Agenda item no. 12

GOVERNING BODY MEETING

Date of meeting 20 March 2018 Agenda item number 12

Title of report Patient and public engagement update report

Paper Presented by: Claire Lewis, Acting Executive for Governance, Patient Safety and Risk

Paper prepared by: Amanda Bate, Community Engagement Manager Kate Hurry, Head of Communications, Engagement and Development

CCG strategic Develop and maintain an effective organisation  objective supported Commission high quality, safe and cost effective services which  by this paper: reduce health inequalities and improve access to healthcare (please tick  ) Effectively engage patients and the public in decision making  Develop excellent partnerships which lead to improved health  outcomes Make the best use of resources 

Purpose of report

The purpose of this report is to provide an update to the Governing Body on the Clinical Commissioning Group’s patient and public engagement activity over the last two months.

Recommendation

The Governing Body is asked to note the contents of the report.

Please indicate which Group this has been discussed with (please tick )

Executive Management Team Quality Improvement and Governance Cttee  Clinical Commissioning Committee Finance and Performance Committee Audit Committee Remuneration Committee Council of Members Other/Not Applicable Patient and Public Engagement: The paper outlines the activity for patient and public engagement

Equality Impact Assessment: Equality impact monitoring forms part of patient and public engagement activity

Resource Implication(s): Not applicable

For further information please contact: Amanda Bate, Community Engagement Manager [email protected]

Agenda item no. 12

Agenda item 12 GOVERNING BODY MEETING – 20 MARCH 2018

PATIENT AND PUBLIC ENGAGEMENT UPDATE

This paper provides an update to the Governing Body of NHS Fylde and Wyre Clinical Commissioning Group’s patient and public engagement activity over the last two months. The Governing Body is asked to note the content of this report.

Key

Number Communications and engagement objective 1 Help us to deliver our 2030 Vision 2 Help people to make healthy choices and use NHS resources effectively 3 Use patient experience and opinion to improve NHS services 4 Engage our workforce, clinical partners and stakeholders 5 Make sure we are meeting our legal duties 6 Manage the reputation of the CCG and the wider NHS 7 Build capacity and capability around communications and engagement

Empowering People and Communities

The empowering communities work in each neighbourhood continues to grow and provide some excellent examples of communities working together to improve health and wellbeing.

Healthier has completed their young Chef of the Year aimed at all Year 5 children. This is planned for re-launch again in 2018 and the potential to implement across the Fylde coast is currently being explored. A ‘Tea and Talk’ event was held at Marine Hall in February 2018 and attended by a number of stakeholders and services. Approximately 150 local residents attended to talk about their experiences and their community.

The WIN neighbourhood has being working in partnership with Wyre Borough Council on an onward referral for leg ulcer patients to the Stepping Out service, a physical activity programme utilising local green space which will help to support patients remain well following their treatment. The neighbourhood has also been working on a Social Prescribing Framework.

Lytham St Annes neighbourhood continues to work with local friendship group Just Good Friends who in February 2018 appointed two temporary part-time link workers. These link workers will support any members admitted to hospital by continuing to visit them and maintain links for re-entry to the group on discharge. The workers are available to reach new members who are very isolated. Training for volunteers to ensure sustainable continuous growth of the group will also be part of their role. Holland House Surgery has recently launched an art and health competition open to all residents. The dementia friends training and dementia singalongs in Lytham St Annes are very well attended.

The Kirkham neighbourhood has launched its community hub website GOTCHA (‘Getting our thriving communities healthy and active’). To date this partnership hub between GP practices and the community has had over 2,500 views. The neighbourhood has set up

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coffee morning sessions to provide asset mapping opportunities and grow the volunteer base in the area. So far there is an established walking group, a new COPD support group and future work will concentrate on young carers, social isolation and school attendance. There is also support for working with the local community on growing projects to link with the young chef approach being considered for the Fylde coast.

The fourth annual PPG conference, which is coordinated by the CCG, is scheduled for 22 March 2018. For the first time it will bring together all empowering communities pilot sites and PPG representatives from across the Fylde coast. With approximately 100 delegates, each neighbourhood will be able to share best practice and begin to develop plans for future empowering communities work.

Communications and engagement strategy objectives: 1, 2, 3, 4, 6 and 7

World record attempt

The Fylde coast world record attempt has gathered significant momentum during 2018. This event will take place on Saturday 21 July 2018 at the Lytham Festival arena. The CCG, working in partnership with Lytham Festival organisers Cuffe and Taylor and Fylde Borough Council, will bring together statutory, voluntary and commercial sector partners across the Fylde coast in this ambitious project as part of the NHS70 celebrations. There is significant celebrity and national media interest in the project and an official launch is planned for early May 2018 with promotional videos. Participants will be able to register in advance to take part and the event will be accessible to all. An update will provided at the next Governing Body meeting.

Communications and engagement strategy objectives: 1, 2, 6 and 7

Care home engagement

In February 2018 the CCG held its scheduled quarterly care home meeting, which the CCG has hosted for the last three years. This meeting brings together and supports care homes in Fylde and Wyre to share good practice, receive updates on training, scope new services and an opportunity for everyone to network.

This event is always popular. In February there were 68 delegates from 25 care homes, County Council and the interim care home team. Two matrons also attended from the Teaching Hospitals.

The event was videoed to enable the team to share promotional material and encourage new participants. A range of Vox Box soundbites was also captured with delegates sharing the value of the event to their own work.

Communications and engagement strategy objectives: 1, 3, 4, 5 and 6

Commissioning a better patient experience

Workstreams within the Macmillan Service User Involvement Project have continued to progress in 2018. Analysis of dialogue from the National Cancer Patient Experience Survey (NCPES) Focus Group (held in December 2017) has been carried out and included input from the Patient Cancer Care Improvement (PCCI) group, Fylde Coast Cancer Steering Group, the North West Macmillan team, and the Cancer Nurse Specialist Forum. At the

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event, service users were asked to provide service improvement suggestions in response to the 2016 survey. Resulting initiatives have been co-produced and so far include a Cancer Carer’s Café, a Macmillan funded calendar for newly diagnosed patients (scheduled for 2019), a ‘breaking bad news protocol’ for inpatient diagnosis, and a checklist to assist nurses in having discussions on intimacy. In January a workshop element was introduced to the PCCI group, to promote a shift towards a more proactive role. The group has been feeding into existing workstreams within cancer service improvement such as the NCPES workstream and combatting two week wait missed appointment rates. In order to engage with lesser heard voices, a second patient reference group has been launched in an evening at Blackpool Teaching Hospitals. The group has nine members who are affected by cancer but work daytime hours so find existing engagement events inaccessible. Additionally, a Learning Disability Cancer Network has been established to allow health professionals and providers across cancer and learning disability services to work together. The network will provide a forum for service users with learning disabilities to feed into service development.

Communications and engagement strategy objectives: 1, 2, 3, 4 and 7

Did not attend appointments campaign

The CCG has launched a campaign to highlight the number of missed GP appointments across the Fylde coast and the costly implications of ‘did not attends’ (DNAs).

Figures showed that in December 2017 there were almost 7,000 missed appointments. A press release was developed and run on the front page of the , while BBC Radio Lancashire also featured the piece on its drivetime show with Dr Tony Naughton being interviewed live on air.

The campaign has been promoted heavily on social media with a reach of more than 400,000 and posters have been distributed to all GP practices to promote the importance of keeping or cancelling appointments to local patients. We will evaluate for any reductions in DNAs for the period January to March 2018 and will include an update in the next Governing Body report.

Communications and engagement strategy objectives: 1, 2 and 6

Winter resilience/planning

Significant communications and engagement activity took place over the winter months to support the management of increased urgent care need. This work took place across the Fylde coast and was supported by team members from both CCGs and the hospital. This included promotion to increase uptake of flu vaccinations, signpost people to the most appropriate health services, and support people to self-care as much as possible. Specific activity included a bus advertising campaign which included artwork on the rears and bus stops; paid-for social media advertising, press releases and newspaper adverts. This work complemented the national stay well campaign and helped to make sure that A&E was used appropriately. As this contributes to a wider programme of patient education, monitoring of effectiveness forms part of a wider assessment of A&E utilisation. Work is underway to continue this activity to support resilience over the Easter holiday period.

Communications and engagement strategy objectives: 1 and 2

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Referral management

A patient letter has been developed for GPs to use when having difficult conversations regarding commissioning/medicine policies and what is and isn’t available in Fylde and Wyre. This letter has been produced with the input of the Council of Members and patient representatives. The letter has been approved by the Plain English Campaign. We will evaluate its effectiveness in six months.

Communications and engagement strategy objectives: 1, 2, 4, 6 and 7

FYi directory of services statistics

The FYi directory of services data from 1 September 2017 to 28 February 2018 shows the website has received over 26,000 visits. Visitors to the site varied across age ranges with a largely even split across 25 to 54 years. The number of people aged 55 years plus accessing the site is lower and the lowest user category is people aged 18 to 24 years of age. The steering group continues to meet to ensure the integrity of entries onto the directory is robust and to plan further promotion across the Fylde coast.

Communications and engagement strategy objectives: 1 and 2

Children and young people

Work has begun in relation to engaging children and young people around mental health. A Fylde coast steering group has been set up to look at what work has already been carried out in this area and what insight is already available. Healthwatch (part of the steering group) has previously undertaken a project which involves speaking to young people via ‘care circles’ about their experiences of health and wellbeing. A care circle is where people sit in a small circle and share experiences. As part of this, Healthwatch asked young people their preferred methods of communication, which will prove invaluable when developing future campaigns aimed at this audience. The CCG, along with partner organisations on the steering group has recruited a number of ‘peer champions’ to help take this work forward. The immediate goal is to hold a young people event with a focus on mental health in May 2018. The aim is to engage with children and young people, who are a seldom heard group, by offering them the opportunity to share their views on services across the Fylde coast and to share their experiences in order to influence the future of services. The event is being supported by commissioning and safeguarding colleagues and feedback will be sought on a range of relevant services such as sexual health and mental health. Outcomes from the information will be processed via our You Said We Did approach and reported to a future Governing Body meeting. The event will also aim to raise awareness and reduce the stigma of mental illness.

Communications and engagement strategy objectives: 1, 2, 3, 5 and 7

NHS Diabetes Prevention Programme (NDPP)

The CCG continues to coordinate communications and engagement activity across Lancashire and south Cumbria to support the rollout of the NHS Diabetes Prevention Programme (NDPP). Since going live in July 2017 more than 2,000 people have been referred to the programme. External communications is aimed at raising awareness of type 2 diabetes and the programme in general. Nearly 293,500 people were reached across the Fylde coast via Facebook and Twitter between July and December 2017.

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Further to this, Lancashire and south Cumbria is one of eight pilot areas selected to test drive a range of innovative digital products, apps, gadgets and other online tools. The CCG continues to work closely with the NHS England communications team in relation to the public facing communications. Locally, media coverage was achieved in the Blackpool Gazette, Fleetwood Weekly News and That’s Lancashire TV. Internal communications was also developed and shared with the other Lancashire and south Cumbria CCGs.

The uptake to the programme has been good across the Lancashire NDPP footprint and the need for communications has reduced. Activity to promote the programme is now focusing on areas of lower uptake and any new developments such as the digital pilot programme which Lancashire and south Cumbria is part of.

Diabetes commissioning update

The CCG is the lead organisation for a Lancashire and south Cumbria-wide project looking at improving uptake to type 2 diabetes structured education. The project is operating across six of the eight STP CCGs. There will be two co-production meetings in each CCG locality, managed by a specially commissioned behavioural insight provider. In all there will be 12 co-production meetings, the outcomes of which will be used to identify ways to get more people to complete type 2 diabetes structured education. The co-production meetings will bring together the views of patients, carers, and healthcare professionals.

The CCG is the lead organisation for a Fylde coast project to improve outcomes for people with diabetic foot disease. As part of the continued development of a multi-disciplinary foot care team (MDFT) the CCG is engaging with different groups to ensure that the service meets the needs of our population. Engagement has included regular input at project meetings from local Diabetes UK representatives (both professional and patient) and linking in with broader representative groups including Lancashire LGBT.

Communications and engagement strategy objectives: 1, 2 and 7

End of life update

During the development of the end of life strategy the CCG worked with the CCG Influence Panel to test the proposals within it. This was a key stage in the strategy development – there had already been extensive engagement with professionals groups and organisations that support people at the end of life; however, engaging with patient/public representatives allowed for a more nuanced approach to the challenges that were being identified in the draft strategy. The group directly influenced a number of areas, including implementing the strategy over a five-year period, introducing regular review of the progress of the strategy, and increasing the education offers available to patients, carers, and professionals on the Fylde coast.

Communications and engagement strategy objectives: 1, 3, and 5

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Agenda item no. 12

Lancashire policies review update

The CCG is working collaboratively with the other CCGs across Lancashire to review, update and harmonise a number of clinical policies. Engagement with patients, the public and other stakeholders around these policies is taking place on a policy by policy basis and feedback is taken into account prior to approval by the CCGs for implementation.

The following policies have now completed the development process agreed by the Commissioning Policy Development and Implementation Working Group (CPDIG), which included clinical engagement and a review of the evidence base:

• Policy for Dilatation and Curettage • Policy for Hysteroscopy • Policy for Hip Arthroscopy • Policy for Commissioning Cosmetic Procedures

Ratification of these policies will be sought from the Joint Committee of Clinical Commissioning Groups (JCCCG) this month on behalf of all eight CCGs.

A further policy – assisted conception – is now at the patient and public engagement phase of the process. There has been excellent quality feedback from the attendees of two local events which will help to influence the policy. The consultation ends on 6 April 2018.

Communications and engagement strategy objectives: 1, 3, 5 and 6

National pharmacy consultation

The NHS England consultation on prescriptions of over-the-counter medicines ended on 14 March 2018. The CCG promoted this survey via a press release to local media, direct emails to stakeholders and Influence members and a number of social media posts on both Facebook and Twitter.

The CCG now awaits the results of the consultation from NHS England. Communications and engagement will be required in the planning of local implementation of any recommendations made by the national team.

Communications and engagement strategy objectives: 3, 5 and 6

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Agenda item no. 12

Patient and Public Engagement Group

The Patient and Public Engagement Group (PPE) is chaired by the CCG’s lay member with remit for engagement. The group meets monthly and discusses a range of issues pertinent to the CCG, patient experience intelligence, local concerns and partner activities, equality and inclusion and the continuous development of the CCG’s patient and public engagement activity and infrastructure. The core function of the group is to hold the CCG to account for undertaking meaningful engagement with patents and public. Membership of the PPE Group is diverse, with a number of patient representatives across protected characteristic groups. The group receives regular updates from executive and commissioning leads. The minutes of this meeting are submitted to the Quality Improvement, Governance and Engagement Committee.

In January the group was asked to comment on proposals to change the name of the Memory Assessment Service to the Dementia Assessment Service. The group agreed that this could lead to a number of people not accessing the service who might be discouraged due to fear of a dementia diagnosis. This was fed back to the provider who has decided to retain the current name.

The group also reviewed its Terms of Reference and took part in an interactive workshop session to establish a workplan for 2018 identifying a number of strategic, commissioning and health priorities to guide the CCG’s engagement activity.

The group undertook its function as critical friend on the CCG’s legal duty to involve by receiving and commenting on engagement activity via the patient experience report and public pledge update – pledge 4 (receive high quality healthcare). Key themes in the report outlined: • CQC inspections with all GP practices being rated good. • Winter pressures across the Fylde Coast. • E.Coli targets and progress were also featured. • The Influence Panel update around bowel cancer screening promotion. • There were 11 new members to the Influence Scheme.

The group reviewed the King’s Fund public perception report acknowledging the reluctance for change in the NHS from a public/patient perspective and commenting on the challenges in patient behaviour change to access services appropriately. In February the group reviewed the patient and public engagement which had informed the new GP Quality Contract. The group was informed that a range of patient experience data informs the contract for example the public perceptions survey and the GP patient Survey which is published annually. In addition a range of CCG gathered soft intelligence feeds into the contract. A report detailing where patient opinion and insight has been influential, and the difference it has made, is being finalised.

The group also reviewed the CCG’s Annual Report 2016/17 and Review of the Year 2016/17 to establish if these met the CCG’s legal duty to involve. Comments from the session will inform the report and any public facing materials produced for the period 2017/18.

The group reviewed and supported the materials and engagement plan for the ‘Did not attend’ campaign.

Communications and engagement strategy objectives: 1, 2, 3, 5, 6 and 7

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Agenda item no. 12

Patient Participation Groups

It was with great sadness that we learnt of the sudden death of PPG chair for Clifton, Peter Morgan. Peter was a much respected regular contributor to the PPG chairs’ group and was deeply committed to ensuring the patient voice was represented in the commissioning of services. The CCG and chairs would like to pass on their sincere condolences to Peter’s family.

The PPG chairs’ group continues to meet bi-monthly and build upon shared good practice.

In January the meeting was attended by 17 PPG members representing 13 practices. All neighbourhoods are now represented at this meeting.

The group welcomed new Holland House PPG chair Karen Donley who has been very active within her PPG organising and delivering dementia friends training to practice staff and wider community members. Karen also plays a significant role in organising the very popular dementia singalong events in Lytham.

Chairs were informed that the GP patient survey would be live between January and March 2018 and were asked to assist in promoting this where possible to encourage patients to fill out their form if invited to take part. Posters were distributed at the meeting for display in practices.

The group also discussed the GP Quality Contract with a presentation by B. McKeowen.

Individual updates included the Thornton Practice PPG who has been working with local schools on the Healthier Heroes art competition which has won a Health and Wellbeing Education Award. Ash Tree House walking group continues to grow with 12 regular members. Holland House PPG now has over 200 virtual members as well as a face to face core group which meets regularly. The surgery has been holding ‘dementia singalongs’ and plan on continuing this activity. They have also just commenced on a new art work project to design a calendar to raise money for a charity. Park Medical held a Christmas jumper day.

The fourth annual PPG conference will take place at Ribby Hall on 22 March 2018. This is a full day event which for the first time will bring together PPGs and neighbourhoods to showcase the empowering communities work across the Fylde coast. There will be a range of presentations and workshops to enable neighbourhoods to develop their priorities and plans for working with their local communities utilising the PPG volunteers as appropriate.

Congratulations also go to Kirkham Health Centre which now has an active PPG with around 10 members.

The CCG continues to assist practices to get the most from social media. A total of 15 practices are now using Facebook, which has been shown to be an extremely effective tool to reach a large local audience.

Communications and engagement strategy objectives: 1, 2, 3 and 7

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Agenda item no. 12

Influence Panel

The Influence Panel has continued to meet monthly. In January, 15 members were present to discuss the national consultation on over-the-counter medicines. The Panel was largely supportive of the proposals being suggested in the consultation, but did make a number of comments which will be fed back to NHS England as part of the CCG’s response.

In February, 11 members attended to discuss the CCG’s annual report and how patient and public engagement should shape the documents this year. The group expressed a desire to be given opportunities to proofread the annual report prior to its publication.

A recruitment drive has been launched in March in an effort to attract new members to ensure a representative voice from across the Fylde and Wyre area.

Communications and engagement strategy objectives: 1, 2, 3, 5 and 7

Influence membership

The CCG’s Influence membership scheme continues to keep members up to date on news relating to health and care in Fylde and Wyre, while also offering people the opportunity to take part in surveys or events.

There are currently 841 Influence members.

Communications and engagement strategy objectives: 2, 3, 6 and 7

Online patient survey

The CCG constantly gathers feedback from local people electronically using the online patient survey. All information gathered from the survey is inputted into Datix to assist the CCG in identifying any themes or trends in comments from the public.

There have been 359 completed entries to the patient survey since it was launched. The majority of respondents are positive about their experience of primary care locally, with 89% describing their experience of their GP surgery as ‘very good’ or ‘fairly good’.

Communications and engagement strategy objectives: 3, 5 and 7

Social media

The CCG has continued to grow its following on social media, ensuring important messages about health and care in Fylde and Wyre are received more widely.

The CCG’s Facebook page is ‘liked’ by 1,484 people and ‘followed’ by 1,505. This places the CCG in the top nine followed CCG pages across the UK. Content is regularly updated and receives high levels of engagement.

On Twitter, the CCG has 2,899 followers.

Communications and engagement strategy objectives: 1, 2, 3, 5 and 6

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Fylde Coast Integrated Care Partnership

The core script and associated materials to support the ICP’s development have been refined, and the communications campaign will be launched shortly.

A significant amount of work has been ongoing to better understand the function and capacity of the partner NHS communication and engagement teams, and to develop protocols to ensure consistency across all ICP workstreams with respect to communications.

Communications and engagement strategy objectives: 1, 2, 3, 5, 6 and 7

NHS England assurance

Analysis of NHS England’s patient participation toolkit has been undertaken, and an action plan has been developed to address any gaps, or to further develop what the CCG is already doing well. Key actions include the following: • Ensuring the annual report 2017/18 meets the statutory guidance with regards to engagement • Further strengthening how we capture engagement activity ongoing across the CCG and ‘you said, we did’ stories • Further developing the CCG’s Patient and Public Engagement (PPE) Group to strengthen its advisory/quality assurance function, and include a feedback loop at meetings • Ensuring all ‘seldom heard’ groups have a voice at the PPE Group • Updating the website to ensure any gaps in engagement activity are addressed

Communications and engagement strategy objectives: 1, 3 and 5

Recommendation

The Governing Body is asked to note the contents of the report.

Kate Hurry Amanda Bate Head of Communications, Community Engagement Manager Engagement and Development

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