date will be September 2016.
Approval date: 21 September 2015
Appendix K
Enfield CCG Engagement on Future Planning of Health Services
Gail Hawksworth, Head of Communications and
Engagement
Presentation to EVA’s Combined AGM and Conference
Wednesday 28 October 2015
36
About NHS Enfield CCG
• We are a clinically led organisation • All 49 GP practices are members of Enfield CCG • We commission most of the health services for Enfield i.e. hospital, community and mental
health services • GP practices work in 4 localities; each locality elect 2 GPs who lead the Governing Body • The Governing Body consists of 8 GP elected members, NHS managers, a secondary care
doctor, a nursing representative, a practice manager representative, lay members, including the Patient Participation group representive, representatives from London Borough of Enfield and the Chair of Healthwatch
• Enfield is a financially challenged CCG that was under its “fair shares” allocation by £33m in 2013/14, £24m in 2014/15 and £16m in 2015/16.
• We posted a deficit of £18.9m in 2014/15 due to increased activity at our main hospitals • We have set a deficit target of £14.4m for 2015/16
37
What we spent in 2014-2015
38
Voluntary and Community
Stakeholder Reference Group
• Established following the results of the 360° Ipsos MORI Stakeholder Survey in March 2015 • Worked with local authority colleagues to invite a number of voluntary groups that would cover all
9 protected characteristics of Equality Act 2010 i.e. age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion and belief; sex; sexual orientation
• Initial scoping meeting held on 5 August 2015 • It was agreed that attendance would be from the umbrella groups • The purpose of the Group is:
To provide the patient, service users and public perspective, as articulated by voluntary and community sector representatives on the development, planning, implementation and evaluation (success and challenges) of health services commissioned by Enfield Clinical
Commissioning Group (Enfield CCG).
39
For more information
www.enfieldccg.nhs.uk
Follow us on Twitter @EnfieldCCG
Contact: [email protected]
Email: [email protected]
Tel number: 0203 688 2822
40
Appendix L
Enfield CCG 360 Degree Stakeholder Improvement Action plan-
Version 1.6. 2 February 2016
Summary:
NHS England commissioned Ipsos MORI to carry out a 360° Stakeholder Survey for
all CCGs in England as part of the assurance process and to support the CCG with
its continuing organisational development. The survey was carried out from 10
March to 7 April 2015.
Brief summary of the results were:
• The response rate had increased from 60% last year to 68% this year. • The main report and verbatim comments showed a mixed picture although the
CCG scored lower compared to last year • Responses from Primary Care indicated the challenges they are under and
that further close working with practices is necessary though both formal and informal meetings e.g. GP Membership events, Locality Commissioning meetings and Protected Learning Times
• We have a very good working relationship with the HWB and the local council • Healthwatch has suggested a number of areas including earlier involvement
in the CCG plans to re-commission services. They also said through the strong working relationships with CCG colleagues, a number of positive actions were taken such as promotion of use of BSL by GP practices, encouraging GPs to improve their NHS Choices listings and improving the clarity of information presented to the Governing Body
• Stakeholders had a general understanding of the challenges faced by the CCG
• There were some very positive comments about the engagement events were helpful ; that CCG members were available for support via email and telephone; someone felt that they could not ask more of the CCG; it was noted that the CCG was moving towards recognising that engagement affects the and involves the whole organisation
• Concern was expressed a number of times and in a number of ways about CCG’s priority being to save money at the expense of quality of care, primary care budget and mental health provision
Areas of Improvement are shown from pages 2- 15; positive feedback is given on pages 16- 18.
41
Comments received from
stakeholders giving areas for
improvement
Actions taken & to be taken Lead Target Date
GP member Practices
Another tier of actions to do – not
helpful to running of general practice
Through locality commissioning, our aim is to be more joined up in the
way we work with practices and this should reduce the number of
meetings and be more efficient.
We are conscious of the need to take more account of the day to day
pressures on GPs with planning new schemes.
GMD
ongoing
CCG should make regular monthly
visits to the practice and listen to the
difficulties and help the practice in
achieving its’ goals instead of
criticising
Practice Visits are now carried out by the Locality Commissioning
Team on a bi-monthly basis.
Where feasible, attendance also includes Medicines Management,
Primary Care and Integrated Care.
GMD
Done
Visits to practice need to be
supported by relevant data e.g.
referral rates
Practice Visits are now carried out by the Locality Commissioning
Team on a bi-monthly basis. Visits are supported by comprehensive
Practice Reports detailing activity information for secondary care
services amongst other areas of interest. Practice Visits are also
tailored to areas of interest and the agenda may be determined by
performance in specific areas.
GMD/
MO
Done
CCG relationship is not as workable
as desired. Smaller workgroups
would be good. Contact details
Locality leads in place:
North West – Janet Powell (starting Feb 16)
GMD ongoing
42
would also be useful as difficult to
know who to speak to when issue
arise. Good to have one CCG rep
for a Practice to help channel
who/which department to contact.
Good for practice management to
have some input/contact with the
CCG issues
South West – Thomas Araya (starting March 16)
South East- Asifa Mian
North East- Matt Rogers
GP Prescribing leads:
North West – Dr Megha Dhavale
South West – Dr Vip Thiagarash
South East- TBA
North East- Dr Sarit Ghosh
slow or no response to Emails Locality Commissioning Team will aim to respond to all
emails/telephone messages within 5 working days. None response to
emails sent to other CCG members should be raised with the Locality
Manager who will follow-up on the practices behalf.
ALL ongoing
A suggestion concerning reducing
hospital admissions was for the
CCG to consider using a pilot in the
midlands that sent out a GP with
ambulance crews and decreased
admissions by 5 percent. It was
noted that there was a lack of
The newly commissioned Community Crisis Response Service started
on Monday 18 January 2016. The Community Crisis Response Service
is nurse-led, with medical provision from Barndoc, and will operate out
of hours between 5pm to 2am, 7 days a week (including bank
holidays), 365 days of the year. The service will be delivered by
Enfield Community Services (Barnet, Enfield and Haringey Mental
Health Trust). The team will work in the community and in care homes
GMD Done
43
response by the CCG to this
suggestion.
to assess and treat adults in Enfield at risk of hospitalisation with the
aim of preventing unnecessary acute admissions. This is a new service
that will be piloted for one year.
We are well-informed about plans
and priorities, although it does not
usually feel as though there is much
opportunity to influence large-scale
plans, although our comments and
suggestions are welcome in many
quarters, though not all. However,
the difficulty in influencing major
plans is probably partly due to the
financial position and partly due to
how long it can take to vary
contracts and procurement.
Practice members are strongly encouraged to help shape the design of
local services and planning through the following means:
- GP Members Events (every 4 months) - Locality Commissioning Business Meetings (every 2 months) - Practice Visits (every 2 months) - Adhoc workshops/engagement events
In some cases, due to other competing factors, it may not always be
possible to take on board suggestions however we will aim to
adequately justify the reasons where this is the case. Where the
financial position or contractual status is an issue this should be
explained.
GMD ongoing
Engagement feels more like an
afterthought for predetermined plans
rather than a genuine attempt and
seeking GP views to determine the
direction of travel.
As above. We will aim to take the approach of ‘you said, we did’ when
planning redesign and development of new services and involvement
will start during early developments. In some examples, the work we
are progressing has arisen from practice suggestions and therefore it is
fundamental to us that this engagement continues throughout design
and mobilisation of new services.
ALL ongoing
CCG tends to try and control and
performance manage practices,
rather than listen to their views in
As addressed above through ‘you said, we did’ and Locality
Commissioning approach.
GMD ongoing
44
commissioning secondary care. I
cannot see any real genuine support
for primary care in the area.
Further, issues raised by practices during Locality Commissioning
meetings and visits are being logged and progressed by the team. We
acknowledge that issue resolution in the past requires significant
improvement and this may have been hampered by the limited
resource within the CCG, however we will explore new ways of
addressing practice issues and ensuring that turnaround is as quick as
reasonably possible. These actions should help to change the
perception as locality commissioning becomes embedded.
The CCG has agreed to establish a permanent primary care team with
effect from 1st April 2016. As co-commissioners of primary medical
services with NHS England since 1st October 2015, the CCG now
attends practice visits with NHS England to offer advice and support.
Enfield Practice Nurse Forum was re-established in November 2015
and with the support of the CCG has a schedule of six-weekly
meetings up until December 2016. To date, the Forum has covered
topics such as Nurse Revalidation, IAPT, End of Life Care and
Childhood/Influenza Immunisations and Vaccinations.
In collaboration with Barnet CCG and University of Hertfordshire, a new
course for General Practice Nursing and been developed. Following a
45
recruitment and selection process, five GPNs have been appointed in
Enfield. Five Enfield GP Practices have been selected to employ and
host a GPN from 1st February 2016 for one year. These GPNs will
spend half their time in the practice and the remainder of their time on
the programme at University of Hertfordshire. At the end of the
programme, these GPNs will receive a formal qualification in General
Practice Nursing and it is anticipated will be retained by the five GP
Practices who have agreed to employ them for the duration of the
programme.
Since August 2015, the CCG has worked with its members to develop
a Primary Care Transformation Framework, developing and agreeing
priority areas for implementation in 2016/17.
This year, the CCG was able to secure sufficient funding to migrate 17
GP practices from Vision to EMIS Web, develop an Enfield global
library to support practices with managing onward referrals by
augmenting referral templates and optimising documents and
commission a Primary Care Urgent Access service to provide
additional GP capacity for patients registered with an Enfield practice.
In March 2015, the CCG commissioned six facet and CQC compliance
surveys on all GP Practice premises. It has since worked with
practices to ensure that timely action plans are developed for remedial
46
works required. In December 2015, the CCG arranged for the CQC
London Inspection Manager to provide an update on the inspection
process to local Practice Managers.
On-going advice and support has been provided to practices in respect
of CQC inspections, Infection Control and Prevention inspections,
submission of Primary Care Infrastructure Fund and Improvement
Grant bids and NHS England’s due diligence process.
GP Networks currently not working
well together
Facilitation talks offered. This is an ongoing concern being addressed
in collaboration with the LMC and network representatives.
GMD ongoing
Practice suggestions for cost saving
not given enough consideration
Issues raised by practices during Locality Commissioning meetings
and visits are being logged and progressed by the team. We
acknowledge that issue resolution in the past requires significant
improvement and this may have been hampered by the limited
resource within the CCG, however we will explore new ways of
addressing practice issues and ensuring that turnaround is as quick as
reasonably possible.
GMD ongoing
CCG's priorities are different to GPs
views
As a membership organisation, the CCG priorities should represent the
majority of members’ views. We will continue to work with our member
practices to ensure that this is the case.
GMD ongoing
More time; ability to have more
protected time to do CCG work.
Practices have been supported by Locality Commissioning
engagement monies (£250k across Enfield) which allow the practices
to attend Locality Commissioning Business Meetings and engage/drive
GMD ongoing
47
the work the CCG is doing.
The opportunity to make a
difference to the health of the
population and the future of the
health service Development of a
new skill with reference to
leadership
We welcome involvement of GPs in the work of the CCG and are
happy to consider Continuing Professional Development requirements.
GMD/
MO
ongoing
Greater in depth knowledge of
forthcoming plans and services
needed
Information to continue to be provided:
at GP Member Events
via the GP e-communications
on the GP intranet
GMD ongoing
Listening to opinions and effecting
change. Clear signposting of
changes would make practices feel
involved. Another crucial factor is
time as Primary care is swamped at
present.
As addressed above through the Locality Commissioning approach
‘you say, we do’.
We aim to continuously demonstrate the progress we are making
within the Locality Commissioning Programme – the first part of
Locality Commissioning Business Meetings always focusses on the
progress we have made against the key issues arising from practices.
GMD ongoing
Health and Wellbeing boards
The CCG staff seem to be very busy
and have difficulty attending
partnership meetings.
The CCG is a relatively small organisation and cannot be represented
at all meetings. This will be reviewed within the CCG to agree which
meetings should be prioritised.
ALL ongoing
48
Upper tier or unitary local authorities
Budget holding and influential CCG
staff are not regular attendees at
partnership meetings (this is a
reflection on the overall workload of
the CCG and the fact it is a heavily
underfunded CCG).
The CCG is a relatively small organisation and cannot be represented
at all meetings. This will be reviewed within the CCG to agree which
meetings should be prioritised.
ALL ongoing
NHS providers
Lack of money seeming to paralyse
decision making and leading to
problems in negotiating contracts
The contracting round has been especially challenging as financial
constraints impact.
Action: We have appointed a Recovery Director and a contracting
expert, which has already yielded results through decision making and
negotiation skills.
RW Done
There are some good
commissioners involved in
monitoring and they understand the
services. However, separating
quality from finances doesn't really
work; funding decisions are clearly
impacting on quality and the
response 'that can be taken up in
I agree that the contracting process was conducted in “silos” to some
extent and with the overall point being made.
Key to this is for the CCG to recruit and retain key staff over an
extended time period.
RW ongoing
49
the contract meeting' doesn't really
cover the issue adequately.
The CCG must have a mechanism to control expenditure and improve
quality.
This year we have been integral to the contract negotiations with Royal
Free, NMUH and (as lead) BEHMHT. The results of this may be
perceived as low profile, but I am confident that we have participated
fully with demonstrable financial results.
From September 2015 contract review and quality assurance meetings
have been combined to provide greater assurance that investment in
and transformation of services results in improved performance and
quality of service for patients
Action: Deliver continuity of key staff.
Enfield have much to contribute
directly and it would be good to see
them working more with lead
commissioners on contracts
especially with CCG Board
members (quality leads already
work well together)
Please see above, we have been fully involved with Royal Free and
NMUH, as well as BEHMHT.
We agree that involvement from non-finance/commissioning staff could
be improved and will try harder to ensure clinicians are involved in key
meetings.
RW ongoing
50
Much of this is down to meeting “structure” and we need to get the
service models and pathways clearly defined earlier in the process.
Action: RW will push for the clinical and quality conversations to
happen before the financial one. Or at the same time where that is not
practical.
Other CCGs in the North Central London (NCL) sector
No comments Although there were no additional comments made, we will continue to
work collaboratively with the other CCGs within North Central London.
ALL ongoing
Local HealthWatch/ patient groups/wider stakeholders
The importance of patient and public
voice, while very well recognised by
many individuals, is not yet culturally
embedded throughout the
organisation.
Earlier involvement of a broader
range of the local public is needed
in:
local commissioning plans
re-commissioning of services
Outcomes based
commissioning
The CCG is increasingly trying to embed the patient and public voice in the strategic plans and proposals for service change and outcomes. Experience to date has been positive.
The model of patient and public engagement used in the development of Integrated Care for Older People will be used as the framework for embedding the patient and public voice in the future
ALL ongoing
Need to embed the patient and The report and verbatim comments have been shared with AF ongoing
51
public voice throughout the
organisation
Senior Managers.
The report will be discussed at all Staff and Team meetings to the embed Patient and Public Engagement work across the organisation.
Healthwatch attendance at the CCG Quality & Safety Committee was discussed at the July 2015 Committee meeting. Following a meeting with the Committee chair, Director of Quality & Integrated Governance & Healthwatch CEO, it has been agreed that Healthwatch will attend and trial the CCG Quality & Risk Sub Group which reports to the Quality & Safety Committee and
reviews patient safety and patient experience in detail.
ECCG needs to ensure that their
planning and monitoring of their
PPE work oversees and captures all
such work across the whole
organisation, not least so that PPE
is increasingly seen as an integral
part of all their work.
Engagement log being amended to take into account NHS England’s requirements as well as comments from survey
All staff involved in engagement activity to complete the engagement log
PPE Committee will continue to monitor patient and public engagement activity
AF
ongoing
Clear monitoring and reporting of
engagement activity is still needed
so that they, and others, can
understand and evaluate the
success and impact of any
engagement activities they
undertake. How do they know if the
engagement activities
that they do are good value for
money, or could be done better
Event Feedback forms are available at all events
Comments from event feedback forms to be shared with all staff and taken into account when planning the next event
Becomes part of ‘You said, We did’ feedback
Information to go onto the CCG website
ALL ongoing
52
differently?
They also need to distinguish more
clearly between engagement
activities with CCG members, other
professional stakeholders, and
patients and the public. They are all
important, but they are not all PPE.
Engagement log has been amended to indicate the different stakeholders as currently all engagement events are shown by date they occurred
AF
Done
Engagement events have been
more information events rather than
engagement events
Making our Patient and Public Engagement Events more participative, with more time spent with GP Governing Body members leading workshop sessions. This started in January 2015 with the most interactive one being held on 3 June 2015
Giving regular feedback
AF ongoing
They are just starting to focus more
on clearly identifying what points the
public and patients have made on a
consultation/involvement and being
clear about what difference it has
made to their thinking. They need
to be clearer about publicising such
results and feeding them back
where possible to those who were
engaged with (though feeding back
is not always possible).
Feeding back – You said, we did’ at out stakeholder events and promoting the ways patient and public can communicate with CCG e.g. through dedicated Communications and PPG emails address; twitter and our website
Will continue to review how to improve feedback of issues/points raised
AF ongoing
Greater clarity is needed over the
purpose and focus of public
engagement events. If people don’t
know in advance what an event is
about then they are less likely to
Themes to be agreed well in advance and circulated to stakeholders via email; website; twitter and local newspapers
Advance notice provided about themes to be discussed at the next PPE meeting on 9 September 2015
MO/P
J/GM
D/AF
ongoing
53
attend.
Engagement appears to be on
predetermined plans rather than
genuine attempts to gain patient
views
To review current engagement
To ask the PPE Committee consider and suggest possible ways for this to be addressed
ALL ongoing
ECCG could do more outreach to
hear from those who are seldom
heard. They have recently started
to do more in this field, which is very
welcome.
We will continue to look at ways of engaging the harder to reach groups
This will be further discussed at the Patient and Public Engagement (PPE) Committee
GMD/
AF
ongoing
CCG need to respond in a more
pro-active way with regard to
equalities issues; lack of clarity on
lead on equalities and what the
strategy and action plan are
Enfield CCG has commissioned support from North East London Commissioning Support Unit to meet its Public Sector Equalities Duties
Director lead on Equalities is Aimee Fairbairns
Issues raised to be taken to the Equality Diversity Scheme 2 (EDS2) Task and Finish
Equality and Diversity Strategy 2012-2016 is available on the website which details the ECCG approach
The CCG has developed an annual EDS 2 action plan which will be shared with Patient and Public Engagement (PPE) Committee and progress will be reported through the PPE Committee
ECCG publicises its equality information on its websites on 31 January every year: http://www.enfieldccg.nhs.uk/Downloads/Enfield%20CCG%20Equality%20Information%20summary%20-%20January%202015.pdf
AF ongoing
54
CCG needs to show the community
what their exact plans are on
equalities issues and actions they
will take to eradicate inequalities.
EDS2 and the Workforce Race Equality Standard are the two key documents that have the objectives and actions of the CCG.
The CCG is currently working with Public Health to analyse health needs
ECCG is also working with our providers to ensure better equality performance.
ECCG will be refreshing our Equality and Diversity Strategy in 2016-17.
AF ongoing
CCG are slow to engage with
Barnet, Enfield & Haringey Local
Optical Committee Engagement is
needed at an early stage in any
discussions relating to eye health in
the community and/or
ophthalmology transfer from
secondary to primary care.
Engagement is also in developing
excellent services for patient care,
reducing costs, waiting times and
unnecessary hospital appointments.
We try and engage when working on ophthalmology projects.
We will discuss with the Barnet, Enfield & Haringey Local Optical
Committee:
how engagement can be improved in the future
about the opportunities and alternative mechanisms of engagement
GMD ongoing
Engaging with the VCS is very
different from engaging with the
general public and o try and
combine the two groups into one
meeting does not really work. Hence
the decreasing engagement with the
VCS.
New voluntary and community Stakeholder Reference Group set up
First initial scoping meeting held on 5 August
Further meetings to be agreed
Terms of Reference to be agreed by the Stakeholder Group which will report to the Patient and Public Engagement Committee
AF End of Aug
2015
It is quite hard to meet up with
representatives of the CCG to
The CCG is a relatively small organisation. It is difficult at times to be
available for meetings. However, requests for meetings will be
ALL ongoing
55
discuss issues and develop a
professional relationship.
considered on a case by case basis.
Too focused on cost saving rather
than quality of care. Too much
money spent on outside
consultants.
Quality of care is always of critical importance. Through the
CQRG/TPG it is not possible to take a decision to save money without
clinical backing. It would be useful to have some specific examples of
this to look into.
“Outside” consultants fall into two categories
1. Interim staff. Whilst some interim staff are on high day rates it is often the case that the gross costs are similar to staff on the payroll. This is when the pension, annual leave, sickness and other employment rights of permanent staff are taken into account. Enfield, perhaps due to its geography, finds it difficult to attract and retain permanent staff. A recent professional search for a Deputy Chief Finance Officer came up with very limited results. The same applies to GP’s; this is one of the most under doctored CCGs in England. In this case we feel that the continuity of staff is critical.
2. Hired companies for specific purposes. In some cases local CCG management is left with no option other than to engage such companies. This can be for external reasons or where a specific skill set or capacity is not available internally.
3. Action: We will keep expenditure on external consultancies to a minimum, and follow the NHSE guidance which requires the CO, CFO and NHSE to approve contracts > £50K.
ALL ongoing
56
The CCG needs to communicate its
plans clearly and simply.
We are happy to look at ways to improve the way our plans are
presented.
GMD ongoing
Concerned about the responses to
proposals for supporting people at
home
We welcome opportunities to discuss these proposals further as the
patient and public voice is important when developing our plans.
GMD ongoing
It’s unclear what commitment
clinicians on the CCG GB (other
than the CCG chair) have to driving
up primary care quality where
results are suboptimal.
The clinicians are fully committed to driving up the quality of primary
care. We continue to work with our practices through GP protected
learning times, locality commissioning and network meetings.
MO ongoing
Would like to see the PPGs
operating effectively
Most Patient Participation Groups (PPGs) members are volunteers except where the practice manager is the chair of the PPG
Enfield PPGs now have an elected representative, who sits on the PPE Committee and the Governing Body
Created a work plan at their Network meeting on 21 May 2015
PPGs working together to decide how they function as they are volunteers and deliver their work plan
Elected PPE representative to keep PPE Committee and Board updated
PPG PPG elected
rep to review
and
comment.
ongoing
Positive Comments made
Stakeholder Group Good practice for noting
GP Member Practices CCG responsive to questions and queries; regular updates from the communications person who is
57
excellent with links to new services; new referral pathways and any information that is relevant to us as a
primary care organisation.
excellent newsletter; Updates at PLT; locality Commissioning meetings; GP Engagement events; regular
contact with Locality leads
The CCG provides updates at the monthly PLT meetings. If partners do not attend they will not hear about
things first hand though are always practice representatives present
We have a friendly relationship with our CCH and they are very helpful.
Regular meetings and e-mails.
I attended most of the engagement events and felt that the CCG did well to engage the local GPs. We had
opportunities to discuss in small groups as well as larger audiences. The senior members of the CCG did
actively listen to the suggestions. I am unsure if these were implemented
CCG engaged well at the local GPs at events attended; opportunities to discuss in both small and large
groups; senior CCG colleagues listened to suggestions
Responsive board members
Have access to a Locality person and have they organise Regular PLT meetings that enable networking with
both clinical and non-clinical updates
I think submitting a Vanguard bid together was great even though not successful
Provide a good platform for clinicians to update their knowledge and share ideas with colleagues.
Provided more support for local practices
58
Health and Wellbeing
Board
Very satisfied with Enfield CCG’s engagement with HWB and the council.
Always an advantage to surface issues at as early stage to ensure any problems can be discussed.
Enfield CCG has fully engaged with the production of the JSNA and the Health and Wellbeing strategy
Upper tier or unitary
local authorities
CCG has worked hard with the local authority on a range of initiatives
Enfield CCG has fully engaged with the production of the JSNA and the Health and Wellbeing strategy
The CCG has worked well with the public health team. The CCG has commissioned a CVD quality initiative
in 2 practices which led to 1000 patients having a 10mmHG decrease in BP and 0.5mmol/l decrease in
cholesterol. The CCG with PH commissioned an AF initiative which will deliver results.
Our working relationship with ECCG is strong and continues to develop further. We look forward to
continuing to engage with them in the coming year.
NHS providers CCG has worked hard to engage and listen to providers e.g. CCG agreed to delay tendering community
services following representation by providers The CCG has also decided to delay Value based
commissioning to allow the integration agenda to develop further
Other CCGs in NCL Chairs meet regularly and speak on phone offering advice and support
59
Local HealthWatch/
patient groups/ Wider
stakeholders
We find that there are a number of individuals with whom we have strong working relationships, who are
helpful, engaged and responsive.
The CCG has responded very well over the dementia pathway, for example. They responded to public
concerns over changes to Memory Clinics and decided to make changes. They then involved people in their
work on the pathway, as a result of which they included greater post- diagnostic support for individuals,
taking account of what people had told them they needed. This sort of success needs to be heralded more
widely so that all those involved at all levels of the organisation can understand the benefits of such
engagement work.
Mixed working relationships –positive CCG responses on e.g. use of BSL by GP practices; encouraging
GPs to improve NHS Choices listings and more information in relevant GB papers about PPE
Well-informed about plans and priorities
The organisation has come a long way in a relatively short period and is really making a difference to patient
care and raising quality in primary care
Keep up the good work in reducing health inequalities in the Borough. Do not be deterred from the fact that it
takes a long time to reap the benefits of what you are doing now.
Working in difficult circumstances while in RED is remarkable.
I have been a member of the Enfield Primary Care Strategy Implementation Board. To that extent I have
been included within a group who take in to account views from a range of stakeholders within the Health
and wellbeing Board area. I have been able to articulate issues, concerns and developments to the Board,
often this has given me an opportunity to see the points raised dealt with by appropriate members of staff
within the CCG.
60
We are pleased to see moves towards recognising that all aspects of the CCG's engagement and
involvement work are, or should be, part of their organisation-wide engagement strategy. This relates to
seeing engagement as something that affects and involves the organisation as
A coherent whole, and moves towards this are very welcome.
Engagement events and afternoon CCG meetings have given me the opportunity to express my views
The CCG chair is excellent, but it is unclear what the other clinicians on the governing body deliver and what
the extended range of clinical leaders are actually delivering. It can come across that they are spending a lot
of time in meetings debating; debating primary care provider networks and commenting during meetings with
providers. It is unclear if they are having face to face meetings with other GPs and are driving quality
improvement amongst their peers. It is unclear what CPD is done by the other clinical leaders and how well
informed they are about what is happening in other parts of London (outside NCL) (both in terms of excellent
practice but also in terms of usual practice).
The CCG has responded very well over the dementia pathway, for example. They responded to public
concerns over changes to Memory Clinics and decided to make changes. They then involved people in their
work on the pathway, as a result of which they included greater post- diagnostic support for individuals,
taking account of what people had told them they needed. This sort of success needs to be heralded more
widely so that all those involved at all levels of the organisation can understand the benefits of such
engagement work
61
Appendix M
Enfield CCG Patient and Public Stakeholders Engagement Activity log for year 1 April 2015- 31 March 2016
Version 1.3.2- This log does not include all elements of informal engagement, but attempts to show the depth and breadth of engagement that
Enfield CCG is involved in.
Date/s of
activity
Type of
activity
e.g. Meeting,
focus group,
deliberative
event, online
discussion,
online
Target audiences
e.g. Local patient
groups, public,
stakeholders,
public, disease
specific groups
Number of
attendees /
number of
hits or users
How were
participants
informed (invited,
media release,
advertisements,
flyers, online)
Aims and Objectives Feedback/Outcomes
22 April
2015
Health and
Care Careers
Information
and Advice
Event
Year 12 and Year
13 students at
Enfield County,
Edmonton County
and Chace
Community Schools
and Oasis
Academy Hadley.
Up to 50
students
attended
This event was
organised through
L3 Health and Care
network.
Career opportunities in the
NHS
What is a Clinical
Commissioning Group
NHS Organisational
Structure
Provide information on
Choose Well campaign
and IAPT
Attendees requested
that this becomes an
Annual event.
Provisional date set
of:
9 March 2016
62
24 April 15 Health & Well-
Being Board
Patient & Public
stakeholders
varies Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
and local tertiary
providers and local
patient events
where possible
Seek views on
development of Health &
Well Being Strategy in
Enfield
Engagement of local
residents in Health
well-being strategy
28 April 15
Patient
Information
engagement
event
BEH CCGs patients
and public
TBC Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
and local tertiary
providers and local
patient events
where possible
Information on NHS 111
and Out of hours
procurement/ to inform
development of service
specification for the
procurement process
Feedback on current
services to inform
development of
service specification
19 May
2015
Attending an
Over 50s
Forum
meeting
Over 50s Forum
members
50+ By Over 50s Forum
newsletter
Seek views on the
proposals for NHS 111/GP
OOHs changes
Feedback on:
Conflicts of interest;
maintaining quality of
services; privatisation
of the NHS all fed
back to NEL CSU to
63
add to the
engagement on this 5
borough work.
21 May
2015
PPG Network
Meeting
All PPG Network
members
Via email; press
advert
To introduce the newly
elected PPG
representative
Communications between
PPGs and ECCG
How do we work with
Elected Representative
PPG Champions
Learning from good
practice in Enfield
Gaining views – use of
Smartsurvey
Volunteering for
involvement in CCG work
PPG Work plan for
2015/16
Development of draft
role of Locality
Champions
Working Together
including how to
recruit young people
and people who
don’t speak English
as a first language
Developed a work
plan for 2015/16:
Do Not Attends
(DNAs)
Ask all Practices to
monitor June’s 2015
DNAs for physical
appointments
Look at actions that
could be done to
make this figure less
Ensure a notice goes
on the board to
inform other patients
64
regarding the wasted
time.
Promoting Healthy
Lifestyles
Ask Public Health –
Litsa to contact Public
Health, I have an
appointment with
Shahed Ahmad,
Director Public Health
for 3rd July 2015
Get resources from
Public Health
PPGs may focus on
different things
Knowing about
PPGs
Making sure they are
representative
Making sure people
know about them
Effectiveness of PPG
Monitor
- Number of people
who attend
- Champions could
monitor work of
PPG’s on Work Plan
On line booking
65
On line electronic
prescribing
25 May
2015
Patient
Information
Enfield, Haringey
and Barnet patients
and carers
interested in
advance care
planning,
particularly end of
life, mental health
and LD conditions
No. of
Attendees -
TBC
Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
and local tertiary
providers and local
patient events
where possible
Information on Lasting
Powers of Attorney and
Advance Care Planning
(Mental Capacity Act
2005)
3 June Patient and
Public
Corporate
engagement
event
Patient and Public
in Enfield
About 40
attendees
local newspaper
advertising; Twitter
(@EnfieldCCG),
stakeholder list,
emailed to: patient
participation
groups, voluntary
and community
stakeholder
database; member
practices bulletins
Theme of event was:
Getting the best value for
every NHS pound. We
want to discuss with you
where we spend our
money now and how we
should spend it in the
future.
Areas considered were:
Finance and Quality,
Innovation, Productivity
Stronger prevention
strategy needed
Focus on supporting
patients to
understand screening
Support patients to
understand more
about their long-term
conditions/s
66
and Prevention (QIPP)
Integrated/planned care
Urgent Care
18 June
2015
Patient
Information
Enfield, Haringey
and Barnet patients
and carers
interested in
advance care
planning,
particularly end of
life, mental health
and LD conditions
10 Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
and local tertiary
providers and local
patient events
where possible
Information on Lasting
Powers of Attorney and
Advance Care Planning
(Mental Capacity Act
2005)
22 June
2015
Patient
Information
Event-
Compassion
in Dying
Enfield, Haringey
and Barnet patients
and carers
interested in
advance care
planning,
particularly end of
life, mental health
and LD conditions
>10 Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
and local tertiary
providers and local
patient events
Information on Lasting
Powers of Attorney and
Advance Care Planning
(Mental Capacity Act
2005)
67
where possible
End June
2015 - 27
November
15
Improving
CAMHS
Services
Strategy
Consultation
CAMHS survey
launched on CCG
and LBE websites
TBC Detailed Draft
Transformation
Strategy
Questionnaire to inform
development of CAMHS
services in Enfield
Questions included:
location of services,
availability of
information, where to
access help/ support
and treatment,
engaging with
professional groups,
priorities to inform
local services, top
three issues to be
addressed in
transitioning from
CAMHS to services
for adults, and
investment priorities
ranking.
7 July
2015
Health
Improvement
Partnership
Board
Members of CCG/
LBE
?No. of
attendees
CCG and LBE
email and internal
Bulletins
Information about HHWB/
JSNA/ Service
developments
To inform JSNA and
HHWBB strategy and
implementation of
local priorities
16 July
2015
Oakwood
PPG meeting
Members of the
Oakwood PPG
40-50 Advertised by PPG
Chair in practice
and local
Information about the 5
year Forward view
Questions covered
funding of local
services; role of GPs;
68
pharmacies A&E waiting times;
medicines
management; NHS
IT; NHS 111/GP
OOHS
4th
September
2015
Mental Health
- All day
Deliberative
Event and
workshops
event
Mental Health adult
service users and
3rd sector
organisations in
Enfield
125
attendees of
which 108 are
service users
Event organised by
EMU, discussed at
the MH Partnership
Board. Poster
distribution. This
event is the
borough follow on
event from 23rd
April 15
Seek engagement and
discuss with service
users/carers what they
wish to see in service
provision for adult mental
health, including the Crisis
Pathway
The event will be
written up by EMU
and a feedback
system will be agreed
with attendees on the
day. It is agreed
Enfield CCG will host
2 similar engagement
events per annum
organised by mental
health user
organisations. One in
March 2016 and the
following on 10th
October 2016 which
is World Mental
Health Day.
Report will be shared
with CCG on final
validation by EMU at
their evening event
on 06/10/15.
9 Patient and Patient and Public About 30 local newspaper Focussed on Commissioning Intentions
CAMHS:
69
September
2015
Public
Corporate
engagement
event
in Enfield attendees advertising; Twitter
(@EnfieldCCG),
stakeholder list,
emailed to: patient
participation
groups, voluntary
and community
stakeholder
database; member
practices bulletins
i.e. CAMHS; Urgent Care; Medicines Management- particularly prescribing of antibiotics and gluten free products
Comments received
will support the
development of the
CAMHS
Transformation Plan
Medicine
Management
Develop and
implement a
consistent approach
for the prescribing of
antibiotics with public
health and local
providers
Monitor the quantity
of items dispensed
with the help of
pharmacies to reduce
wastage
Review Enfield’s local
gluten-free policy
Urgent care
Incorporate feedback
into the North Central
London (NCL) NHS
111 and GP Out-of-
70
hours engagement
programme.
Discuss the themes
at the NCL Urgent
Care Programme
Board
11
September
2015
Neuro
Navigator
Engagement
Event
Professionals, GPs,
patients, carers,
social care,
voluntary 3rd sector
commissioning
About 30
attendees
stakeholder list,
emailed to: patient
participation
groups, voluntary
and community
stakeholder
database; member
practices bulletins
Focus on the new role within Enfield for a neuro-navigator. How this role will help co-ordinate support for patients across the pathway from hospital to rehabilitation and into the community. Input from patients, carers and health and social care professionals into the design of this role. Acknowledging what currently works well, and what needs to be improved upon.
Feedback currently
being collated by the
Royal Free at
Edgware
14
September
2015
Health & Well-
Being Board
Patient & Public
stakeholders
TBC Poster and
information via GP
PDGs, provider
carer networks and
newsletters, GP
bulletin. Email to
CCG patient reps
Seek views on
development of Health &
Well Being Strategy in
Enfield
Attendees requested
(Frequency Bi-
Monthly)
71
and local tertiary
providers and local
patient events
where possible
24
September
and 25
September
15
Joint Health
Overview &
Scrutiny
Committee
Patient & Public
stakeholders
Not noted CCG/ LBE and
Stakeholder’s email
and internal
Bulletins
To review and scrutinise
CCG strategic and
operational plans and
contract delivery Inc. NHS
111 and Out of Hours
procurement
Awaiting report to
confirm comments
received
1 October
2015
Attendance at
Age UK Event:
Celebrating
National Older
People’s Day:
Keep Safe,
Keep Well
Public 50+ Age UK responsible
for advertising the
event
Explain what Enfield CCG did; antibiotics usage and medicines management; publicise annual report; cover any issues raised about primary care by attendees
Issues raised were:
Medicines
management
Minor ailment scheme
Choose well
campaign- being
superseded by NHS
England’s Stay well
this winter campaign;
GP access
14
October
2015
Integrating
support for
working aged
adults and
older people
Community service
provider (ECS –
part of BEH MHT)
including nursing
staff and senior
mangers; patients
30 delegates Invitation was sent
via ECCG
To discuss bringing together the thinking about the long term conditions pathways and integrated care in the community; to generate a proper
Feedback about the
workshop was very
positive and the
delegates found it
helpful. The following
key areas identified
72
workshop and carers from
diabetes patient
support group,
patients with COPD
and patients with
heart failure; GP
clinical lead in
cardiology/diabetes,
CCG staff; Enfield
public health and
LBE
discussion over the issues on the integration of models for patients with long term conditions for Enfield; to explore new ways of working with professionals from primary care, community care, secondary care and social care, identify any gaps and any additional resources required and how we are taking this forward
for further work were:
patient information
needs to be more
explicit in terms of
their treatment and
the outcomes;
communication at all
levels; better co-
ordination of care
throughout the patient
pathways; self-
management and
emotional support. In
addition to this, early
identification of
patients at chronic
risk of developing
LTCs in primary care
and shared records
would support the
emerging single
model of care.
15
October
2015
Diabetes
Stakeholder
Group
meeting
Acute providers:
NMUH and RFL;
ECS (part of BEH
MHT); patient rep
from Enfield
Diabetes patient
support group;
Enfield Public
13 attendees To meet at a three
month interval
aiming to offer an
update on where
we are with
diabetes services in
Enfield, what issues
we have and how to
To meet at a three month interval aiming to offer an update on where we are with diabetes services in Enfield, what issues we have and how to work collaboratively to address any issues within the system. Sharing
Good meeting and
meeting notes were
made. The key areas
discussed at the
meeting were: hypo
pathway; update on
the South East
locality diabetes
73
Health work collaboratively
to address any
issues within the
system. Sharing
information and
sharing notes and
promote
partnership working
between providers
and the
commissioner
information and sharing notes and promote partnership working between providers and the commissioner
locally commissioned
service; training and
support to GP
practices on diabetes
education;
diabetes/renal
services. Follow up
meeting was
scheduled for 17th
December 2015.
22
October
2015
JSNA Steering
Group
Patient, CCG, LBE
stakeholders
12 attendees Organised by DPH,
LBE
To review JSNA priorities and development of local priorities in support of LBE JSNA
Ensuring wide
stakeholder
engagement in
development of JSNA
28
October
2015
Speaker at
Enfield
Voluntary
Action AGM
and
Conference
Voluntary and
Community Groups
TBC Organised by EVA Presentation on engagement with Voluntary and Community Stakeholders
Issues raised were:
Dissemination of
issues raised at
Voluntary and
Community
Stakeholder
Reference Group
meetings;
ECCG engagement
log being made
publicly available on
website;
74
Role of Pharmacists
is trying to support
the reduction of
dispensing unneeded
drugs;
Who undertakes
medicines reviews;
Review of
prescription
exemptions for
individuals under 60
with a long term
condition/s who were
prescribed items that
do not relate to their
condition;
engagement with
people with sensory
impairment e.g.
Engagement with
Enfield Vision.
21
November
2015
Carers Rights
Day organised
by the Carers
Centre
Carers, GPs, GP
practices,
community &
Voluntary sector,
Public Stakeholders
? No. of
attendees
Invitation from
Carers Centre
Sitting on an Expert
Panel- Awaiting report
Awaiting report
9
December
Integrated
Care Steering
CCG, Trusts and TBC Organised by Paul To review Integrated Care Strategy priorities review
Continuing to work
towards further
75
2015 Group LBE Stakeholders Allen implementation plan integration
14
December
2015
Peer Support
development
discussion
meeting
Diabetes UK
representative and
patient
representative from
Enfield diabetes
patient support
group
3 attendees Email invitation to
the attendees; it
was organised by
ECCG
An exploratory meeting with diabetes UK with regards to peer support work they have worked on and how Enfield can learn from the good practice and develop a good peer support model for Enfield
The meeting was very
productive. Further
advice will be given to
ECCG at next
meeting re:
community champion
work they have done.
Mentoring support
offers a vital part in
keeping the peer
support work afloat.
Next meeting was
scheduled in January
2016.
17
December
2015
Diabetes
Stakeholder
Group follow
up meeting
Acute providers:
NMUH and RFL;
ECS (part of BEH
MHT); patient rep
from Enfield
Diabetes patient
support group;
Enfield Public
Health
7 attendees Email invitation to
the attendees; it
was organised by
ECCG
Follow up meeting with an update where we are since last meeting in October 2015.
The meeting was
productive. The
following areas were
covered at the
meeting:
Diabetes MDT
proposal to secure
the CEPN funding;
commitment from the
providers to deliver
the diabetes MDT
meetings in terms of
dates for the period
76
between January and
March next year; the
development of peer
support group;
community patient
education and
revised Enfield
patient booklets.
Future meetings to be
set up for 2016.
19
February
2016
Over 50s
Forum Winter
Fair
Enfield Over 50s
Forum members,
stakeholders and
Enfield residents.
Invitation from
Christine
Whetstone, Enfield
Over 50s Forum
Chair
To provide information leaflets on services as well as launch the urgent care review survey.
A large number of
responses to the
Urgent Care review
were received at/as a
result of this meeting.
1 March
2016
PPG Meeting Patient participation
groups
12 Email, online, flyers Healthwatch, Accessible information standards, PPG work plan, locality champions, PPE report.
Members raised the
following:
Report on shortage of
GPs in Enfield; how
the minor ailment
scheme was
functioning;
information on the
consultation on
reduction of funding
for pharmacies as this
could not be found on
NHS England’s
website; concerns
77
regarding building
houses without
schools and
healthcare; would like
to discuss what good
practice could be
shared; could
champions have
access to the emails
of the chairs – it was
noted that consent
was required before
emails could be
shared.
23 March
2016
Patient and
Public
Engagement
Event
Patient and Public
in Enfield
20 Email, online,
flyers, press advert
Achievements since April 2015 and plans for 2016/17. Workshops on Teledermatology, Urgent Care Review, Mental Health, Values and Priorities. Panel questions.
Attendees provided
constructive feedback
during workshop
sessions. Comments
will be used to update
the patient leaflets on
teledermatology,
were taken as part of
the Urgent Care
Review, used to help
promote IAPT and
mental health crisis
as well as to inform
the CCG objectives.
78
Appendix N
Quality and individual participation
Example 1: Quality in the Commissioning Cycle using the CCG Early Warning Process
Outcome
This led to the CCG review of
the CCG’s commissioning
arrangement for this service to
identify were contractual
monitoring needs strengthening
through the use of the national
contract
CCG Objective:
To improve
transparency and
reporting for quality,
safety and patient
experience (including
duty of candour).
Identify gaps is service
provision
(Radiology early warning
alert on delays in receipt of
x-ray results in General
Practice
Intelligence used to escalate
to the trust for further
investigation into turnaround
times.
Decide Priorities & Service
Redesign
Investigation subsequently
prompted a review of
Standard Operating
Procedure for Turnaround of
x-ray results
Monitor & Manage
Performance
Escalated for further
discussion through contract
and assurance that delays
were not adversely
impacting on patient
outcomes management
Identify gaps in
Quality via review of
services.
Data sources –
safety, effectiveness
and patient/staff
feedback
Triangulate both
qualitative and
quantitative to give a
full picture of quality
Timely and accurate
quality data flows
Review provider
performance data
Information sharing
Contract Quality Review
meetings
Escalation and contract
levers for
underperformance
Provider quality visits
Example 2: Complaint Feedback
Enfield CCG Corporate Objective
Maintain and improve the quality of health
services our citizens receive and ensure a strong
focus on quality as services change
Activity
Utilised patient’s complaint feedback to identify early quality and safety issues. Complaint related to: Funding request for children requiring intensive Physiotherapy intervention Whilst investigating the complaint the Head of Children’s Commissioning was informed that there are a number of other children who have similar clinical needs
Outcome
Concerns about funding for additional capacity were subsequently raised with the Director of Quality at ECCG and the Head of QIPP and Service Redesign. It was agreed that the service provider should provide a business case for CCG scrutiny. The business case being prepared by the Trust to request funding to support this client group will inform commissioning intentions.
Quality Objective (Directorate
Objective)
To improve transparency and
reporting for quality, safety and patient
experience (including duty of
candour).
Appendix O
Latest Information:
NHS England CHAT
NHS Enfield CCG - NHS England CHC Survey
NHS Enfield CCG
The survey manager is: Steve Deller
All email notifications are being sent to: [email protected]
Where were you assessed for NHS Continuing Healthcare?
Answer Total
100%
Other
Royal Free London NHS Foundation Trust (Chase Farm 0
Hospital)
Royal Free London NHS Foundation Trust (Barnet Hospital) 0
North Middlesex University Hospital NHS Trust 0
Other 2
If 'other please state below
North London Hospice
Home
1: How would you rate your overall experience of using this service?
Answer Total
50% 50%
Excellent
Very Good
Excellent 1
Very Good 1
Satisfactory 0
Not Satisfactory 0
Please tell us why you feel that way
The overall care and change in my medication and the stress free facilities were a tremendous benefit.
No answer: 1
2: Did you receive a Public Information Leaflet?
Answer Total
50% 50%
Yes
No
Yes 1
No 1
3: Was the Public Information Leaflet explained to you?
Answer Total
100%
No
Yes 0
No 2
4: How satisfied were you with the explanation?
Answer Total
50% 50%
Excellent
Satisf actory
Excellent 1
Very Good 0
Satisfactory 1
Not Satisfactory 0
5: Were you satisfied with your involvement in the process?
Answer Total
50% 50%
Excellent
Satisf actory
Excellent 1
Very Good 0
Satisfactory 1
Not Satisfactory 0
6: Do you understand why the assessment took place and the outcome?
Answer Total
100%
Yes
Yes 2
No 0
If ‘no’ please tell us why you feel that way:
as stated earlier the caring process
I felt the social worker was willing to grant my request which was turned down by C.C.
7: Were you satisfied that you were being listened to and your views were taken into account?
Answer Total
50% 50%
Excellent
Satisf actory
Excellent 1
Very Good 0
Satisfactory 1
Not Satisfactory 0
8: Did you receive all the information you needed?
Answer Total
50% 50%
Strongly Agree
Agree
Strongly Agree 1
Agree 1
Neutral 0
Disagree 0
Strongly Disagree 0
9: How would you rate your overall experience of Continuing Healthcare regarding Communication?
Answer Total
50% 50%
Excellent
Very Good
Excellent 1
Very Good 1
Satisfactory 0
Not Satisfactory 0
10: How would you rate your overall experience of Continuing Healthcare regarding Professionalism?
Answer Total
50% 50%
Excellent
Satisf actory
Excellent 1
Very Good 0
Satisfactory 1
Not Satisfactory 0
11: How would you rate your overall experience of Continuing Healthcare regarding Patient/Relative/Representative involvement?
Answer Total
50% 50%
Excellent
Satisf actory
Excellent 1
Very Good 0
Satisfactory 1
Not Satisfactory 0
Appendix P
INTEGRATED LOCALITY TEAM MDT CARE PLAN
Name DoB
Address
GP
NHS Number
RIO ID
Care First ID
Date of presentation to MDT
Care home resident? Yes No
Care Coordinator
Professionals involvement to date (key summary)
Named accountable GP
Community Matron
Mental Health/IAPT
OT
Physiotherapist
Speech Therapist
Social Worker
Safeguarding
District Nurses
Dietician
Wheelchair service
Macmillan Nurses
Care Agency
Other
I.e. Specialist Nursing
teams
Diabetes
Stroke
ICT/Enablement
Presenting issues
Including medicines, past medical history, limitations to daily activities, cognition tested
Actions and outcomes to be achieved
Outcomes can be across the following domains – health,
mental health, mobility, lifestyle, eating and drinking, personal
care, safety, money, household tasks, housing, relationships,
leisure, communication, other
Domain:
Action:
Outcome to be achieved:
Actions agreed at MDT
Including initial outcomes to be achieved for the patient, guidance on
intervention/deterioration, unmet need to support patient, agreement plan in emergency;
and risk & Safeguarding issues
Actions Who When MDT
Updated
Has consent been given by the patient?
Please circle
Yes No
Date of first review
Date of second review
Appendix Q
NEWS
Monty’s fresh blast for mail-order pharmacy amid problems
A CAMPAIGN group for Enfield’s over-50s says it has been vindicated over concerns about an online mail-order pharmacy after technical problems meant some patients faced uncertainty as to whether they would receive the medication they had ordered over the Christmas and the New Year period.
Dr David Geddes, head of
primary care commissioning for NHS England wrote to GP practices just before Christmas warning that some using Pharmacy2U would be “unlikely” to receive their medicines until January 11. Mr Geddes, who is putting in place arrangements to reduce the risk and inconvenience to patients, said the situation was “unacceptable”.
The Enfield Over 50s
Forum has campaigned against the free digital delivery service provided by Pharmacy2U, whereby those with the authority to prescribe medication, such as GPs and practice nurses, can send prescriptions electronically to any dis- penser the patient chooses.
The forum believes it undermines the role of the
local pharmacist in offering personal help and advice to patients, as well as being ready to deliver medication to the homes of those with mobility issues.
“NHS England should not in my view be offering to help Pharmacy2U ‘rectify the situation’, but should immediately withdraw the company’s NHS recognition which I cannot see has any
positive role within the health economy,” said forum president Monty Meth.
“It has failed to meet the needs of its main target market – the frail, elderly, vulnerable people, many living alone, who may have had some difficulty in get- ting out for their prescription to be dispensed,” he added.
The forum wants Enfield and Southgate MP David
Burrowes and Enfield North MP Joan Ryan to take up what it claims is “outrageous evidence of incompetence” with Health Secretary Jeremy Hunt. A
statement on the Pharmacy2U website apologises and blames the delays on “unforeseen difficulties in transferring to our new automated dispensing centre”.
Top nurse is impressed by ‘excellent’ services
Impressed: Chief nursing officer Jane Cummings speaks to Dr Rupa Gune during her visit to Enfield
By Russ Lawrence
ENGLAND’S top nurse praised a range of co-ordinated services aimed at preventing disabled residents and those with mental health issues from being admitted to hospital or placed in care homes when she visited Enfield yesterday.
Jane Cummings, the country’s chief nursing officer, was glowing in her admiration for the Inte- grated Learning Disabilities Ser- vice, which is run in partnership by Enfield Council and the NHS
through the Enfield Clinical Com- missioning Group.
The service, based in St Andrews Court, in River Front, Enfield Town, was set up in 2008 to support people with learning disabilities, mental health diffi- culties, autism and multiple dis- abilities continue to live independently in the community by using various interventions to keep them out of hospital or in residential care.
They include psychiatry, nurs- ing, psychology, speech and lan- guage therapy, occupational and art therapies, physiotherapy,
employment support, social work and care management.
Interventions aim to avoid admissions to assessment or treat- ment units wherever possible and if an admission is absolutely nec- essary then it is for as short a period as possible.
“The council and its health part- ners are providing excellent ser- vices which recognise the needs of their users,” said Mrs Cum- mings. “It is an example of inte- grated good practice developing services and treatment with the users and their families.”
Alev Cazimoglu, the council’s
cabinet member for adult social care, said that vin the light of the revelations uncovered by Panorama in 2011 of physical and psychological abuse suffered by people with learning disabilities and challenging behaviour at Winterbourne Private Hospital, in Bristol, the council was more determined than ever that “each service user is treated with respect and is supported to achieve all they can”.
“We are very proud of the work this service provides and in the way that it supports people,” she added.
