South Staffordshire Patient Participation Group (PPG) Self-Assessment Findings January 2019

• Help PPGs and Practices reflect on their strengths, areas they’d like to improve and opportunities • Inform future planning by the PPG and joint working opportunities with the Practice • Help shape the picture the CCG has of PPGs across the patch, as a baseline • Inform the resources and information available on the new PPG Resource Webpage • Support 1-to-1 conversations with Practices by the Primary Care Team • Promote the fantastic work undertaken by PPGs and the difference they make

PPG self-assessment template shared with Practice Managers and PPG Chairs

Representatives from PPGs and GP Practices complete and return the self- assessment (either separately or jointly)

Findings collated to identify common themes & trends

Small workshop with a Lay Member, Communications Team and Primary Care Team representatives to discuss results and consider next steps

Report to be shared to Primary Care Committee, then wider dissemination Current Stage and next steps taken forward

5 out of 14 SAS GP Practices (36%) 14 out of 23 CC CCG GP Practices (61%)

3 both Practice & PPG Perspective 5 Joint PPG & Practice Perspective 1 Practice only perspective 5 Practices only perspective 1 PPG members only perspective 4 PPGs only perspective

(8 PPGs Regularly are represented at (9 PPGs regularly represented at District PPGs) District PPGs)

11 out of 17 SES Localities 2 Seisdon Peninsula Locality GP GP Practices (65%) Practices (22%) 1 Joint PPG & Practice perspective 1 Joint PPG & Practice perspective 4 PPG only perspective 1 Practice only perspective 6 Practice only perspective

(5 PPGs regularly represented at District (8 PPGs regularly represented at District PPGs) PPGs)

538 PPG Members 18 PPGs (including virtual members) Engage with members virtually regularly (e.g. quarterly / monthly / Approximate Frequency of weekly) Meetings PPG Chair 2 PPGs 18 PPGs 9 PPGs 20 Patient Chair No meetings Quarterly Never or infrequently engage with members 6 Practice Rep virtually 1 Joint Patient & Practice Rep 3 PPGs 9 PPGs Monthly Approx Bi-Monthly

Meet and Greet Newsletters Patient Folders AGM / Meetings with Patients Telephone Posters Facebook Comments / Suggestion Box Adverts Notice Board Emails

Community / Forum Coffee / Sales Waiting Room Video Articles in Community Website Morning Screen Group Newsletters

Comments Forms Local Councillors Encouraging Flu Uptake Nextdoor Website

Patient Satisfaction Survey / Questionnaire / Diabetes Awareness Event including training Displaying Results

Talking to patients in the waiting room (e.g. to Website (including PPG section on the Website and/or promote online access) Minutes)

• Several PPGs are using Facebook to update patients, share articles and gather vievws • Several PPGs are considering the use of social media (including plans to introduce over the next 12 months) • Concerns raised around social media use included around monitoring / moderation, patient confidentiality, offensive language, expertise and time for set up & maintenance. • Closed Facebook groups are being considered or implemented in some PPGs. • A PPG highlighted sharing intelligence gained from social media at monthly meetings.

Average Score Across the South Staffordshire CCGs

G: PPG Makes a Difference and Celebrates Achievements SCORE

F: PPG is Organised Effectively SCORE

E: PPG Communicates and Involves Patients SCORE

D: PPG is Accessible and Inclusive SCORE

C: PPG & CCG Work Communicate Well Together SCORE

B: PPG & Practice Work Effectively Together SCORE

A: Approach & Ethos SCORE

0 0.5 1 1.5 2 2.5 3 PPGs & Practices working together and being effectively organised scored the highest average ratings The PPG and CCG working and communicating well together has the lowest overall average

Category / Number PPGs Comments D: ‘Our PPG is accessible and ‘Things in place for discussion at next meeting’ inclusive to all patients and we ‘Patient survey to be completed in new year’ proactively seek a range of views’ ‘Open meetings are generally just when we have the AGM as these have been quite lively in the past. Only one 4 PPGs new member has joined 2016-18, 2 new members joined 2015-16. Most of the group have been long standing members of the PPG. This can sometimes discourage new members as the group appear very clicky’ ‘We aim to be accessible but have not managed to gather views from patients outside of the PPG’ E: ‘Our PPG effectively ‘Other than a patient survey bi-annually we don’t feel that we do engage with other patients.’ communicates with and involves patients’ 5 PPGs F: ‘Our PPG is organised ‘An example of effective organisation to us is when dates of meetings are set in advance in order to give ample effectively’ time to advertise open meetings. Meetings are not regular and open meetings are not well advertised due 2 PPGs to time frame between setting the date and the event. ‘ G: ‘Our PPG makes a difference ‘… but we intend to!’ and celebrates our achievements’ 5 PPGs

14 PPGs had a self-assessed rating of ‘1’ for at least one category

Overall Average Score by CCG/Locality and Practice

CC - B

CC - D

CC - F

CC - H

CC - J

CC - L

CC - N

SAS - B

SAS - D

SES - A

SES - C

SES - E

SES - G

SES - I

SES - K

SP - B 0 0.5 1 1.5 2 2.5 3

x12 Self-Assessments: Good relationship between PPG & Practice (e.g. communication, supporting through change and co-operation)

x7 Self-Assessments: Newsletters

x5 Self-Assessments: Surveys

x5 Self-Assessments: Increased PPG membership

x5 Self-Assessments: Regular PPG Meetings and Attendance

Production of a Practice Handbook Networking with community Provided refreshments at flu clinics for new patients organisations locally

Help with Health Awareness Appointed a PPG Chair Reduction in DNAs Sessions

Members attended surgery to Run informal coffee mornings Agree Terms of Reference encourage use of touch screen

Promoting online access Setting up a carers group Funding a Phlebotomy chair

Leading the Practice Achieving CQC Report Good across 5 areas Improved Noticeboard and Signage Dementia Friendly Status

x13 Self-Assessments: Increase PPG membership including diverse representation

x7 Self-Assessments: Improve communication and engagement with patients e.g. increase communication frequency

x7 Self-Assessments: Virtual Group / increase social media use

Hold patient information Review survey results and Support and promote sessions develop improvement plan community signposting

Be more proactive Set up a PPG Noticeboard Improve the website

Try to increase online Continue DNA monitoring Become more patient led appointments and uptake

Educate patients about repeat Promote PPG involvement & Start a carers café prescriptions & dispensing representation from other sites

x6 Self-Assessments: Recruitment of PPG members & continuity

x5 Self-Assessments: Diversity of membership (e.g. age range)

x5 Self-Assessments: Maintaining interest & commitment to the PPG, alongside other commitments & time pressures

Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 15 Example of other challenges raised & PPGs’ own resolutions Challenges Resolutions No PPG members who are willing to be a member of the District Group Difficult engaging with the local community Attend support groups that represent wide variety of different service users and give talks about the work of the PPG

Using the meeting as a vehicle to complain about Introduced ToR and Code of Conduct services which was affecting morale Reducing wasted appointments Robust work in sending out DNA letter & using Newsletter to advertise cancellation of appointments Difficulty in collecting soft intelligence Encourage sharing of soft intelligence. Opportunity to make sharing soft intelligence more readily available to patients?

PPG found it hard to understand a GP cannot always be present at the meetings Changes with the practice Actively support Doctors and Reception staff

Category / Number PPGs Comments

A: ‘Our PPG has an effective ‘I don’t feel that members have an effective approach. Certain members make decisions, the rest follow.’ approach and ethos that is proactive and promotes listening, engaging and learning’ 3 PPGs

B: ‘Our PPG and the GP Practice ‘We normally have 2 PPG meetings at the practice a year. The main contents of these are normally GP work effectively together in availability, problems with the telephones and lack of producing of the newsletter. I feel that the PPG group partnership’ expects a lot of the practice but gives little back in return’ 2 PPGs C: ‘Our PPG and the Clinical ‘The chair feels this could be more effective by listening to what Practice members request and ideas put Commissioning Group (CCG) forwards to help promote groups.’ communicate well together’ ‘Our members who were on the board did not attend’ 8 PPGs ‘We have 2 PPG representatives that attend the District PPG. Whilst links between the PPG and CCG are strong, our representatives often feel that the relationship is one sided as they feel they contribute very little to the District PPGmeetings since we are very practice-focused.’ ‘No input from CCG’ ‘Requested a meeting with the CCG which the declined’ ‘Previously members representing the group at district and patient council level became increasingly disappointed that the CCG no longer appears to listen to the patient voice’

• Ask University students what they would like from a group? • Small budget / funding to support PPG work? • PPG is encouraged with additional staff / changes in the practice (e.g. additional hours the surgery is open) • Feedback that the exercise was expecting too much of the PPG volunteers, limited resources and time. • Expectations around PPG volunteer role • PPG actively targeting DNA appointments – including sending letters to patients and displaying monthly DNA appointments in the waiting room. • Meeting monthly sustains the momentum and interest of group members. • ‘Attendance of clinical staff and the Practice Manager at PPG meetings demonstrates the close working partnership that underpins all the [PPG does] and reflects mutually shared respect and appreciation.’ • ‘How do you overcome patient apathy?’

Conclusions and Next Steps

• Strong evidence of PPGs and Practices working together effectively to make a positive difference to patients / carers and their practice. • Clearer picture on the status, achievements, plans & challenges faced by half of the South Staffordshire CCG GP Practices’ PPGs. • Virtual groups, use of social media and continuing to grow PPG membership & inclusion is an area of development for many practices in the coming months, though there are still some reservations and challenges to wider rollout around social media. • The importance of good relationships between the Practice / Clinicians and PPGs to supporting strong and effective groups was highlighted. • PPGs use a range of opportunities to engage with patients to not only keep informed but canvas opinions, co-develop and promote new ways of working (such as patient online access). • PPG and CCG communication together is an area that could be developed/improved upon further. • PPGs have led on or supported a range of changes and developments in GP Practices, including encouraging greater use of patient online access and achieving dementia friendly practice status.

Recommended Next Steps Encourage and Enable Achievements and Case Studies to be Shared Regularly: • Ask for case studies for use on CCG websites and bulletins (for example around work by a PPG to help reduce DNAs or encourage flu clinic attendance). • Consider additional opportunities for PPGs to share ideas and initiatives, such as at future workshops • Consider nominations for PPG of the month and/or annual celebration to recognise PPGs work • Consider adding a PPG category to any future CCG Annual Awards • Consider highlighting example PPG achievements / case studies to CCG AGMs and Annual Reports • Promote the role and impact of PPGs across GP Practices during Engagement Visits. Facebook / Social Media Developments: • Learn from the North Staffordshire & Stoke-on-Trent CCGs use of Facebook by PPGs (such as impact, costs and how challenges have been resolved). • Encourage social media use by South Staffordshire CCG Practices and PPGs to engage with patients. • Explore opportunities for funding to support PPGs to use social media to engage with patients.

Recommended Next Steps Build on the Resource Toolkit for PPGs • Include additional case studies, examples and ways PPGs have resolved challenges. • Share good practice and help link PPGs together to discuss ideas and experiences. • CCG could provide a steer on upcoming priorities that PPGs could chose to focus on • Support PPGs’ role in CCG health awareness campaigns • Encourage use of the toolkit at District PPG meetings Engage with Practices • One-to-one conversations by a relevant member of the CCG to discuss challenges, concerns and opportunities where a practice self-assessed one or more criteria with a ‘1’ score. • CCG to engage with practices that have not completed a self-assessment to understand position (e.g. if a PPG is in place, what’s working well and any challenges faced).

Cannock Chase Clinical Commissioning Group North Staffordshire Clinical Commissioning Group Stafford and Surrounds Clinical Commissioning Group East Staffordshire Clinical Commissioning Group South East Staffordshire and Seisdon Peninsula Clinical Commissioning Group Stoke-on-Trent Clinical Commissioning Group 22 Recommended Next Steps Other Next Steps: • Repeat this self-assessment exercise in South Staffordshire later in 2019 to compare to this baseline. • Share the details of this exercise with the Staffordshire CCGs in the North and East to enable the option for a countywide roll-out. • Explore a query on fundraising by PPGs – especially where this is used towards the practice. • Explore the option for all PPGs to join the NAPP.