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Patient and Public Engagement
Annual Report 2014/2015
Name of CCG: Enfield Clinical Commissioning Group
Name of person who completed this report: Laura Andrews, Patient and Public
Engagement Manager
Internal sign off obtained from: Patient and Public Engagement Committee on 3
September 2015. The draft report was then circulated to all Governing Body members
for comments. Approved by Chair of Enfield CCG and the lay Chair of the patient and
Public Engagement Committee. The report will be formally ratified at the Governing
Body meeting on 14 October 2015
Healthwatch statement completed by: Deborah Fowler, Chair, Healthwatch Enfield
Date submitted to regional team:
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Contents Introduction ............................................................................................................................................ 2
SECTION ONE - Context Setting ...................................................................................................... 2
Vision for Engagement .................................................................................................................... 5
Structure and Resources ................................................................................................................ 7
SECTION TWO: Developing the Infrastructure for Engagement and Participation ................. 10
Processes ........................................................................................................................................ 10
Networks .......................................................................................................................................... 13
Structures ........................................................................................................................................ 14
Partnerships .................................................................................................................................... 15
SECTION THREE- Engagement and Participation Activity......................................................... 16
SECTION FOUR- (Meeting the Individual Participation Duty) .................................................... 19
SECTION FIVE- Forward Plans for 2015-16 ................................................................................. 22
SECTION SIX - Healthwatch Statement ........................................................................................ 24
Appendix A: Commissioning Cycle.................................................................................................. 26
The Engagement Cycle ..................................................................................................................... 26
Appendix B: Quality and individual participation ............................................................................. 0
Appendix C: PPG training ................................................................................................................... 0
Appendix D: Engagement log ............................................................................................................. 0
Appendix E – Collective and Individual Participation duty activities 2014/15 ........................... 13
2
Introduction
We are pleased to present our second Annual Patient and Public Engagement
Report. This report describes how we discharged our statutory responsibilities for
patient and public participation as described in the Health and Social Care Act 2012
during the period 1 April 2014-31 March 2015.
SECTION ONE - Context Setting
About Enfield Clinical Commissioning Group
Enfield Clinical Commissioning Group (CCG) is a clinically-led organisation and all 49 GP practices in the London Borough of Enfield are members of the CCG. Our GP member practices have signed up to a Constitution which sets out the governance of the organisation and explains how all the practices collectively work together for their patients to buy the best quality health services. The CCG commissions most health services that GPs refer on to including hospital, community and mental health services. GP practices in Enfield also work closely together in four localities and each geographical area elects two GPs onto our Governing Body. The Governing Body is the executive team that leads our organisation and develops the strategies that will deliver our vision and corporate objectives. The elected GPs lead a Governing Body that includes NHS managers, a secondary care doctor, a nursing representative, lay members, other clinicians, a practice manager, partner organisations and patients. Our organisation serves a London borough that has a growing and changing population and diverse health needs. In this section we would like to introduce you to our borough and the local population that we commission services for. Enfield CCG is coterminous with Enfield Council. We commission health services for more than 326,000 residents in Enfield and we have three main local providers:
Barnet, Enfield and Haringey Mental Health Trust (including Enfield Community services). We are lead commissioner for this Trust.
The Royal Free London Hospitals NHS Foundation Trust (on 1 July 2014 Barnet and Chase Farm Hospitals became part of the Royal Free London NHS Foundation Trust). We are the lead commissioner for the Chase Farm site.
North Middlesex University Hospital NHS Trust. Following the merger of Barnet and Chase Farm Hospitals with the Royal Free London Hospitals NHS Foundation Trust on 1 July 2014 and following the implementation of the Barnet, Enfield and Haringey Clinical Strategy in December 2013, we now commission the majority of hospital services from the North Middlesex Hospital.
We also hold NHS contracts with a range of other acute, community and mental health providers ensuring that a wide range of services are available to support the needs of our diverse population and to support the delivery of choice under the individual patient participation duty.
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We work closely with NHS England who in 2014/15 were the lead commissioners of primary care services. CCGs have an important role under the Health and Social Care Act in helping NHS England to improve the quality of local primary care services. During 2014/15, Enfield CCG, in partnership with the other CCGs in North Central London, applied to NHS England for level 3 primary care co-commissioning responsibilities. This means that later in 2015 we will start to have more influence over the development of primary care in Enfield and can build further on the legacy of the NCL primary care strategy, which was a three year investment programme that ended in March 2015. Although we won’t have the contractual or financial control over the development of new primary services or be involved in performance management, level 3 co-commissioning will allow us greater control in primary care decision making, in particular, strengthening our role in improving quality. Patients and stakeholders tell us that good access to high quality primary care is a very important issue for local people. As a GP-led organisation, we know the impact that good primary care can have on maintaining and improving people’s health and believe that Enfield CCG taking on co-commissioning responsibilities is a very positive step towards improving local services. We also work closely with other four CCGs in North Central London (Barnet, Camden, Haringey and Islington) to plan and improve services together when there are benefits across a bigger population. This includes this includes delivering stakeholder engagement together where appropriate. This year we have worked on larger scale projects together with other CCGs such as planning to commission an integrated GP OOH/111 service across NCL, and this includes planning communications and engagement activities together. Enfield place Enfield is the most northerly London borough and it’s also one of the largest in terms of size (31 square miles). It’s also the greenest borough in London as two thirds of Enfield is open space or designated green belt land, with a wealth of country and urban parks, farmland and fields. Enfield is often called a borough of two halves, divided by the A10 running north-south and the A406 running east to west. The geographical location of these roads provides the grid to understanding Enfield’s population distribution. Not only do most of the population live to the east of the A10 and south of the A406, but deprivation and health problems are also more concentrated in these areas. Enfield is a borough with a significant level of high deprivation. Enfield has the highest number (23,210) of children living in poverty within London. It is the 14th most deprived of the 32 London boroughs and the 64th most deprived local authority district in England out of 326. 32.8% of children under 16 years live in poverty, ranking 6th worst in London and 10th worst nationally. The three Edmonton wards, in the South East, are all within the most deprived 10% of wards in England, whilst 12 of Enfield’s twenty-one wards are in the most deprived 25% of wards in England. The population is also growing faster in the deprived wards. Overall, the proportion of Enfield’s population who are living within the most deprived 10% of areas throughout the country as a whole has increased from 7.0% to 10.3%.
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Enfield people Enfield is an ethnically diverse borough with over 154 languages spoken in schools and over 60% of the population recorded as being non-white. The current population is 326,700 (ONS mid-year 2014 population estimate). The Office of National Statistics (ONS) predicts the population of Enfield will grow by an average of 1.40% per year, and by 2020 the population will be 355,200 which is 7.15% growth from 331,500 in mid-year 2015. The ONS estimates the growth will become gradually slower towards 2020. In contrast, the Greater London Authority (GLA) estimates lower numbers, but predicts that the population will be gradually rise towards 2020 and the highest rise years of growth will be 2017 and 2018. Enfield’s population is also shifting in terms of age. Ages 55-59 and 85+ are rising the most at an average of 3.79% and 3.73% per annum respectively. 20-24 age-group and 45-49 age-groups are predicted to be shrinking by an average of -0.47% and -0.71% per annum (ONS).The proportion of under 15s (21.2%) is higher than both England (17.7%) and London (19%) averages. Our health and wellbeing challenges Our diverse community faces significant health and wellbeing challenges. These challenges can begin before they are born and they can accumulate throughout their life. We are committed to improving the health and wellbeing of people in Enfield throughout their lives. Some of our main challenges to achieving this are:
• There are differences in life expectancy between different areas of Enfield. In the areas of higher deprivation, men live 8.7 years less, and women live 8.6 years less.
• Enfield has largest number of children in poverty in London and the 3rd highest infant mortality rate in London.
• We have a high number of obese and overweight children. • Our population is growing, placing more demand on local services. • We have an ageing population which will need more support in daily living due to
physical frailty, chronic conditions or multiple impairments and significant support from health and social services.
• There is significant variation in the rates of mortality between wards. The largest numbers of deaths in are due to circulatory (cardiovascular) diseases (32%), cancers (29%) and respiratory diseases (14%).
• The rate of employment in Enfield is 67.0%. This is the eleventh lowest rate in London - well below the London average of 69.5% and the England average of 71.1%. Further detailed information about Enfield and the health needs of our population can be found in the Joint Strategic Needs Assessment (JSNA). Our diverse population with their changing health needs presents us with significant challenges in mass communications and engagement. To overcome the challenges of communicating with such a large audience we work closely with local partners and the voluntary sector to ensure our corporate messages and engagement are disseminated across as many channels as possible. We segment our approach to communications and engagement as described on page 13 of our Communications and Engagement Strategy. We have also mapped our stakeholders as an organisation (p12 of our Communications and Engagement Strategy).
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We also take a bespoke approach to communications and engagement planning for programmes of work that focus on improving service, mapping stakeholders and developing activities that match the needs of each project. This ensures we get patient groups and representatives of those health conditions involved in shaping our plans. Going forwards we promise to continue to develop more creative and innovative engagement approaches to get everyone in our community more involved in the CCG.
Vision for Engagement
Enfield CCG continues to work closely with local people to ensure that health
services in Enfield are high quality, good value for money and meet the needs of
people living in our borough. Although our strategic plans for improving health
services will always be based primarily on the health needs of our population, NHS
priorities and clinical evidence, we want patients and stakeholders to become more
involved individually and collectively in helping us to commission local NHS services.
We believe that empowering patients to understand more about their NHS and
increasing patient involvement in designing the health services they use will lead to
better health outcomes for our local population. We also want people to make
positive and informed choices about their health and enable them to select
appropriate services aligned to their needs.
We are also committed to working with our partners to create a sustainable health
economy in which people feel empowered to influence the health and wellbeing of
their community and demand high standards of care with a focus on quality and
safety.
We have listened to what local people, clinical colleagues, partners and other stakeholders have told us about the aspirations of our community and our member practices in developing our corporate vision. “We are committed to commissioning services that improve the health and wellbeing
of the residents of Enfield borough through securing of sustainable whole systems
care.”
Enfield CCG recognises that engagement is one of the key enablers to deliver this vision and states: We will do this by:
Working in partnership with individuals and patient groups to ensure they are central to our work.
Ensuring we work in an open and transparent way with our public and all partners.
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The Communications and Engagement Team plays a strategic role in helping to
ensure our organisation delivers high quality communications and embeds
engagement across all our work.
We know that to achieve the very best health for local people, we need to listen, understand and hear what they are saying about their needs and their current experience of local services and reflect that feedback in all that we do to improve services. We also want to ensure that the services we commission are fair, equitable and do not disadvantage particular communities or groups. Our vision for engagement describes the principles of how we will deliver the
statutory collective and individual participation duties in the Health and Social Care
Act 2012.
“We are committed to delivering the highest standards of communications and
engagement and putting the patient voice at the centre of our organisation.
At every stage of our commissioning cycle we will work to ensure that the services
we plan, buy and monitor are all coordinated and tailored to the individual needs and
preferences of patients, their families and carers - delivering a patient centred NHS.
We are committed to an open and active dialogue with our community. We will
always be honest about the challenges we face and ask patients, partners and our
stakeholders to help us find the best way to improve local health services and get
better value for money.
We aspire to develop more creative and innovative methods of engagement to get
our whole community involved in the NHS and improving their health and wellbeing.”
Appendix A shows how we embed our participation duties in our commissioning
cycle. An example of how we have delivered this vision of a patient centred NHS this
year is through our Integrated Care Strategy. A case study for this piece of
engagement can be found in section three.
Details of key outcomes are given in Section 2, Individual Participation, Section 3
Engagement and Participation Activity and Appendices D- Engagement log and E-
Collective and Individual Participation duty activities 2014/15.
We also use The Consultation’s Institute’s definition of consultation to define the
principles of how we will deliver our statutory requirements to consult under the
Health and Social Care Act 2012.
“Consultation is the dynamic process of dialogue between individuals or groups,
based upon a genuine exchange of views with the objective of influencing decisions,
policies or programmes of action.”
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Structure and Resources
During the year 2013/2014 Enfield CCG directly employed an in-house
communications and engagement team of three, all of whom work full time. This
Team provides comprehensive in-house internal and external communications and
engagement services for Enfield CCG as well as strategic and professional advice to
the organisation on communications, engagement, media, reputation management
and public affairs.
The Head of Communications and Engagement reports to the Director of Quality and
Integrated Governance, whose portfolio also includes: quality, governance,
safeguarding and patient experience. Our team works to the principles described on
pages 10-11 of our Communications and Engagement Strategy.
During this year, along with 12 other CCGs in north and east London, we also
purchased some communications support from North and East London
Commissioning Support Unit (NEL CSU) via a service level agreement (SLA) which
dated from April 2013. The service lines purchased during this year were:
Freedom of Information (FOI) service - This service line manages all FOI
requests. Enfield CCG’s Communications Manager operationally manages
this service line, giving final operational approval and tracking performance.
Media and reputation management - This service line provided a press office
function. Enfield CCG’s Communications Manager operationally manages this
service line, giving final operational approval and tracking performance.
Public Affairs This service line manages MP correspondence (non-
complaints) as well as the Joint Strategic Health Overview and Scrutiny
Committee (JHOSC) in North Central London on behalf of Barnet, Enfield and
Haringey CCGs. There was some resource in 2014/15 for consultation, which
was not required. Enfield CCG’s Patient and Public Engagement Manager
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operationally manages this service line, giving final operational approval and
tracking performance.
Strategic Communications - This service provided additional support for
communications across organisations such as the Barnet, Enfield and
Haringey Clinical Strategy. The Head of Communications and Engagement
operationally managed this service line.
Web and Marketing - This service provides the web technical and hosting of
the CCG’s website and intranet. There is also a marketing team which Enfield
used to plan and deliver a Choose Well campaign and App in partnership with
Barnet and Haringey CCGs. The Communications Manager operationally
manages this service line.
During this year, there was an opportunity for Enfield CCG to review the SLA with
the CSU. Following the review of the SLA, the following service lines were
decommissioned: public affairs, media management, strategic communications,
marketing, and media and reputation management. Operationally, most parts of the
standard operating procedures for these services were already being delivered in-
house. These services were transferred back to Enfield CCG on 1 January 2015.
Enfield CCG decided to renegotiate a smaller bespoke support service from NEL
CSU which delivered the following services to the end of last financial year:
FOI, which formed part of the CSU’s new core offer
Web technical support and hosting of the CCG’s website as this offers value
for money and a service that cannot be delivered in-house.
JHOSC support in recognition of the fact that this committee reviews work
programmes undertaken by one or more CCGs and therefore is best
delivered at scale.
Out-of-Hours media support – This was purchased as a time limited contract
while the services transferred back in-house bedded-in. Going forwards our
team will manage this service alongside the in-hours media function.
Additional services purchased from NEL CSU with SLAs
Equality and Diversity service – This was originally commissioned as a
specialist service line from communications and engagement and remains a
separate contract. This service provides specialist knowledge and operational
capacity that is unavailable in-house. This service was therefore
recommissioned in 2014/15.
In March 2015, an SLA was set up with NEL CSU to deliver communications
and engagement on proposals to commission a joint GP Out-of-Hours and
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NHS 111 service when the current contracts come to an end. This programme
of work is led strategically by Enfield CCG who commissioned the
communications and engagement piece for the CCGs across NCL. This
additional SLA recognises how important it is to resource the communications
and engagement function to support large programmes of strategic change. It
also demonstrates the importance of consistent communications and
engagement planned activities across the North Central London.
The decision to decommission the majority of the CSU’s communications services
has released some funding that was planned to be used to recruit a band 4
Communications and Engagement Assistant that can help with routine administrative
tasks, events and basic online content uploading. This will improve the capacity of
the team to deliver communications and engagement activities and to undertake
more innovative and strategic work. The recruitment for this post began in the
financial year 2015/16 with the hope that it will be filled by the end of summer 2015.
The decommissioning of the CSU does not translate to any non-pay budget being
transferred back to Enfield CCG. The communications and engagement activities
that are delivered annually in line with constitutional requirements (three GP
membership and three Patient and Public Engagement events) are funded via a
central corporate budget. Bespoke communications and engagement activities that
support commissioning programmes or projects are funded by the commissioner for
that area through a budget line approved in the Project Management Office (PMO).
This year, the team was supported by a small budget of £10,000 which was originally
given to CCG’s by NHS England in March 2014 to support engagement activities.
This money was invested broadly across a number of areas to support
communications and engagement. This included:
Sponsoring National Association of Patient Participation (N.A.P.P.)
membership for every Patient Participation Group (PPG) in Enfield that
wanted to join. N.A.P.P. membership and the resources it provides will
support the ongoing development of individual PPGs and the network.
Training sessions for PPG representatives including: developing aims,
objectives, vision and mission statements, governance and minute taking. The
training was selected by patients and well received. It has supported the
development of their PPGs and learning has been shared across the network.
Appendix C shows how the PPGs used the developed their own aims,
objectives, vision and mission and developed a statement of how they want to
work together. The CCG’s approach to encouraging PPGs to develop their
own statement, similar to our own Constitution, was highly acclaimed by PPG
representatives from other areas.
Purchasing equipment to support the team and the delivery of events.
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Funding a corporate patient and public engagement event that met the
individual participation duty by focusing on how we can plan person centre co-
ordinated care.
Specialist training from Enfield Voluntary Action for the Head of
Communications and Engagement focusing on managing volunteers. The
Patient and Public Engagement Manager also attended a course on recruiting
volunteers through social media.
Funding corporate membership of The Consultation Institute. This has given
the CCG access to resources that can support ongoing learning and
development such as webinars, briefings and an online knowledge base. We
also have access to an advice line, which we used once during this year. We
also block purchased training places to support the team’s continuous
professional development (CPD). Courses attended during this year included:
The Law of Consultation and Consultation Essentials. We have more courses
booked for 2015/16 and the Head of Communications and Engagement and
Patient and Public Engagement Manager will achieve a certificate of CPD.
SECTION TWO: Developing the Infrastructure for
Engagement and Participation
Processes
Collective Participation
In our first year as a CCG our first priority was to establish the engagement structures that were laid out in our Constitution. During our time as a shadow organisation, Enfield CCG had adapted the model CCG Constitution to ensure that it reflected the needs of our local population and also our ambitions to be an innovative CCG who is committed to including patients in our membership organisation. Enfield CCG has a particularly democratic constitution in many areas and set up a strong governance process that gave patients a voice in our organisation. Our Patient and Public Engagement Committee was formally established in April 2013 and is one of the five sub-committees of the Governing Body. The PPE Committee meets bi-monthly and has a strategic role in developing patient engagement and participation across the CCG as well as monitoring equality and diversity. The terms of reference for the PPE Committee are available on our website. The PPE Committee is chaired by the Lay Member for PPE and members include two other Governing Body members – the Director of Quality and Integrated Governance and the Practice Manager Governing Body Representative as well as the Head of Communications and Engagement, PPE Manager along with representatives from Public Health, Healthwatch Enfield and during this year, two interim Patient Participation Group representatives.
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During this year the PPE Committee received delegated responsibility from the Governing Body to progress the recruitment process of an elected PPG representative. It also discharged other key functions in line with its terms of reference such as: reviewing work programmes against participation duties, the publishing of Equality Information and advising on key partnership work such as engagement for the Better Care Fund.
During our second year as a CCG we have continued to improve and develop our processes for engagement. We recognise the importance of embedding engagement throughout our organisation’s work and at every stage of the commissioning cycle. This is reflected in our annotated commissioning cycle diagram (Appendix 2) which underpins our planning for our corporate PPE events, which happen three times a year. We use You Said, We Did feedback to show how we have used the comments given at each PPE event to shape our projects and influence our future strategy.
The Communications and Engagement team provides a bespoke service to advise
commissioners on how best to communicate and engage with GP members,
stakeholders and the public on the wide range of issues and improvement
programmes. We have a wide range of operational tools available such as: website,
intranet, Twitter, Smart Survey and stakeholder e-bulletins that can be used to target
audiences with updates about the CCG. We also share updates from our partners
such as NHS England. For larger projects focused on service improvement – such
as our Transformation Programme, the Communications and Engagement Team
work with project leads to develop bespoke communications and engagement plans
using a standard corporate template. This ensures that a stakeholder analysis is
undertaken at the project initiation phase, key messages developed, risks assessed
and activities mapped to ensure delivery of the work programme. Part of this
specialist advice service involves testing the level of engagement needed and
whether a consultation needs to be planned into the project timeline. Advice on
Communications and Engagement at the beginning stages of the project is
complemented by an equality impact assessment (EIA) and Quality Impact
Assessment (QIA). All three documents are reviewed as the projects develop.
This year, some of the examples of how we have met our collective participation duty
include:
Delivering the cycle of corporate events described in our Constitution including: 6 Governing Body meetings in public (one in each locality) and three patient and public engagement (PPE) events.
Targeting hard to reach groups like our Turkish community (Turkish Cypriot Luncheon Club), blind and visually impaired patients (Enfield Vision) and deaf services users (Enfield Deaf Image Group). We visit these groups to talk to them about the CCG, health promotion and find out more about their needs. An example outcome of these meetings is that we developed an audio version of the Choose Well Campaign to support members of Enfield Vision.
Attending community events including: the Enfield Town Show and the Edmonton Festival.
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Providing speakers for partner or voluntary sector events including our Governing Body GPs presenting at the Over 50s Forum winter health fair, Enfield Carers Centre and the Enfield Racial Equality Council.
Planning and delivering joint events with Enfield Council including: engagement on the Better Care Fund and Integrated Care as well as a careers fair with sixth form students focused on jobs in health.
There are many more examples in Appendix D which is our corporate engagement
log.
Individual Participation
The CCG has clear responsibilities in relation to commissioning for quality, informed
by the NHS Constitution (2011):
To ensure that services we commission are safe, effective, provide good
patient experience and continuously improve
To secure health services that are provided in an integrated way, working
in partnership with the Local Authority
To actively seek patient feedback on health services and engage with all
sections of the population with the intention of improving services
As a membership organisation, working with NHS England, support
primary medical and pharmacy services to deliver high quality primary
care
The charts in appendix B describes how we monitor quality and the individual
participation duty delivered through providers during the commissioning cycle.
The key ways we monitor our contracts and services locally across the three quality
domains are:
• Our early warnings system – designed for reporting concerns from our GP members based on feedback from their patients. Our system has been adopted by other CCGs.
• Providers send us patient experience reports that are discussed at the Clinical Quality Review Groups (CQRQ).
• Our patient enquiries service and our communications inbox or telephone numbers, which often receive comments, complaints and concerns.
• Feedback from Healthwatch Enfield • Monitoring Twitter. We have a standard response for complaints or feedback
received. • Collecting feedback directly from patient groups • Monitoring feedback on national websites such as NHS Choices, Patient
Opinion and other public comments • Viewing feedback from patient forums such as the Maternity Services Liaison
Committee (MSLC), the North Middlesex University Hospital Focus Group, Parent and Young People Participation Group.
• Evaluation of services we commission such as the Older People’s Assessment Unit (OPAU) at Chase Farm, falls programme and tele-health
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using semi-structured interviews, surveys or complaints/compliments received.
Key outcomes included:
• Of 38 early warning quality alerts received in 2014/15, 13 (43%) arose directly from patient feedback to the GP. Themes and trends are reported to the CCG Clinical Reference Group and escalated to the Governing Body as necessary through the Quality and Safety Report.
• The views of patients have led to improvements such as: greater GP involvement in the falls programme and the selection of a tele-health provider.
• We met with a relatives and carers group of The Oaks, an adult ward at BEH-MHT which cares for people with mild to moderate dementia, depression and psychotic illnesses, provided additional feedback and insight to support a visit.
• Improved quality of care from individual providers. For example, the Care Home Assessment Team (CHAT) has worked with a number of care homes to improve the standard and quality of nursing care in Enfield
• BEH MHT Care Homes Assessment Team works closely with LBE’s and Enfield CCG’s Safeguarding Teams and Enfield’s safeguarding procedures (which include CQC involvement) to identify and address any provider concerns
• Any quality issues identified or raised during via the quality alerts process go to the quality meeting for the contracts the CCG manages.
• More partnership working with TDA, CQC, and NHS England on quality issues.
Networks
Enfield CCG has an extensive list of stakeholders and takes a proactive approach to
networking.
We run three corporate PPE events around our commissioning cycle. These events
are open to the all our stakeholders and members of the public. The events are
accessible to everyone – and we are pleased to provide BSL translators at these
events for our deaf community who regularly attend as well as accommodating any
other needs as requested. The objective of these events is gathering feedback on
our commissioning plans and supporting quality improvements. A report is prepared
after every event and attendees become part our stakeholder network, receiving
email updates. Based on feedback we have received from patients, these events are
now clinician led and group work focused. Outcomes from these events have
included: patient feedback on our Procedures of Limited Clinical Effectiveness Policy
and on the quality outcomes we should focus on.
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We work closely with patient groups and networks around service improvements.
This involves a range of activities including: patients attending focus groups or
steering groups as expert patients. It also provides patient experience data gathered
through these methods or surveys that can be used to support service
improvements. Example outcomes from such activities included: patient involvement
in our Patient Experience Tracker project which has provided GP member practices
with a tablet device and the opportunity to gather live patient experience data.
We host a network for our GP member practices’ Patient and Participation Groups
(PPGs). During this year the group was jointly chaired by the interim PPG
representatives. The group sets their own agendas. Action notes are taken by CCG
staff and circulated to network members. The PPG network reports in to the PPE
Committee and up to the Governing Body. Outcomes have included: PPGs getting
involved in promoting Choose Well and European Antibiotic Awareness Day as well
as sharing best practice. The network also advised the CCG on the recruitment of
the elected PPG representative.
Structures
Enfield CCG takes a proactive approach to engagement, building it in to all of our
work. The Communications and Engagement team ensure that structures are in
place to support engagement work and that activities are planned, monitored and
outcomes reported. Examples of this approach include:
The Communications and Engagement team support the bi-monthly Governing Body
meetings which are attended by a number of members of the public. Written
questions can be submitted in advance and the Communications and Engagement
team supports the delivery of written answers to any questions asked, as well as
hosting a tea and coffee session with patients before the meeting. The Governing
Body meetings are an important way for the public to be kept up-to-date on the work
of the CCG and the organisation welcomes participation in these meetings.
We hold an Annual General Meeting (AGM) as required by our Constitution at which
we present our Annual Report and Accounts. Our Constitution requires that we have
attendance from our GP membership to approve the Annual Report and Accounts
and we also advertise the event to the public and send invitations to our
stakeholders. Last year we developed a plain English summary Annual Report and
Accounts for stakeholders which received very positive feedback and will produce
the same type of document for discussion this year. The format for our AGM is
presentation led, but in our first year we had a vibrant questions and answers
session on our challenges and future plans.
The CCG also held many other patient events during 2014/15 which focused on
particular projects or key work programmes including integrated care and service
redesign. These workshop style meetings enabled patients to hear about proposals
at an early stage and commenting on the plans. They also offered an opportunity for
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expert patients to become more involved in long-term projects and taking the plans
forward by sitting on steering groups and taking on an advisory role.
Patients and Healthwatch Enfield were also involved in commenting on key
publications including: the Equality Information and our summary Annual Report and
Accounts and patient questionnaires for the Community Services improvement
programme. The CCG is committed to being open and transparent about our plans
and we believe that seeking patient feedback on how we can best have an open
dialogue with our community will enhance our engagement.
The Communications and Engagement team works with commissioners and project
managers to design bespoke programmes of communications and engagement
using a corporate template. This ensures that projects utilise the existing
engagement structures such as weekly e-newsletters to GP member practices, the
website, intranet and Twitter. It also ensures that managers understand that activities
and outcomes must be recorded to enable reporting up to the PPE Committee.
Our website, intranet and Twitter are a key communications channels. We have over
2,000 followers on Twitter since starting our account on 1 April 2013. Our followers
include key stakeholders such as providers, partners, local MPs, Councils and
voluntary sector partners as well as members of the public. We use Twitter to
promote our organisation but we also retweet other organisations when they have
news, healthy lifestyle information or campaigns that we feel would benefit our
patients. We regularly review our website and intranet statistics for trends. We use e-
communications channels to have an active dialogue with harder-to-reach
communities such as the young and working adults. For example, the Patient
Experience Tracker project which purchased tablets for practices allows people to
complete a questionnaire giving real-time feedback on patient experience. We also
use Smart Survey to create online surveys and are planning to expand the use of
this as other features are added to this product in 2015/16.
Partnerships
Locally we have a very vibrant and engaged population and we are very committed
to hearing people’s views on the NHS and how we can improve it. At Enfield CCG
we believe we have built strong partnerships with our local stakeholders as
evidenced by our 360 stakeholder survey results for 2014 commissioned by NHS
England. We have developed an action plan so that we can respond proactively to
the comments in the report.
We work very closely with key partners including Enfield Council and local NHS
providers to improve local health and social care services and to ensure the long-
term sustainability of our health economy. This year we have worked with Enfield
Council on the Better Care Fund engagement. We have also worked closely with
Enfield Council on the Joint Health and Wellbeing Strategy, Joint Strategic Needs
Assessment and delivering our joint plans for integrated care.
16
We have also worked in closer partnership with other CCGs in North Central London
to develop our strategic plans for transformation, planning improvements to services
together when there are benefits across a bigger population. We have taken key
steps towards co-commissioning primary care with the other CCGs in partnership
with NHS England which will be further developed during 2015/16. An example of
this partnership engagement work across NCL is the joint commissioning plans for
GP OOH/NHS 111 under which a patient reference group has been set up.
SECTION THREE- Engagement and Participation Activity Enfield CCG regularly undertakes activities to meet the collective engagement duty.
This duty places a requirement on CCGs to ensure public involvement and
consultation in commissioning processes and decisions. It includes involvement of
the public, patients and carers in:
planning of commissioning arrangements which might include consideration of
allocation of resources needs assessments and service specifications.
proposed changes to services which may impact on patients.
In this section, we will focus on examples that show how we have approached
delivering the collective duty across a number of key areas.
During 2014/15 we began engagement on three major contracts that the CCG plans to procure – community services, musculoskeletal services and NHS 111 and GP Out of Hours Services. Enfield CCG works in line with our local Procurement Policy, which requires patient involvement and also uses specialist support from the procurement team at North and East London Commissioning Support Unit (NEL CSU). Improving Community Services Objective: Our current provider is BEH-MHT. We engaged on moving towards procuring a contract that is delivered around populations – not traditional service lines. This means that community services can focus on delivering outcomes based care for both episodic and long-term conditions. Activity: We worked up proposals for an outcomes based commissioning approach in partnership with Healthwatch. We developed a patient questionnaire to benchmark experience of current services and also to explain how we think services could be better delivered around population groups in the future. Who was involved? We distributed questionnaires to the public at corporate events, community events and promoted it through our website and Twitter. The questionnaire was designed to be answered by patients who have been receiving long-term care from community services, or episodic care. Outcomes and impact: Patients widely supported our approach to segmenting population groups. We will use the outcomes from this survey to further develop our
17
commissioning plans moving forwards, influencing our strategy and commissioning intentions for this important service. In the meantime, we have invested more in community services to reflect some of the survey feedback. More information about this engagement work can be found on our website. NHS 111 and GP Out-of-Hours (GP OOH) services Objective: Currently, the five CCGs have a single 111 provider –London Central & West Unscheduled Care Collaborative (LCW) and two GP OOH providers: Barndoc for Barnet, Enfield and Haringey and Care UK for Camden and Islington. The five CCGs plan to commission an integrated NHS 111 and GP OOH service in the future. Enfield CCG is the lead organisation for this piece of work across North Central London. Activity: Together the five CCGs have delivered a mixture of local events and collective public engagement such as questionnaires. Outcomes: A five borough patient reference group, including Healthwatch and campaign groups started meeting in March 2015. More information about this engagement work can be found on our website.
Service planning, design, redesign and decommissioning
Patient involvement is an important part of our service redesign programme. We routinely involve patients throughout the commissioning cycle and have patient representation on projects where possible.
Examples in 2014/15 include:
Integrated Care for Older People
Objective: Planning a new Integrated Care System for older people with Enfield
Council. Maintaining independence and self-direction is a key element of the
integrated care programme and was the focus of the last PPE’s event presentation
about the integrated care network.
Activity: The CCG has been working closely with stakeholders on developing the
plans and organised a public event in March 2015. Enfield CCG and Enfield Council
hosted this event which was about updating patients on their plans and engaging
them on how we could develop better services. This event was also supported by
updates on the development of integrated care at our Patient and Public
Engagement Events in 2014/15. We have used public events to talk to patients
about integrated care, but we also have a regular dialogue with user groups and the
voluntary sector which has helped us to understand the needs and aspirations of
older people.
18
Outcomes: In December 2013, the Older People’s Assessment Unit at Chase Farm Hospital
opened in line with the Barnet, Enfield and Haringey Clinical Strategy to support
older people with their urgent care needs. We receive excellent feedback from
patients who have used the unit. Following patient feedback a new community
transport service was commissioned to help older patients get to the popular Older
People’s Assessment Unit at Chase Farm Hospital
Ensuring a truly person-centred approach in which patients had choice and control is a key element of the integrated care programme and ongoing patient engagement helps us to continue to develop these values. Patients have told us what good services would look like in terms of outcomes.
Improving Respiratory Services Objective: Improving rapid access for patients with respiratory problems in the community. Activity: We held co-design meetings with patients and local groups such as Breathe Easy Enfield to find out more about patients’ needs. We also worked with Enfield Community Services as the current service provider to build a complete picture of the current pathways and patient experience. Outcomes: Patients helped us to understand what they would need from a rapid access service and the outcomes they would like. A new direct access telephone service was commissioned that helps patients who are having breathing problems access care fast, supporting them to manage their condition at home, improving their wellbeing and confidence in managing their condition.
Commissioning Intentions
Objective: We have a statutory responsibility to engage with patients about our commissioning responsibilities and we want patients to work with us on our ambitions to design services around them and their health needs. Activity: We worked with our stakeholders to develop and explain our commissioning intentions at: Patient and Public Engagement events – example agenda, The Health and Wellbeing Board, Governing Body meetings. Key outcomes: Feedback from these events helped us to better understand the aspirations of our community for their health and wellbeing and how they would like local health services to be delivered in the future. Patients helped us to shape and develop our Commissioning Intentions. Improving our Patient and Public Engagement Events
Objective: We hold three patient and public engagement events a year in line with our Constitution.
19
Activity: We hold these events in a central location. We advertise the events publically and we send invitations out to our stakeholder lists including: voluntary sector groups, patient groups, providers, Healthwatch Enfield, partners and members of the public who have signed up for email updates. Outcomes: This year we changed the format of these events. In our first year, our events always had presentations on the CCG and the new NHS. Based on stakeholder feedback and now that there is a better understanding of the new system and responsibilities, we now make sure that our PPE events are clinically-led and focus on group work. Our GP Governing Body members each have a portfolio as a clinical commissioner and they update the Governing Body on progress in these areas, as well as leading discussions on their area at public events. We have responded to feedback that our Commissioning Intentions and other documents should be written in plain English. We also now explain to our stakeholders where commissioning intentions fit with national priorities – e.g. we focused part of a PPE Event and had other meetings with patients about the Five Year Forward View and our five year plan. We also clearly explain when we are developing intentions with other partners or boroughs, such as the Better Care Fund plans with Enfield Council or our NCL commissioning plans.
SECTION FOUR- (Meeting the Individual Participation Duty) This duty requires CCGs to ensure they commission services which promote the
involvement of patients across the full spectrum of services. This duty requires
collaboration between patients, carers and professionals, recognising the expertise
and contribution made by all.
Enfield CCG is committed to redesigning and commissioning services that enable
patients to take control of their health through individual participation in their care
planning. Enfield CCG wants to put patients in control of their health and support
them to achieve outcomes that improve their wellbeing. This section provides some
examples of how we met the individual participation duty this year.
Developing outcomes based commissioning for a new musculoskeletal
(MSK)service
Objective: There is a wide range of pathways for MSK and entry points into the
system. Enfield CCG has ambitions to move to a lead provider model to encourage
services to work closer together. Self-management tools will also play a much bigger
role in the new pathways with an expert patient programme planned to promote self-
care and pain management.
Activities: We have worked with clinicians and patients to map current pathways
and understand their individual journey and experiences through them. We used
interviews and questionnaires to collect this information. Later in the project we used
20
a patient focus group to review the anonymous patient data and help us work up
outcomes that will enable better individual participation in care planning.
Outcomes: New patient centred outcomes have been developed through
engagement. We have now have five outcomes that we believe can represent
people’s individual goals for recovery and we want patients to feel empowered by
working in partnership with clinicians to deliver better health and wellbeing for
themselves. We believe this will deliver better quality services for patients requiring
episodic or long-term care.
The ability of patients to manage their conditions, including our expert patients
programme participants, will be monitored by a patient questionnaire. Patient
satisfaction with the new system will be measured by a patient and carers
satisfaction survey.
Enabling Continuing Healthcare patients to manage their personal health
budget
Objective: Helping patients who receive Continuing Healthcare (CHC) funding to
understand their rights to a personal health budget and to provide them with support
if they would like to manage it.
Activity: Since 1st April 2014 every individual eligible for CHC funding who lives in
the community are informed by letter of their right to have a personal health budget.
An indicative budget assessment is undertaken for all Individuals who request a
personal health budget. My Support Broker has been commissioned to work with
individual/family/carers and works in conjunction with them to understand their needs
and complete a support plan. Once all parties agree support plan is signed off by the
CCG’s CHC team and monies are released. The patient’s support plan is reviewed
after three months and then annually or if needs change as in line with the CHC
framework.
Key outcomes: The support plans are shaped and owned by the individual CHC
patient. All parties were signed up to the support plan. Each patient is supported in a
manner that meets their needs and enables them to take full responsibility for their
own care management. We believe that this has improved individual participation for
patients and their experience of receiving NHS CHC.
Working with providers to deliver individual participation
Objective: We work with providers using the levers provided by the standard NHS
Contract and other local quality indicators to continuously improve patient
experience.
Activity: We undertake a wide range of activities both through contract management
and through governance as well as quality and safety measures to regularly monitor
21
provider data. We have a positive dialogue with providers about continuously
improving quality but we also vigorously challenge when we believe services could
be improved. Our regular activities with providers are
Key outcomes: An example of this work is improving the quality of care from
individual providers. For example, our local Care Home Assessment Team (CHAT)
team has worked directly with a number of care homes to improve the standard and
quality of nursing care in Enfield.
Meeting the collective and individual participation duties: Recruiting an
elected Patient Participation Group Representative to our Governing Body
When our GPs designed our Constitution they were embedded the values of patient
and public engagement in the governance of our organisation by extending the
concept of membership from local GP practices to the member Patient Participation
Groups. Clause 21.2 of our Constitution formally extends the concept of membership
to our member practices’ Patient Participation Group and allows us to co-opt an
elected PPG member to our Governing Body.
By June 2014 all our member practices had PPGs. Practice Managers were
supported by our GB Practice Managers lead and were given a toolkit to help setup
and manage the group. During 2013/14 we recruited two interim PPG
representatives through an advert and interview process. The successful candidates
signed a one year voluntary contract and sat on the CCG’s Governing Body and
PPE Committee as well as helping us to start up our PPG network.
Our PPG network met quarterly during 2014/15. Chairs, members and practice
managers and staff that support PPGs all attend this meeting. The network was
supported by NHS England engagement funding in its first year and money has been
spent on training for PPGs including: developing mission, vision, aims and objectives
and developing governing documents as well as sponsored membership of the
National Association of Patient Participation.
During the year the PPG network shared good practice and strengthened their
working relationships with each other and their practices. Guest speakers presented
to the networks on topics of interest such as: primary care estates and Care.data. A
short verbal update on PPG network development was a standing item at both the
Governing Body and PPE Committees throughout this year.
During 2014/15 the PPE Committee planned for the recruitment of the elected PPG
Body representative. The Committee reviewed and updated the process used for
advertisement and selection of the interim PPG representatives. This included
revising the role description and voluntary agreement based on the learning of the
interim representatives as well as updating the recruitment pack. It was agreed that
the recruitment process should be an application form and interview before the
22
candidate was put forward for election. The PPE Committee also discussed a
proposed voting process for the PPGs.
The PPE Committee received delegated responsibility from the Governing Body in
November 2014 to proceed with the election. It was agreed by the PPE Committee
that the Electoral Reform Services would manage the process independently from
Enfield CCG, in line with other elected Governing Body posts. The election
recruitment pack, role descriptions and voluntary descriptions were all discussed
with the PPG network who were able to amend the documents and comment on the
process. The PPG network agreed that each PPG should get one vote and that
groups would meet to agree which candidate to vote for. The election process was
an online, first past the post system. Provision was made for postal votes if the
person asked to vote on behalf of their PPG did not have an email address.
Two candidates came forward for election from two different localities. Having
successfully completed the application process, each candidate was invited for
interview. The CCG invited two PPG representatives from other London boroughs to
sit on interview panel. The patient representatives gave an independent view to
Enfield CCG about the role. Following the interviews, both candidates were put
forward for election.
The majority of PPGs in Enfield took part in the election process and Electoral
Reform Services confirmed the appointment of Litsa Worrall. Litsa took up her new
role as elected PPG representative in May 2015. The role is three year appointment
in line with other elected Governing Body positions.
More examples of how we met the individual and collective participation duties are
available in appendix E.
SECTION FIVE- Forward Plans for 2015-16
We are proud of what we have achieved in 2014/15, but we are an ambitious and
innovative organisation that always strives to deliver more. Here are some of our
forward plans for 2015/16.
• The CCG plans to support its PPG network to develop further now that the
elected representative is in post. This will include funding four network
meetings a year. We will consider whether training or further support could be
offered again to members of the network in 2015/16.
At the first meeting chaired by the elected representative in May, the PPGs
were encouraged to produce a work plan and choose their own priorities for
the year. This included core work such as sharing best practice and raising
awareness of PPGs but also some further collaboration around: reducing do
23
not attends, promoting public health messages and working with practices on
their falls registers.
The CCG plans to develop a more formal approach to recruiting and
managing volunteers. The Head of Communications and Engagement and the
Patient and Public Engagement Manager are attending specialist courses run
by Enfield Voluntary Action.
The CCG plans to develop a voluntary and community stakeholder reference
group in 2015/16 to provide early support and feedback on the development
of strategic change programmes.
The CCG has invested in corporate membership of the Consultation Institute,
along with buying specialist training courses which will be used to develop
the Communications and Engagement Team and other senior leaders in the
organisation.
Continuing the programme of three PPE events a year to inform and support
engagement on the development of the CCG’s strategy and commissioning
plans.
To continue with targeted engagement on service redesign. Increase patient
involvement with steering groups and procurement.
Developing more You said, We did outcomes from engagement.
Continuing to develop the website and Twitter.
Reviewing the 360 degree survey results, segmenting the responses and
developing a targeted action plan by September 2015 which will be shared
with CCG staff, PPE Committee and Governing Body.
Continuing and developing further GP-led engagement, (as requested by
patients).
We will continue to engage on our Commissioning Intentions and we will
consult on any plans that involve substantial changes to the delivery of
services.
Developing a programme of visits of hard to reach groups. Continuing to
respond to requests for visits to patient groups.
Carry out an annual review of Communications and Engagement Strategy
and work plan by September 2015.
The Communications and Engagement Team will continue encourage all
teams to report engagement activities that they undertake and these are
24
recorded in an engagement log that is regularly viewed by the PPE
Committee.
Operational and strategic support across the organisation will continue to be
provided by a very experienced in-house team of three communications and
engagement professionals. We aim to recruit a Communications and
Engagement Assistant to strengthen the team’s capacity following the
decommissioning of communications services from NEL CSU.
SECTION SIX - Healthwatch Statement
Healthwatch Enfield and Enfield CCG have a strong working relationship that
enhances the work of both organisations in promoting the interests of patients.
Enfield CCG are responsive to formal reports that we submit to them and to
informal issues that we raise with them. We are able to feed in intelligence from
local people to help inform the CCG’s understanding of the services that local
people receive from its providers. Equally, the CCG trusts Healthwatch Enfield
with confidential information, where necessary, for example, having
representation from Healthwatch in North Central London on the NCL Urgent Care
Programme Board.
Enfield CCG has pursued its ambition of having an elected PPG Representative on
its Governing Body and it has been good to see it supporting the development of a
functioning PPG network. Although it is still early days for the PPGs and for the
PPG network, it is an area of activity that has considerable potential.
During the year, Enfield CCG has successfully adapted its set-piece engagement
events in response to feedback, securing better attendances and more meaningful
engagement. In other work, they have now started to show how feedback has
influenced services, for example in the development of a community transport
service for patients of the Older People’s Assessment Units as well as the selection
of a telehealth provider. They also established a Patient and Public
Representation Group to advise on NCL’s re-procurement of Out of Hours and 111
services.
Importantly, Enfield CCG have also begun to develop more of a whole-organisation
approach to engagement, with the PPE Committee now at least made aware of
clinical engagement work led by other parts of the organisation. We hope that this
will develop over time into a role that also seeks assurance on the effectiveness of
all engagement work. This is part of a move towards a more holistic approach to
engagement by the Committee that is very welcome and which also involves a
growing focus on outcomes and impact and will hopefully embrace relevant
aspects of the individual participation duty in due course.
25
We are pleased to see the progress that Enfield CCG has continued to make in its
approach to patient and public engagement in 2014-15. We are confident that
their strong commitment to this work will ensure that it continues to develop and
starts to yield more tangible results over time.
26
Appendix A: Commissioning Cycle
The 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.
Appendix B: Quality and individual participation
Example 1: Quality in the Commissioning Cycle using the CCG Early Warning Process
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
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
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
Quality Objective (Directorate
Objective)
To improve transparency and
reporting for quality, safety and patient
experience (including duty of
candour).
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.
Appendix C: PPG training
Feedback from Patient Participation Group (PPG) training
session: 19 June 2014
Enfield Clinical Commissioning Group (CCG) is committed to supporting the
development of member practices Patient Participation Groups (PPGs). The CCG
has been working with PPGs to develop a network. As part of this work, Enfield CCG
commissioned a training session from Enfield Voluntary Action to support groups to
develop and collaborate for the benefit of patients. The training package that was
selected was “Agreeing Aims, exploring visions and setting objectives”. This training
package was put forward to the meeting of the PPG Chairs and it was agreed that
this was a good choice of training course at their May meeting.
On the 19 June, a small group of PPG representatives from six local practices came
together for the training, which was tailored to meet the needs of PPGs. The PPG
representatives decided that they would like to work together to design a generic set
of aims, visions and objectives to discuss and refine with their PPGs and also to
share with other PPGs that couldn’t make the training session.
What are aims?
The session began with a definition of how to set group aims. Aims help to explain
the overall mission and vision. Usually the aims are a set of statements that define
the detail behind the overall mission and vision of the group.
The group agreed that they would like to work together to design the aims of a PPG.
The group came up with five aims of a PPG:
1. To work with the GP practice and patients to improve patients’ health.
2. To engage and communicate with patients.
3. To help GP practices improve the services that they offer to patients.
4. To empower patients to have a voice.
5. To enable the GP practice to support patients with particular health needs and
outreach to community groups where needed.
Mission statement
A mission statement summarises the purpose of the group. An effective statement
should be able to tell the story of your group and share your ideals in less than 30
seconds.
We looked at the five aims that the group had just developed together. Each
participant was asked to write one word from the aims on a post-it note that was the
most significant to them. The choices were:
1
We used these key words to design our mission statement:
Enfield PPGs empower all patients to have a voice through supporting involvement,
representation and communication with their GP practices and Enfield CCG to
develop and enhance services.
Vision
The group then discussed how we could design a vision for PPGs. A vision should
capture the perfect situation, so should describe what you would achieve if you
deliver your mission and overcome any challenges you may face. You will always
strive to achieve this perfect situation so it can be as powerful and challenging as
you wish to make it.
Our vision:
Through working with patients and the practice team we develop an efficient,
effective and welcoming GP practice where patients become equal partners in their
care.
Values
Values are descriptive statements that emotionally connect with what drives you,
what you believe and what you are prepared not to tolerate. We discussed some
universal values such as honesty, passion and commitment as well as looking at
some examples from the charity sector. We also looked at the NHS Constitution
which describes the principles and values of the NHS, along with the rights and
responsibilities of staff and patients.
We developed our values together:
We believe in mutual respect between patients and the practice team. This
includes a commitment to removing barriers to communication by reducing
and explaining jargon.
We believe in collaboration. Clinicians will enable and educate patients to take
responsibility for their own health by listening and respecting their opinions.
We want a committed, compassionate and caring NHS for staff and patients.
Learning from comments, complaints, concerns and compliments.
The Elevator Pitch
The aim of an elevator pitch is to come up with a short summary statement that you
can use to speak to someone in the time it takes to take a ride in a lift/elevator. Plan
Empower Communication Involvement Voice Support
2
your pitch so you can state clearly what your group does, what the challenges you
are trying to address, what you are aiming to achieve and why the other person
should join or help you. Be persuasive and passionate! Each group came up with an
elevator statement.
Designing outcomes
We went back to our aims and discussed how we could achieve them. We came up
with some activities and outcomes for each aim.
1. Work with the practice to improve patients’ health
Conduct and act upon patient surveys
Work with patient support and community groups
Share good practice throughout the network
2. Engage and communicate with patients
Promote membership of the PPG
Develop patient reference/virtual groups for members who can’t make
face to face meetings and involve them through newsletters, surveys
etc.
Use iPlato (CCG purchased SMS system) to send text messages to
patients
Encourage people from different backgrounds to join the PPG
Provide information in other languages or formats (this could be
enabled through networking)
Develop great networking skills
Advertise PPGs through the Enfield Voluntary Action (EVA) volunteer
centre
Develop links with the voluntary and community sector services
Look into new advertising opportunities – e.g. community centres,
supermarkets, places of worship.
3. Help practices to improve their service
Conduct patient surveys and use the feedback to develop new and
improved services
Collect data on specific health issues to improve services
Collect information on services and patients’ communication needs to
improve accessibility
Support innovation – especially around exploring technology e.g.
patient consultations using Skype and text messaging for appointment
or test result reminders
Use technology to support PPG communications e.g. .e-newsletters,
conference calls, webinars
3
4. To enable patients to have a voice
Work towards the PPG being representative of the practice
demographics
Consider meeting at different times or alternative venues
Promote good practice amongst PPGs – share what works
Use the link with Laura Andrews at the CCG to raise issues that can’t
be dealt with
Use the option of the current interim and later elected PPG
representative on the Governing Body to raise issues and champion
PPGs
Next steps
Participants agreed that this was an enjoyable and productive training session. The
group produced together aims, a mission, vision and values for a PPG. We also
came up with lots of ideas about how we can achieve our aims, including practising
writing an “elevator pitch” that we can use to recruit new members.
The next steps are to share the outcomes of this training session at the next PPG
network meeting in September 2014. At this next meeting, we will also review a list
of other training opportunities that could be funded by the CCG to support the PPG
network development.
Appendix D: Engagement log
Enfield CCG’s Patient and Public Engagement Activity Log 1 April 2014- 31 March 2015
Key:-
ECCG Corporate Patient and Public Engagement Events organised by ECCG Engagement Team
ECCG Engagement Team invited to attend
Patient Participation Group Events organised by ECCG Engagement Team
PPE Engagement Events/meetings organised by ECCG Colleagues
Patient and Public Engagement Activity for year 1 April 2014- 31 March 2015
Date of activity
or dates
activity ran
from and to
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
How were participants
informed (invited, media
release, advertisements,
flyers, online)
Key themes identified/ areas
covered
Number of
attendees /
number of
hits or users
1
3 April 2014 Attending their
Luncheon club in
Edmonton
Enfield Turkish Cypriot
Association
Contacted via e-mail and
telephone
What is the CCG; Enfield and its
health challenges; chose well
campaign; NHS 111- translation
services; hospital bed for home;
PPGs; breast screening; diabetes
35-40
older men &
women-
Turkish is
first language
8 April – 11
June 2014
MSK Patient
Engagement
MSK patients attending
community clinic
appointments (ECS),
acute appointments
(NMUH/BCF) and
attending community
meetings (Over 50’s
forum)
Face to face contact with
project manager. Surveys
conducted at meetings, as
well as distribution of
event flyers for the MSK
patient workshop
Surveys conducted at meetings, as
well as distribution of event flyers for
the MSK patient workshop
8
appointments
attended
16 April 2014 Respiratory Co-
Design meeting
Public, partners and
key stakeholders,
voluntary sector
groups. (Breathe Easy)
patient rep
Email / Telephone Update on the current service
Look into successes and
development needs from a provider’s
perspective
Discuss what could be changed
within the systems
Agree next steps
21
Ongoing
engagement
via website and
Online
engagement
Public, partners and
key stakeholders,
voluntary sector
Website, intranet, twitter Information on Call to Action and Call
to Action London available and linked
to on e-channels; Chose Well
followers:
894 as of
2
twitter groups. Campaign
03/04/14
As part of the
integrated care
programme
(Older People’s
Assessment
Unit)
1. Patient satisfaction questionnaires
Patient care &
engagement as
part of service
evaluation process
Patients over 65s
/carers
At point of service
attendance,
questionnaires were
completed
Feedback on patient centred co-ordinated care was effective
Treated with dignity and respect was acknowledged by 99% of patients
A multi-disciplinary approach to care was identified as been effective and accessible to patients
Time spent in total to be seen or assessed by all staff needed slight improvement
Overall satisfaction with care/ treatment provided was very good
20 May 2014 Patient
Participation
Group Network
meeting
All members of PPGs
in Enfield
Advertised in local papers,
website, twitter; emails to
PPG chairs; summer
events
Welcome and feedback from the last meeting (you said, we did)
Explaining the role of CCGs and the new NHS system
Locality working in Enfield
Group work including your feedback on how we can support you to work
20-25
3
together
An update from NHS England on Care. Data
How PPGs are involved in CQC inspections
Training, future meetings and any other business
5 June Cardiology co-
design follow up
workshop
Public, partners and
key stakeholders,
voluntary sector
groups. (Heart throbs)
patient rep
Email and face to
face/telephone
Map current services; discuss key
issues and what the good looks like
25
10 June Patient and Public
Engagement
Public, partners and
key stakeholders,
voluntary sector
groups.
Advert, Website, intranet,
Corporate Update including 5 year plan
Royal free Acquisition update
Transformation Programme- overview of projects
Commissioning for Quality
Workshop on developing quality Outcome measures
Panel question time
30+
17 June 2014 Attending Enfield
Volunteers
Organisers
Network
Representatives from
voluntary and
community sector
Invited by EVA What was a CCG
New structures in NHS
Enfield and its health priorities
Ways of being involved in the work of Enfield CCG
10
23 June MSK Patient
Engagement
Workshop
MSK patients, carers Website, intranet, 3rd party
organisations, Posters,
Flyers, ECCG visits to
Gather patient opinion on the current
service and the proposed outcome
measures.
11
4
trusts and ECS
01 July 2014 Respiratory Co-
design meeting
Public, partners and
key stakeholders,
voluntary sector
groups. (Breathe Easy)
patient rep
Email, telephone - Review current ‘as is’ system
- Validate work undertaken so far
on respiratory co-design
- Agree what we need to change
- Next steps
15
24 July 2014 Cardiology Co-
design 2nd
workshop
Public, partners and
key stakeholders,
voluntary sector
groups. (Heart throbs)
patient rep
Emails, telephone Second workshop session provided:
- Recap on previous workshop
- Group plenary – What are
they key service changes that
are being proposed?
- Plenary – How should the
service delivery model look in
the new world?
This well attended session helped
identify a raft of
service/commissioning options and
enhanced commissioning dialog
between both, GPs, acute secondary
care consultants, community
services and patients.
27
1 consultant
1 specialist
heart failure
nurse
7 GPs
1 practice
manager
1 voluntary
sector/
patient rep
26 July to 27
July
Edmonton
Summer Festival
held at Pymmes
Public Advertised in local papers,
website, twitter
Met with over 100 local residents and
provided information on :
200+
5
Park Edmonton Choose Well Campaign
NHS 111
Dental out of hours services
Joining PPG
Participating in service
transformation work being carried out
by ECCG
Engagement on Improving
Community Services
13-14
September
2014
Enfield Town
Show
Public Advertised in local papers,
website, twitter
Met with over 300 local residents and
provided information on:
Choose Well Campaign- particularly
services available at Chase Farm
Hospital
NHS 111
Dental out of hours services
Joining PPG
Participating in service
transformation work being carried out
by ECCG
Engagement on Improving MSK
300+
6
Services
26 September
2014
Patient
Participation
Group Network
meeting
All members of PPGs
in Enfield
Advertised in local papers,
website, twitter; emails to
PPG chairs; summer
events
Primary Care estates
PPG Elections
Setting up of PPGs
General networking
Choose Well
25
1 October 2014 Over 50s
International Older
people’s Day
Members of the Over
50s Forum
Advertised by over 50s
Forum
Keeping warm and well
Choose well
PPG participation
Volunteering to support service
changes
100+
6-12 October
2014
Cardiology Patient
Engagement
Cardiac patients Face to face consultation
within trusts Patient opinions on the services within Enfield
Recommendations for improving the service
Future engagement opportunities
38
22 October
2014
Patient and Public
Engagement
Event
Public, partners and
key stakeholders,
voluntary sector
groups.
Advert, Website, intranet,
Vision for Enfield
Annual Report and Accounts
How to provide feedback
Commissioning Intentions
Commissioning for Outcomes
Primary Care including Medicines Management
Urgent Care
30+
7
Integrated care for older people
People with Long Term Conditions
Children and Young People
Mental Health
13 November
2014
Cardiology Patient
Engagement
Cardiac patients,
carers, family members
Organised through ‘Heart
Throbs’ Patient opinions on the services within Enfield
Recommendations for improving the service
Presentation of outline plans for cardiac services
Future engagement opportunities
40
20 November
2014
Clinical Workshop Consultants from main
providers of acute
dermatology and
community services
across North Central
London, GP Clinical
Leads, Commissioning
Leads from all 5 NCL
CCGs, representative
from British Association
of Dermatologists and
Patient Representative
from PPG
Email/Telephone/ via
British Association of
Dermatologists
Provision of dermatology services across NCL (acute, primary care and community)
Proposal to develop consistent clinical model for integrated community provision
Feedback on how best to:
a. Deliver an integrated model and mange rising demand for acute services
b. Deliver better care in primary care for patients
c. Improve knowledge & expertise in primary care
d. Support patients to manage their conditions better
27
8
18 December
2014
Carers Forum Carers This was one of their
regular meetings
What is a clinical commissioning group
Enfield: its health challenges and working together
Choose the right treatment- Choose well Campaign
30
19 December
2014
Patient
Participation
Group Network
meeting
All members of PPGs
in Enfield
Advertised in local papers,
website, twitter; emails to
PPG chairs;
You said we did
PPG Elections update and review
5 Year Forward View
Medicines Management
35
Stakeholder’s Engagement Activity for year 1 April 2014- 31 March 2015
Date of activity
or dates
activity ran
from and to
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
How were participants
informed (invited, media
release, advertisements,
flyers, online)
Key themes identified/ areas
covered
Number of
attendees /
number of
hits or users
15 January
2015
Patient
Participation
Group Network
meeting
All members of PPGs
in Enfield
Advertised in local papers,
website, twitter; emails to
PPG chairs;
PPG Elections Process update
Networking and developing working together
15-20
22 January Heads of Sixth Heads of Sixth Form in Invited to attend this Role of CCG
Enfield and its health challenges
20-25
9
2015 Form meeting Enfield meeting Choose Well
How to become involved
Careers in the NHS
29 January
2015
Patient and Public
Engagement
Event
Public, partners and
key stakeholders,
voluntary sector
groups.
Advert, Website, intranet,
twitter; email to
stakeholder list
5 year Forward View Workshops on:
Primary Care Improvement/CO-Commissioning
NHS 111 and Out of Hours
Mental health
Clinical and Cost Effectiveness
2 February
2015
Enfield Vision
monthly meeting
Enfield Vision members ECCG invited to attend
their monthly meeting
What is a CCG and its role and responsibilities
Enfield and its health challenges
Choose Well Campaign
The Transformation Programme in particular Ophthalmology Services Redesign Project
Information the CCG provides
How GPs access leaflets
How can they get involved
15-20
20 February
2015
Over 50s Forum
Winter fair
Organised by Over 50s
Forum
Used Over 50S newsletter
and media
Choose well Campaign
Cutting the waste of prescription medicines- how can you help
Five year forward View and The Forward View into Action: Planning for 2015/16
Summary of the Annual Report and Accounts 2013/14
Glossary of Terms
Engagement events information for NHS 111/ GP OOHs services
50-60 people
attended the
stall, but
about 200+
people
attended
10
plus FAQs
Keep Warm Keep Well
European Antibiotics Awareness- Get Well Soon without antibiotics
Advanced Care planning and Power of Attorney
Engagement events information for Sharing Health & Care-
Forms for people to volunteer to help with the transformation programme
20 February
2015
Carer and Patient
Lasting Power of
Attorney and
Advance Decision
Talk and patient
engagement on
suite of
information leaflets
on advance care
planning
Local patients and
carers, in particular
those making end of life
choices about care,
and those suffering
from degenerative
conditions
E-mail GP Bulletin, Tweet,
provider patient networks,
leaflets, hard copy to GPs
voluntary orgs, and
nursing homes
Lasting Power of Attorney – how to, and FAQ’s
Advance decisions – how to refuse treatment, how to make a valid advance decision
23 attendees
23 February
2015
Carer and Patient
Lasting Power of
Attorney and
Advance Decision
Talk and patient
engagement on
suite of
information leaflets
on advance care
Local patients and
carers, in particular
those making end of life
choices about care,
and those suffering
from degenerative
conditions
E-mail GP Bulletin, Tweet,
provider patient networks,
leaflets, hard copy to GPs
voluntary orgs, and
nursing homes
Lasting Power of Attorney – how to, and FAQ’s
Advance decisions – how to refuse treatment, how to make a valid advance decision
6 -10
attendees
11
planning
3 March 2015 NHS 111/GP
OOHs
engagement event
Local patient and public
engagement
Media; website;
engagement events
Details of the joining up of the
proposed NHS 11 Service and GP
out of hours services to enable them
to work better
8
3 March 2015 BME Health
Seminar
Arranged by Enfield
Racial Equality Council
Chair presented
Commissioning for health
presentation
Areas covered were:
The NHS – roles and responsibilities
Enfield health challenges
Budgets
How do we ensure equality and diversity in our commissioning
NHS Constitution
Choose Well Campaign
Primary Care Strategy Achievements
Engaging with stakeholders in the redesign of services
Access to healthcare for asylum seekers
Access to translation services
Joining PPGs Details about the NHS11/GP OOHs engagement event the evening of 3 March was given
60+
6 March 2015 NHS 111/GP
OOHs
engagement event
Local patient and public
engagement
Media; website;
engagement events
NHS 111/GP OOHs proposal for
integration
TBC
12
10 March 2015 Carer and Patient
Lasting Power of
Attorney and
Advance Decision
Talk and patient
engagement on
suite of
information leaflets
on advance care
planning
Local patients and
carers, in particular
those making end of life
choices about care,
and those suffering
from degenerative
conditions
E-mail GP Bulletin, Tweet,
provider patient networks,
leaflets, hard copy to GPs
voluntary orgs, and
nursing homes
Lasting Power of Attorney – how to, and FAQ’s
Advance decisions – how to refuse treatment, how to make a valid advance decision
15 attendees
Feb –Mar 2015 Provider
engagement in
development of
patient information
leaflets on
advance care
planning
Patients and carers
through LPA talks.
Acute, community and
mental health providers
through email and face
to face meetings. GP’s
through GP bulletin
GP bulletin, email and
face to face meetings with
providers
Review of suite of information leaflets to agree content and design for providers to adopt- 3 trusts have requested the information leaflets once signed off to make available to their patients and carers on dementia, stroke wards etc.
100-200
17 March 2015 Carers Forum Carers Invite to attend by Carers
Forum
NHS organisations
Primary Care Services provided by GPs
Feedback on GP services
Joining PPGs
20
13
Appendix E – Collective and Individual Participation duty activities 2014/15
Domain 2: Collective Participation Duties
NHS Commissioners to ensure public involvement and consultation in commissioning process and decisions which includes
involvement of the public, patients and carers in: commissioning activities, planning of proposed changes to services monitoring, insight
and evaluation.
What activity has been undertaken to involve patients and the public in each of the following areas of CCG’s
business and focusing particularly on the period since April 2014, for each how is this being demonstrated in
outcomes?
Domain 2 Activities Objectives associated
with each activity
Outcome realised or planned from each
activity
Procurement Range of patient engagement
exercises to enable their input
into the redesigning of
community services in to key
populations and development
of the service specifications
To gain public opinion on
CCG populations and get
input into key elements of
service specifications for
those populations
Populations agreed by public and some
new additions made to specifications for
populations as well as confirming other
elements within specification
NHS Enfield is leading the work
across North Central London to
explore a potential merger of
NHS 111 and GP OOH
services, which are currently
Explaining the current
geographical use of NHS
11 and the types of calls
currently received.
Commissioning a single integrated service
across a wider geographical area
Developing our commissioning intentions.
14
separately commissioned with
one provider for NHS 111 and
two for GP out of hours – (one
provider for Barnet, Enfield and
Haringey and the other GP
OOH provider covering
Camden and Islington)
A NHS 111 and OOHs patient
and public reference group and
stakeholder and patient
engagement has been set up
as part of the procurement
strategy. There are 4/5 reps for
each borough.
Attending patient group
meetings such as the BME
Health seminar and the Over
50s Forum in Enfield
to explain the potential options
for the new service.
Discussing details of
potentially joining up NHS
111 and OOH services by
commissioning a new
contract.
Meeting with patient
groups on request.
Being open and
transparent about service
redesign and seeking
public participation to
shape those plans.
Gathering patient feedback on current
services and opportunities for
improvement
Developing a new service specification for
GP/111 and OOH
Developing an area of the website focused
on GP OOH and NHS 111 procurement
http://www.enfieldccg.nhs.uk/about-
us/nhs-111-and-out-of-hours-gp-
services.htm
15
We have also discussed the
proposed procurement at public
meetings and PPE events
Procurement MSK stakeholder engagement
as part of the procurement
strategy – two month
engagement exercise,
communications and
engagement plan in place.
MSK co-design follow up
workshop
To give patients face to
face contact with project
manager, conduct patient
surveys and distribution
of events flyers for MSK
patient workshop
Through the patient
engagement, the CCG
looked to gather
information regarding:
demographic Information and how patients use 111
The patient experience of diagnosis and treatment of their condition
levels of satisfaction with
Gathering patient feedback on current
services and opportunities for
improvement.
The MSK surveys have been completed
by forty one patients in Enfield.
It is apparent from the feedback that the
current service is deemed as good by
patients who have been given care for
their MSK condition. Despite this, the
feedback shows that there are several
areas in which this can be revised and
improved in order to improve patient
experience of the MSK services in Enfield.
This feedback was used to shape the
service redesign.
16
the service(s)
how the service can be improved
Gather patient opinion on the current service and the proposed outcome measures
Several key themes were identified when
discussing the proposed outcome
measures.
These included:
• Care closer to home • Need for more effective
communication between healthcare professionals and patients
• Need for greater lifestyle support and self-management information available for patients
• Multidisciplinary teams to support patients at a local level is important
Contract and
service
monitoring
Friends and family test at local
maternity units.
Daily survey conducted that is
reported monthly to
Easily administered
survey via kiosks and
questionnaires.
Measuring patient
experience of maternity,
ante-natal and delivery
Survey results inform staff training and
practice.
Provides valuable feedback to maternity
teams/ individuals on the quality of care
17
management, staff and
commissioners.
services
Benchmarked with other maternity units
A number of “insight and
learning” visits to provider
services to walk the pathway
including Older Peoples
Assessment Unit, Urgent Care
Centres, A&E, Ambulatory care
with discussion with patients as
part of the process
To understand patient
experience as part of
better understanding of
the overall model of care
for particular populations
and service areas
Clinical and managers attend these visits
which assure the quality of locally
commissioned services.
Service planning,
design and
decommissioning
Public engagement in the
development of Better Care
Fund (BCF) plans
To give an update on
progress BCF plan
submission and Plan
implementation.
To give an update on the
current service,
successes and
development
opportunities, and to
General updates on the plans at
Governing Body and PPE meetings.
Engagement largely delivered through
individual schemes within plan. PPE
committee gave overview.
18
discuss what could be
changed in system and
agree the next steps.
Service planning,
design and
decommissioning
Respiratory co-design meetings
• Review current ‘as is’ system
• Validate work undertaken so far on respiratory co-design
• Agree what we need to change
• Next steps
To give an update on the
current service,
successes and
development
opportunities, and to
discuss what could be
changed in system and
agree the next steps.
21 stakeholders and patient group
(Breathe Easy) gave views on:
• key issues impacting on the current service
• what would a good service look like in terms of outcomes
• identification and prioritisation of key initiatives
• These views were used to influence service redesign and prioritisation of initiatives
Service planning,
design and
decommissioning
Integrated Care System Public
Events March 2014 & March
2015
OPAU Sharing Health and Care workshop March 2015
Public-facing Integrated Care Factsheets created and now available to public; tested at
To discuss development
of integrated care and
OPAU and to elicit
patients’ views about their
current experience and
vote on outcomes that
were important to them.
Their views were
incorporated into the
outcomes for the
Views on outcomes became part of the
formal monitoring of Integrated Care and
individual Service Specifications with a
view to monitoring these outcomes in
2015/16. The OPAU patient feedback was
designed to improve practice in the unit
The views of individuals were also fed
19
workshops
Various evaluations of integrated care services which included patient feedback, e.g. falls programme, Tele-Health Services etc.
Patient Experience Tracker
project
Programme in its
Business Plan.
The views of individual
patients through surveys
and semi-structured
interviews were an
important element of the
evaluation of services.
Other objective is to
improve public knowledge
of integrated care,
progress and impact
Including patients in the
design of a questionnaire
for GP practices.
back to professional service design
workshops, e.g. falls management, rapid
response etc. with a view to influencing
service re-design, e.g. in the patient
wanting to tell their story to as few people
as possible. This in turn influenced
commissioning intentions
The views of individuals in evaluations
influenced service re-design, e.g. the need
for greater GP involvement in the falls
programme and more coordination, or the
selection of a Tele-Health provider
Patients designed the questionnaire
Service planning,
design and
decommissioning
Edmonton Summer Festival The CCG had a stall at
this large community
festival. Our stall focused
on:
Talked to over 100 local residents.
Promoted Choose Well leaflet and App.
20
NHS 111
Choose Well Campaign
Dental OOH services
How to engage with the CCG
Engagement on improving community services through a questionnaire
Joining Patient Participation Groups
Volunteering
Promoted NHS 111 and dental OOH
services.
Recruited volunteers
Surveyed opinions on community services
and value based commissioning.
Passed on details to member practices of
patients interested in joining PPGs (with
patient’s consent)
Enfield Town Show
The CCG had a stall at
this large community
festival. Our stall focused
on:
NHS 111
Choose Well Campaign
Dental OOH services
How to engage with the CCG
Talked to over 300 local residents.
Promoted Choose Well leaflet and App.
Promoted NHS 111 and dental OOH
services.
21
Engagement on improving community services through a questionnaire
Joining Patient Participation Groups
Volunteering
Promoting MSK service redesign
Recruited volunteers
Surveyed opinions on MSK services and
outcomes based commissioning.
Passed on details to member practices of
patients interested in joining PPGs (with
patient’s consent)
Visits to patient groups
including: Over 50s Forum,
Enfield Racial Equality Council,
Enfield Carers Forum,
To promote
understanding of the role
of the CCG, to open
discussions on the
strategy of the CCG to
seek groups views on our
strategy.
Raised awareness of the CCG and its role
in commissioning most local health
services.
Gave opportunity for patients to comment
on the CCG’s strategy and encouraged
people to become more involved.
Commissioning
intentions
The September 2014 PPE
event outlined the six
transformation programmes
and the 5 year Strategic Plan
To explain what
commissioning is and the
process of developing
intentions to our wider
Promoting better understanding of the
CCG’s high level commissioning intentions
and how we intend to get the best value
for our local resources and transform local
22
Reports and Presentation the
Health and Wellbeing Board
Five year Plan
Governing Body meetings
Patient participation Group
Network Meeting
Patient and Public Engagement
events 5 year forward view
community.
To present the initial
commissioning intentions
to a range of audiences
to:
• Inform stakeholders of potential plans
• Receive feedback and opinions on intentions
care pathways.
Broad support for most commissioning
intentions.
Feedback supported:
• Greater patient responsibility • More community based services • Specific proposals around urgent
care, dementia, long-term conditions services
Feedback did not support wholesale
tendering of services
Strategy
development
Joint MH Strategy 2014/2019 Healthwatch members of
the Mental Health
Strategy Implementation
Positive support for mental health strategy
and primary care projects.
23
Primary Care Strategy
Implementation Board (PSCIB)
Meetings (ended March 2015)
Steering Group, service
user representation on
the Partnership Board
PCSIB gave oversight of
the projects within the
programme and their
delivery into mainstream
services, and progress
against key programme
objectives
Further development of strategies and
action plans for projects within mental
health and primary care.
How does the CCG transparently and systematically monitor and act on patient feedback, especially in identifying
and addressing quality concerns across all sectors? And focusing particularly on the period since April 2014, how
has service quality improved as a result of this?
24
Monitor feedback
on services and
patient
experience data
Providers are asked for regular
patient experience reports
through work plans for Clinical
Quality Review Groups.
The Commissioning Support
Unit (CSU) also offers theme
and trend reports benchmarked
against other providers in North
East London.
The CCG also has in place an
early warning system for
reporting concerns based on
patient feedback to GPs. These
are reported through the CCG
GP intranet and website
Other methods of gathering
and monitoring feedback
include:
• Patient enquiries and
For Barnet, Enfield and
Haringey Mental Health
Trust (BEHMHT), for
which the CCG is lead
commissioner, this falls
within a quarterly clinical
quality and safety report.
The views of individual
patients through surveys
and semi-structured
interviews are an
important element of the
evaluation of services.
Patients and service
users are given a variety
of options for feeding
back their views on local
NHS services. The
feedback is monitored
and responded to in a
4 of 6 BEH-MHT’s corporate values are
patient specific
Of 38 early warning quality alerts received
in 2014/15, 13 (34%) arose directly from
patient feedback to the GP. Themes and
trends are reported to the CCG Clinical
Reference Group and escalated to the
Governing Body as necessary through a
Quality and Safety Report
The views of individuals are monitored and
triangulated. For example complaints and
concerns data can be triangulated with
Healthwatch and PPG feedback to
investigations and to help with challenging
providers as a commissioner.
Responding to concerns of families and
carers where they are not complaints.
25
communications inboxes • Complaints and
concerns can also be received via general email inboxes, Twitter and telephone.
• Feedback provided on NHS Choices, Patient Opinion and other public websites.
• Healthwatch Enfield feedback
• Feedback from patient groups e.g. Enfield Vision and Enfield Over 50s Forum
• Twitter • Feedback of PPG
network • Various evaluations of
integrated care services which included patient feedback, e.g. falls programme, Tele-Health Services etc. from surveys, semi-structured interviews, complaints/compliments.
• Maternity Services Liaison Committee (MSLC)
• North Middlesex
number of different ways
e.g. complaints and
feedback through Twitter
are responded to on an
individual basis
Feedback on NHS
Choices, Patient Opinion
and other public websites
is used to research and
triangulate other quality
information.
Patient/Focus groups are
used where service
information needs to be
gathered based on recent
individual experience of a
specialist service.
Forums for young parents
to provide feedback on
Involving mothers and organisations (e.g.
NCT) in maternity issues.
Ongoing forum for users and senior
26
University Hospital Focus Group
• Labour Ward Forums • CAMHS forum • Parent and Young
People Participation Group
• Patient Voice events • Draft Joint
Commissioning Strategy for child and adolescent mental health and emotional wellbeing
services
Forum to discuss issues
with organisations
providing services locally.
Forum to discuss issues
with head teachers
maternity staff to discuss maternity and
other hospital issues.
Ongoing forums for users and senior
maternity staff to discuss maternity issues.
Ongoing forum to discuss CAMHS issues
FNP achieved Your Welcome Standard
(NHS accreditation for improving services
for young people
Held two events
Services users provided their views on
IAPT, CAMHS, children’s centre and
maternity services. Feedback to services.
For example, informed breastfeeding
practices
Held events with other organisations
27
Meet with group of Head Teachers and
separate interviews where required
Act on patient
feedback,
especially
identifying and
addressing
quality concerns
across all sectors
Thematic analysis: this provider
also reports thematic analyses
on patient experience every six
months to demonstrate how it
has acted upon patient
feedback; next is scheduled at
the Clinical Quality Review
Group for July 2015. The CCG
uses its early warning system
to escalate to providers as
necessary for escalation and
resolution of concerns arising
All teams discuss complaints
received during their team
meetings and reflect upon how
the issues raised can be used
BEHMHT has reported
that it uses a variety of
methods for identifying
and responding to quality
concerns raised by
patients and will be
incorporating this into its
six monthly patient
experience thematic
analyses
Complaints management
example – a “My Care
Coordinator” has on
occasion not attended to
a patient at home at the
times agreed; Trust
The CQRG for BEHMHT was assured
January 2015 that FFT has been
implemented across the Trust since 1
January 2015 and almost all services have
started collating the feedback and will act
on comments received to improve
services. Further reporting anticipated
through the Clinical Quality Review Group
(CQRG) in due course
28
to improve the services that
they provide; e.g. delays in
processing referrals and
reporting back to referrers
within 48 hours:
• Using formal and informal routes
• 1:1 discussions with patients
• Contract meetings • Quality meetings • Quality accounts • CQUIN
ensuring that this issue is
addressed with the staff
member in supervision to
ensure that all service
users are visited as
agreed and not
inconvenienced
In all but one early
warning alert, they have
been investigated and
resolved. In the remaining
case, contractual
assurance and evidence
is awaited prior to formal
closure (relating to North
Middlesex Hospital)
Oaks Carers Group –
relatives/carers group
provided additional
feedback and insight to
support a visit
To address issues about
quality raised about
providers through formally
agreed QA and
safeguarding processes
Improved quality of care from individual
providers. For example, CHAT has worked
with a number of care homes to improve
the standard and quality of nursing care in
Enfield
Enfield CCG participated in
Haringey’s insight and learning
To ensure that services
investigate concerns
BEHMHT Care Homes Assessment Team
works closely with LBE Safeguarding
29
visiting to North Middlesex
Hospital’s discharge lounge
visit. There was a patient
representative as part of the
visit group.
Patients are also spoken to
about their care during these
visits
Integrated Care: Concerns
identified amongst key
providers follow individual
agencies’ quality assurance
mechanisms, e.g. OPAU at
Chase Farm QA process
governed by Royal Free
London Foundation Trust QA
process
We review the Healthwatch
Enfield Enter and View reports
which are taken to our Q&S
using their own internal
processes, and where
necessary collaborate
with other organisations
on investigations and
collaborate with wider
safeguarding or provider
concern arrangements
Gathering a wider and
independent view of
quality issues
Team and Enfield’s safeguarding
procedures (which include CQC
involvement) to identify and address
provider concerns
Any quality issues identified or raised
during via the quality alerts process go to
CQRQ
Improved quality of care
Preventing poor quality care
30
Committee
You also list a
number of
programme
specific events,
with outputs
identified. Can
you demonstrate
similar activity in
14/15 and
impacts on
outcomes?
IRIS Domestic Violence training
sessions, newsletters to GPs
and posters and leaflets for
patients.
Our Primary Care Strategy
funded a patient experience
tracker project. We purchased
equipment for practices and
patients helped us to design
the questionnaire. We also
visited PPGs on request to talk
to them about the project.
MSK co design follow up
workshop and MSK market
testing day. MSK patient
engagement workshop.
Cardiology Co-design
workshop x 2. Cardiology
To help GPs increase
identification of patients
experiencing domestic
violence. Raising
awareness with patients
that GP practices are DV
aware and providing a
signposting service .
To encourage live
reporting of patient
experience data. To
support practices in
getting ready for the
Friends and Family Test.
To encourage openness
and transparency of data
– practices were
encouraged to discuss
survey results with their
PPGs and put them up on
Identified service and commissioning
options, and enhanced the dialogue
between providers and patients.
Workshops have supported us in
understanding priorities for patients when
they use services and by holding provider
focused workshops, we have been able to
shape our
Enfield Carers Centre asked us to tell
them what to expect from their GP
practice. This talk was led by one of our
GP Governing Body members and
explained the differences between the
levels of services offered in primary care
locally.
We developed an audio version of Choose
Well to meet the needs of the blind and
partially sighted.
31
patient engagement events
Respiratory co design meeting
A programme of outreach visits
have continued during 2014/15.
These included: Enfield Vision,
Enfield English Turkish Cypriot
lunch events and visits to the
Carers Centre. Topics for the
presentations are agreed with
the community to suit the
needs of users
their noticeboards.
Aim to improve capture
rates of patient
experience feedback,
encouraging patient
engagement in improving
services, embedding
effective communication
systems between staff
and patients
Patient awareness of
project
To raise awareness of
Enfield Health
Challenges, choose well
campaign, NHS 111
translation services,
hospital beds for home,
PPGs breast screening
and diabetes
Enfield Carers Centre asked us to tell
them what to expect from their GP
practice. This talk was led by one of our
GP Governing Body members and
explained the differences between the
levels of services offered in primary care
locally.
32
Update on MSK
pathways, test
assumptions and
outcome measures with
local stakeholders.
Looking at commissioning
model
How has service
quality improved
as a result of
this?
Integrated care To improve the quality of
care from individual
providers
For example, a number of care homes with
whom CHAT works have demonstrably
improved their standards of care and
addressed provider concerns as part of a
joint approach between CQC, LBE and
CHAT
You describe in
your 13/14 report
the setting up of
the governance
structures, in
particular the
PPE Committee,
PPGs and
networks; and
Our PPE Committee,
established in March 2013 is
one of the six sub-committees
of the Governing Body. It meets
bi-monthly, reporting back to
the Governing Body and its
terms of reference describe
how it oversees
communications, engagement
To discuss and share with
stakeholders, patients,
key elements of CCG
work in strategic direction
and individual service
changes.
Gather general patient
opinions on services
Every event generates feedback that can
be used by the CCG. We report this
feedback in a You said, we did format.
Stakeholder feedback is used to develop
plans such as Enfield’s Better Care Fund
Plan
33
three annual
events around
the
commissioning
cycle. How have
these developed
and can you
demonstrate
positive
outcomes on
CCG activity by
engagement and
feedback through
these channels?
and equality and diversity
strategically.
We hold three patient and
public engagement events a
year around our commissioning
cycle. These events focus on
the strategic priorities for the
organisation such as
developing commissioning
intentions and feedback on key
programmes of work such as
developing urgent care
services and integrated care.
These three key public meeting
are supported by a range of
engagement visits to a wide
range of voluntary sector and
patient groups.
We hold an Annual General
Meeting as required by our
Constitution at which we
within Enfield.
Recommendations for
improving the service
Identifying future
engagement opportunities
Building strong
relationships with
stakeholders, partners
and our community.
Transparency and
openness
Being a listening
organisation that puts
patients at the heart of
our work
Building our reputation as
Outcome of PPE events reported back to
PPE Committee and Governing Body
Events help us to understand our priorities
might be different from patients. The
integrated care events not only helped us
to map pathways for older people with
frailty, but also helped us to understand
the role that patients would like the
voluntary sector to have.
Collecting feedback from each event to
continuously improve the format – e.g. our
stakeholders told us that they would like
our PPE events to be clinically-led and
more informal so we have changed to a
focus group approach.
Allowing patients to set the agenda and
recommend topics.
34
present our Annual Reports
and Accounts and discuss our
achievements and challenges
with our stakeholders.
Our Constitution extends the
concept of membership to our
member practices Patient
Participation Group. Clause 22
allows us to co-opt an elected
PPG member to our Governing
Body. During 2014 we recruited
two interim PPG
representatives who sat on the
Governing Body, PPE
Committee and helped us to
develop our PPGs.
By June 2014 all our member
practices had PPGs. Practice
Managers were supported by
our GB Practice Managers lead
and were given a toolkit to help
setup and manage the group.
We have also developed a
the local leader of the
NHS.
Supporting our member
practices to develop
active PPGs
Designing and delivering
an election process for a
PPG representative
Recruiting volunteers to work on service
redesign programmes
Delivering an elected PPG representative
to our Governing Body – achieved in May
2015.
Developing a patient-led PPG network.
Developing a governance structure that
delivers a feedback loop from PPGs to
their elected representative to the
Governing Body and back.
We believe we are the first CCG in the
country to have an elected PPG
representative.
35
strong PPG network which
meets at least quarterly.
Chairs, members and practice
managers attend this meeting
and it’s a forum to share good
practice. The network has been
supported by NHS England
engagement funding in its first
year and money has been
spent on training for PPGs
including: developing mission,
vision, aims and objectives and
developing governing
documents
We developed an election
process and governance
structure for the recruitment of
the elected PPG
representative. The election
was managed independently by
Electoral Reform Services.
Every PPG had one vote. Two
candidates came forward for
election from two different
localities and we now have an
36
elected Chair and Vice Chair.
Domain 2: Individual Participation Duties
NHS Commissioners must promote the involvement of patients and carers in decisions which relate to their care or treatment, including
diagnosis, care planning, treatment and care management. This duty requires CCGs and commissioners to ensure that the services
commissioned promote involvement of patients in their own care including: personalised care planning, shared decision making, self-
care and self-management support information with targeted support.
Self-management Integrated Care: Maintaining
independence and self-
direction is a key element of the
integrated care programme and
was part of the last public event
presentation about the
integrated care network
Integrated Respiratory Service
co-design meetings: Objectives
include to bring care closer to
home and empower patients to
self-manage conditions.
Range of engagement for
development of MSK: services
will be commissioned to embed
self-management tools within
The objective was to
ensure that individuals
considered their own
responsibilities in terms of
managing their condition
Update on the current
service:
Look into successes and
development needs from
a provider’s perspective
Discuss what could be
changed within the
systems
This view was generally accepted by most
participants, but the caveat they may need
help from professionals and informed
others to do so.
The evaluation of Tele-Health suggested
remote monitoring was able to improve
individuals’ health outcomes and ability to
understand their condition better and how
to manage it
MSK: Key themes from patient
engagement:
• Care closer to home • Need for more effective
communication between healthcare professionals and patients
• Need for greater lifestyle support and self-management information available for patients
37
the pathway, and an expert
patient programme to promote
self-management. The ability of
patients to manage their
conditions will be monitored by
a patient questionnaire. Patient
satisfaction will be measured
by a patient and carers
satisfaction survey. Patient
centred outcomes have been
developed through
engagement
MSK Patient workshops
April – June 2014 held on
the proposed outcome
based service model with
patients who have, or are,
using current service.
With the objective to:
• talk through each outcome statement with the patient representatives to get their views
• To explore what each outcome statement means more directly for the patient (sub-outcomes)
• To identify any other outcomes the patient representatives feel are important
• To get an indicative scale of importance for each of the outcome statements
• Multidisciplinary teams to support patients at a local level is important
Resulting in a set of patient outcomes,
validated by patients that commissioners
can use to develop measures for measure
MSK service delivery across streamlined
patient pathways
38
Shared decision
making
Integrated Care: Ensuring a
truly person-centred approach
in which patients had choice
and control is a key element of
the integrated care programme
and was part of the last public
event presentation about the
integrated care network
The objective was to
ensure the system and
professionals operating
within it saw individuals
not as passive consumers
of healthcare, but as at
the heart of care planning
and delivery.
This was done by
consulting with patients
on this, and other issues
and feeding these views
directly into action-
learning professional
workshops around which
to design elements of the
system
This view was generally accepted by most
participants and was identified as an
important, but not the most important,
outcome people wanted from the
integrated care network (see Aiii).
Shared decision making and care planning
are fundamental parts of all specifications.
Personalised
care planning
and personal
health budgets
1. Commissioning Mysupportbroker to undertake support plans/finance management
1. The objective was to ensure that the process would be managed effectively by
1. Mysupportbroker were able to
utilise their expertise to ensure a smooth
process for individuals requesting PB
2. All eligible individuals were made
39
2. Since 1st April 2014 every individual eligible for CHC funding who lives in the community are informed by letter of their right to have a personal health budget
3. An indicative budget assessment is undertaken for all Individuals who request a personal health budget
4. Support broker in conjunction with individual/family/carers meet to understand full needs and completes support plan
5. Once all parties agree support plan is signed off by CHC and monies are released
6. Support plan is reviewed after 3 months then annually or if needs change as per the CHC framework
people who have experience of support planning against individual needs and personal budget allocation
2. To ensure all eligible individuals were aware of Personal Budgets in line with government guidance.
3. The objective was to ensure an indicative budget based on the individuals needs was available for the individual at the start of the support planning process
4. The objective was
aware in line with government timeframes
3. Both the individual and the Support
Broker had good understanding of the
expenditure framework they were able to
utilise
4. The support plan was shaped and
owed by the individual
5. All parties were signed up to the
support plan
6. Individual is supported in a manner
that meets their needs and enables them
to take full responsibility for their own care
management
40
to ensure that the individual/family/carers had full input into the support planning process, and met all their holistic needs
5. The objective of sign off is to ensure that health needs are appropriately met and supported within the support plan, and the whole package is sustainable and fit for purpose
6. The objective is to ensure the plan is robust and meets the needs of the individual
Personalised Working with voluntary To follow similar best Met with each family to discuss personal
41
care planning
and personal
health budgets
sector partners, Enfield
Disability Action and
disability parent group Our
Voice
practice processes
already in place for adults
in CHC services
budgets.
Ran an awareness event in April 2015
MCA Advance care
planning talks x 3 and
consultation on advance
care planning leaflets
To raise awareness of
LPA and advance care
planning and develop
patient information
leaflets
50 patents attended and were given
access to specialist speakers from OPG
and Compassion in Dying, patients were
linked into CiD patient engagement
activity. Feedback on leaflets used to
improve leaflets and FAQs for patients
developed from questions asked. Patient
survey on events gave feedback on
reasons for attendance and success of
events.
Domain 2: Collective and Individual Participation Duties
How is
information
technology,
including social
media, being
used to improve
engagement
Enfield CCG started their
Twitter account in April
2013. The Twitter account
was created as a new
account, rather than
renaming the former Enfield
PCT account
To reach a wider
audience through social
media including harder to
reach groups such as
young people and the
working age population
50 patents attended and were given
access to specialist speakers from OPG
and Compassion in Dying, patients were
linked into CiD patient engagement
activity. Feedback on leaflets used to
improve leaflets and FAQs for patients
developed from questions asked. Patient
survey on events gave feedback on
42
activity
We promote events and key
developments on our
Twitter account which has
1.936 followers.
This includes: promoting
PPE events, patient
surveys, special events
such as the MCA Advance
care planning talks. We also
retweet health advice from
NHS Choices and health
awareness messages to
promote people’s
understanding of different
conditions. Wherever
possible we link to a trusted
source of information so
people can find out more
e.g. promoting awareness
of womb cancer and risk
factors and linking to the
Womb Cancer Trust. We
also promote NHS providers
and their campaigns e.g.
NHS Blood and Transplant
or our local providers
We use Twitter to link to our
To support NHS partners
To raise awareness of
health conditions, support
available and promoting
healthy lifestyles to
support our patients to
self-manage their health
To raise awareness of
LPA and advance care
planning
To encourage people to
attend events
To promote news and
updates
To support partners with
campaigns and raising
awareness of local
services
reasons for attendance and success of
events.
Patients are directed to the right place
quickly to feedback on their experience
43
website and post real time
updates of interest to our
community such as:
pharmacy opening times
over holiday periods and the
appointment of our PPG
elected representative.
We take part in social media
campaigns jointly with
partners e.g. mental health
awareness week with BEH
MHT.
We have a standard
process if we receive
complaints or feedback
through Twitter.
The CCG website hosts
information on how to make
a complaint or give
To drive traffic to our
website using Twitter
To build our
organisation’s reputation
as the local leader of the
NHS and raise our profile
To raise awareness of
complaints and informal
patient enquiries. To
explain the new NHS
system
44
feedback to the NHS. The
section includes an
explanation of the new NHS
system and where to
complain to
What benefits
can be
demonstrated
from this?
Our Twitter account has
attracted 1,936 followers and
our tweets are regularly
retweeted by subscribers.
We plan to increase our use of
social media to attract more
volunteers to feedback on
service redevelopment issues.
Our Patient and Public
Engagement Manager will be
attending a specialist course
run by Enfield Voluntary Action
on this issue.
The Patient and Public
Engagement Manager will also
be undertaking specialist social
To increase our Twitter
followers
To increase the number
and diversity of our
volunteers.
This is regularly monitored and has been
reported in to the PPE Committee.
To be engage younger users in particular
45
media courses focused on
engagement and consultation
later in 2015
To learn best practice
To use our training package with the
Consultation Institute to strengthen the
skills of our in-house team.
How is the CCG
systematically
and transparently
holding providers
to account for
patient and
public
engagement and
what
improvements to
care have been
made as a result
of this
accountability?
Providers are asked for regular
patient experience reports
through work plans for Clinical
Quality Review Groups. For
Barnet, Enfield and Haringey
Mental Health Trust
(BEHMHT), for which the CCG
is lead commissioner, this falls
within a quarterly clinical quality
and safety report.
Thematic analysis: BEH MHT
also reports thematic analyses
The CCG is assured that
the provider is collecting
intelligence on patient
experience , is
subsequently acting upon
that patient feedback
(especially identifying and
addressing quality
concerns across all
sectors) and can
demonstrate improvement
GP satisfaction
The satisfaction rate for patient experience
feedback January 2014 - December 2014
for BEHMHT was 91% including all Trust
services. Positive feedback substantially
outweighs negative feedback
BEHMHT has reported that it uses a
variety of methods for identifying and
responding to quality concerns raised by
patients and will be incorporating this into
its six monthly patient experience thematic
analyses
46
on patient experience every six
months
Quality account – CCG
providing formal feedback
which is published in the
annual Trust quality account.
CQRQ monitoring of friends
and family test feedback and
performance issues.
The NCL CCG Quality Leads
meeting reviews provider
patient experience and
complaints benchmarking
report.
Monitoring implementation of
the Friends and Family Test.
Provider complaints
benchmarking report is
questionnaires regarding
the hub access for crisis
home resolution
treatment team (CHRTT).
As a result of feedback,
CHRTT improved their
communications
processes to GP
practices.
Themes and trends
demonstrating early
warnings identified
through complaints and
addressing any quality
concerns and feedback.
Thematic Analyses
demonstrate how
providers have acted
upon patient feedback;
the next for BEHMHT is
scheduled at the Clinical
Quality Review Group
(CQRG) for July 2015
Complaints handled in line with NHS
Complaints regulation e.g. acknowledged
within 3 working days and response
agreed with complainant
Almost all services have started collating
the feedback as of 1 January 2015 and will
act on comments received to improve
services. Further reporting anticipated
through the Clinical Quality Review Group
in due course
Helping to provide assurance on how
providers are handling complaints and
implementing complaints regulations
47
produced by the CSU PEET
Team and reviewed at the CCG
quality leads meeting.
CCG assured through the
Clinical Quality Review
Group (CQRG) that this
has been implemented
across the Trust from 1
January 2015 as was
planned. Service line FFT
data will be monitored
through the Trust’s
quarterly deep dive forum
Regularly reviewing
complaints across the
sector and benchmarking
providers
What plans does
the CCG have in
place for the
further
development of
engagement and
participation in
The CCG has developed a
Communications, Engagement
and Consultation Toolkit to
support programme managers
deliver their project
communications. The Toolkit is
internal only, and has been
tested with programme
Developing systems and
processes for
communications,
engagement and
consultation.
The Toolkit has been developed with the
support and comments of commissioning
managers.
It will be launched as a final, internal only
document in summer 2015
48
2015/16?
managers. It supports all levels
of engagement and also
supports managers to prepare
for HOSC and JHOSC.
The Toolkit includes
appendices which programme
managers can use to support
the development of project
plans and also develop with the
support of the Communications
and Engagement Team.
The Toolkit will is being
developed and the next version
will include visual flow charts
The CCG will continue to
deliver three main PPE events
a year and supported this with
a programme of other events
and visits, tailored in line with
corporate priorities and the
needs of our community.
Developing best practice
49
The CCG plans to further
develop its PPG network now
that the elected representative
is in post. At the first meeting
chaired by the elected
representative in May, the
PPGs were encouraged to
produce a work plan and chose
their own priorities for the year.
This included core work such
as sharing best practice and
raising awareness of PPGs but
also some further collaboration
around: reducing do not
attends, promoting public
health messages and working
with practices on their falls
registers.
The CCG plans to develop a
more formal approach to
recruiting and managing
volunteers. The Head of
Communications and
Engagement and the Patient
Enfield CCG wants to
further develop the PPG
network to be patient-led
and develop a work plan
through co-production.
Patient-led engagement. Peer education
50
and Public Engagement
Manager are attending
specialist courses run by
Enfield Voluntary Action.
The CCG plans to develop a
stakeholder reference group in
2015/16 to provide early
support and feedback on the
development of strategic
change programmes.
The CCG has invested in
membership of the
Consultation Institute, along
with buying specialist training
courses which will be used to
develop the Communications
and Engagement Team and
other senior leaders in the
organisation
Better support for
volunteers including
developing role
descriptions based on
the appendix in the
Communications and
Engagement Toolkit
More formal support and training where
necessary for volunteers
51
More engagement with
patient groups.
Learning best practice,
understanding wider
public sector issues and
techniques for
engagement and
participation
Ensuring training and
development for the team
and the CCG is up to
date.
Setting up a panel approach to get
feedback early on in the planning cycle.
20 specialist training courses have been
purchased. Courses already attended by
the Communications and Engagement
team include the Law of Consultation and
Consultation Essentials
52
What steps have
been taken to
ensure that plans
are robust (e.g.
level of
governance
approval,
evidence of
funding and/or
other resource
commitment)?
Governance for engagement
activities is supported by:
oversight by the PPE
Committee, operational
leadership by the Director of
Quality and Governance and
the Lay Member for PPE. The
PPE Committee has a direct
line of report to the CCG
Governing Body.
Operational support across the
organisation is provided by a
very experienced in-house
team of three communications
and engagement professionals.
The Communications,
Engagement and Consultation
Developing the role of the
PPE Committee in
overseeing engagement
across the organisation
Developing the skills of
the experienced in-house
communications team
PPE Committee monitors activity and
assures the Governing Body
Potential commissioning of specialist
support where required
53
Toolkit has been developed to
further support staff’s
knowledge and understanding
of the importance of planning
communications and
engagement activities.
The Communications and
Engagement Team encourage
all teams to report engagement
activities that they undertake
and these are recorded in an
engagement log that is
regularly viewed by the PPE
Committee.
Developing policies and
protocols to support good
practice
Ensuring that all activities
are reported and
evaluated
Ensuring project managers are using the
same planning processes and that
communications and engagement plans
are developed for all projects.
Increasing the range and diversity of
engagement activities.