PATIENT GROUP & COMMUNITY MEETING

Notes of the meeting held on Thursday 5th September 2013 at Carlisle Business Centre, Bradford NHS Bradford City Clinical Commissioning Group (CCG)

A list of attendees and apologies is provided at the end of this document.

Overview NHS Bradford City Clinical Commissioning Group (CCG) hosted a Patient Group and Community Meeting on 5th September 2013 inviting all city based patient groups, organisations and forums to explore ways of working together and build stronger links for engagement so we can better the health of people who live in the City CCG area. The meeting commenced with a welcome and introduction from Becky Mears of Healthwatch Bradford and District. She gave a brief introduction to the afternoon, setting the scene and explaining the role of Healthwatch as a partner and critical friend of Bradford City Clinical Commissioning Group (CCG). Dr Waheed Hussain, GP from Bradford City CCG, welcomed everyone explained the role of the City CCG, who they are and what they do. The role of the CCG governing body is to make sure that the CCG does its work in the right way. The role of the clinical board is to design and plan the services the CCG need to buy. They are also responsible for engaging with local people to ensure that the services they are paying for and planning will meet your needs. Waheed briefly explained the services that the CCG buy and which NHS England and Public Health are now responsible for. He finished with describing the key areas that Bradford City CCG wants to focus on and why. These are Diabetes and Engagement with local people. The presentation is attached and slides 3-14 cover this content. Max Mclean, Governing Body lay member from Bradford City CCG, thanked everyone for attending and agreeing to share the CCG commitment to engagement. Max explained why it is important to the CCG to get this right as well as setting out the values and principles of engagement in the NHS Constitution. He shared the challenges as assets the CCG has – being a deprived area but with a young population. He talked about his role as a governing body member and the role the Council of Members have in the CCG. Council of Members is there to

2

represent your needs and views on local health services. Each doctor’s surgery has a doctor who represents you. Max then described how people can get involved with the CCGs current work. He then described the challenges of Patient Participation Groups (PPGs) and how Bradford City CCG needs to ensure it has a structure or framework of engagement that works for the people. Max finished by describing an aspiration of working together – he described a model called a Citizens Assembly which will give a voice for patients and the public within Bradford City CCG. This information presented can be seen on the attached presentation in slide 14 – 20. Becky and Max then introduced the discussion activity. They explained the CCG is aware of the challenges described and that the current ways of engaging people don’t reach everyone so they wanted to hear from everyone and learn and improve together. The Citizen assembly was described as one new method of engaging and involving people. The discussion time was also to be used to see if people wanted to meet in this format and how people feel about bringing PPG and community groups together as this was different to the other two CCGs in Bradford District (Bradford Districts and Airedale, Wharfedale and Craven) who have PPG membership only. The three discussion questions were: Q1: What does good engagement look like?

How do we know it is good?

What makes it good?

Q2: Discuss this patient and community network event and if and how to meet in the future

Discuss issues with PPGs in City

Explore future formats and ideas of meeting?

Q3: What are your thoughts about the Citizens Model?

Suggestions, changes, recommendations, comments?

Is there an alternative – what, explain?

The group tables then fed back key points from their discussions and an overall summary was provided by Max and collated by Sasha. The feedback from these discussions can be found on pages 3 - 7. Max and Waheed thanked everyone for the contribution and a commitment to meet again in November was agreed. Please see page 7 for next steps. Max then drew the meeting to a close.

3

Feedback from discussion groups

Q1: What does good engagement look like?

Involvement matters

Changes are seen to be made

Making sure patients are aware of

changes and actual change takes

place

People can see how they can be

involved and at different and all

levels of the organisation

Shared decision making

Patients and communities are

involved in research, audits, reviews

and governance

Communication

2 way processes

Get the first time contact right

Using IT and social media

Clear information

GP practices to promote PPGs

Fun with surveys, e-views, games

and online virtual meetings

Training and resources

Ensure people know how to voice

their view and communicate back

Always feeding back as routine

Sharing and Learning

Group talks on health topics

Have good facilitation

GPs, PPGs, groups all sharing

good practice and working together

Having space and time to listen

Creating and developing ideas and

services together so we can all be

more responsive to needs.

Looking at what is working well

Other comments

Mutual respect and ownership

Allow more time

Joined up approach as too much engagement

Too many structures and fragmented

engagement – people don’t know what to join

or asking the same Qs again

Acknowledge patient time and design around

‘real lives’

People are using services better Openness

about all work

Bring different sectors together

What does good engagement look

like?

Representation and reaching out

Fully representational – reflecting staff, patients,

communities, ages and abilities – everyone counts

Involving young people how they want to be involved

The representation of organisation matches

representation of community

The organisation is part of the community

A range of people involved

Engaging with local people

Reaching patients and people who do not visit a GP

practice

Patient representation from all areas

Key points:

People can see their involvement makes a difference and be part of making change

Good engagement needs to be fully representational of patients, community and staff

Everyone’s view counts

A joined up approach to engaging with people from all health services

4

Q2: Discuss this patient and community network event and if and how to meet in the future

KEY THEMES

Key points:

Make sure people can see changes happening

Support to meet again in this format and also support PPGs to develop

Take account of differences and needs – be representative and inclusive

Support and share good practice

Patients to have the lead

5

Future topics:

How commissioning decisions are made and how people can influence

How you decide who to buy services from (can be included in above)

City, the people, poverty and health

How do you work with the local authority, social care and the new public health

Feedback on complaints and issues – how does this work, where and who to raise issues with

Out of hours services and access to GPs

Quality of services

Diabetes

Young people and promoting good health

Shisha smoking

Mental and emotional health

How do PPGs work and what makes a good PPG

Self-care

Sign-posting and advocacy

How to measure success and good outcomes for a PPG/service-user group

Considerations to bear in mind:

PPG structures are limited – people go when they have an issue

Support for a more inclusive community structure like today’s meeting

Acknowledge that PPGs are not right for everyone, promotion needs to be better

Use different ways and methods – IT, social media, discussion forums

People’s time is precious and people have different roles and responsibilities

Vary the times and places

Consider child care

Create sub-groups so people can attend what interests them (e.g. young people, Eastern

European, diabetes, stroke etc)

Involve and include university resources

Involve more GPs and clinical staff

Work with other groups, organisations and communities to reduce duplicate and increase

reach, meetings could tour varied community settings

Advertise widely

Use different ways of feeding back with newsletters, photos, visual and audio material

Evaluate the PPGs that are working well

PPGs need a ‘driver’ to promote and attract people

6

Q3: What are your thoughts about the Citizens Model?

Key points:

Good idea – take time to get it right – build up engagement of PPGs, groups and grass roots organisations and use existing structures to support it

Ensure that it represents local needs and people and that it is patient led

Make sure it is adequately resourced – with training and support – clear roles and structures

Ensure accountability, membership and outcomes are open and clear

Shared decision making and ability to impact on policy and practice

Citizens Assembly

Patient Led

Fully resourced

and supported

Co-develop policy and practice

Shared decision making

Topical and outcome focussed Built up

from grass roots

engagement

Inclusive, reflective and representative of local people

and needs

Cross-sector

partnership

Integral to CCG constitution and

governance with ability to

have an impact

Accountability and

Transparency

7

Other comments about the Citizens assembly:

Building the foundations right from the outset

Patients should lead from the outset and let the assembly write its own constitution

Ensure that the role is an accountable role and the accountability runs 2 ways - ensure the

CCG is accountable but need to make sure it is accountable to the community

Needs to be formal to ensure it isn’t an empty gesture – but level of formality should not

become a barrier for lay people to engage and be involved

Adequately resourced so it isn’t set up to fail

Name? is this the right name for it? Citizens Council or Council of Citizens? Panel?

Nomination process to be thought out – elections, rolling membership?

Limited time on panel/assembly – 12 months, 2 years, 3 years?

Needs to be representative and pool a wide range of people from different skills,

backgrounds, abilities, organisations, communities, PPGs etc

Use the CVS and CNet as a source to recruit people

Build on existing structures of PPGs, partnerships, hubs, groups and organisations working

with patients (e.g. Strategic Disability Partnership), Barnardos, etc)

How will we decide the numbers needed? Reflect ward areas or GP practice areas? For e.g.

have 28 members to reflect the 28 practice places?

Next steps

The consensus in the room was to meet again and:

1. Sasha to circulate information – copies of the slides and collated feedback

2. Establishing a steering group with patient representatives to oversee the planning of the future network meetings

3. Plan to meet again the week commencing 4th November 2013

4. Include topic on how to share good practice – being creative with presentation

5. Presentation on commissioning intentions with discussion activity

6. Agree next steps (set topic and dates for 2014).

Thank you for attending and your contribution

8

engage@bradford.nhs.uk

Attendees

Name PPG/Organisation/Group Or Individual Representation

Abdul H Ismail CNet

Jean Walker, MBE SDP

Nigel Goff Independent Complaints Advocacy Team

Alam Gir BEAP

Jasmine Husain Community Member

Nisa Iqbal Parkside Medical Practice

Amina Rehman Champions Show The Way

Jennifer Powell Sharing Voices

Paul Anderson Contact

Ann West PPG

Laela Khan Community member

Richard Rowland Community member

Anne-Marie Mitchell Picton Medical Centre

Latifa Ismail Carers Connection

Rory Argyle Horton Community Farm

Ann-Marie Leach Dr Wilson & Partners

Linda Howard Bradford Cancer Support

Roshan Ibrahim Community member

Bindy Bassra Little Horton Lane Practice

Lucy Snow Community member

Sadia Khan Community member

Carol Peltier BOPA

Lynda Smith Dr Jandu & Partners

Sandra Brown BACC

David Spencer Dr Wilson & Partners

Maria Kulsum Community member

Saleem Khan Council Of Mosques

Dr Anwer Azam Parkside Medical Practice

Margot Black Community member

Shakila Hanif Grange Interlink

Elaine Shaw Student Health Service

Margret Butlin Headway, Brain Injury Support Association

Sughera Hussain Whetley Hill

Emmerson Walgrove Bradford Speakout

Mark Nicholson BD Disability

Swapna Basu Whetley Hill

Eunice Bamgboye Maximum Potentials

Mohammed Ibrahim Primrose Surgery

Steve Butlin Headway, Brain Injury Support

Gemma Shann Student Health Service

Mohammed Shabbir Sharing Voices

Yakoob Ali Community member

Iris Laycock Headway, Brain Injury Support Association

Mohammed Yaqoob Undercliffe Medical Centre

Zareen Hamid Community member

Isla Dowds BTHFT

Mussarat Nazir Community member

Zulfiqar Hussain Community member

Isma Khan Community member

Nazia Aleem Community member

Apologies

Name PPG/Organisation/Group Or Individual Representation

Akhtar Khidmat Centre – COM

Firdaws Khan EPP

Poonam Joshi Primrose Surgery

Andrea Beever ICAT

Jalal Uddin BD3 BCA

Sue Whelan Community Member

Ann-Marie Leach Dr Wilson & Partners

Joan Fenton SDP

Sarah Worth Community Member

Claire Blacka Home Group

Julia Hall Good Food Award (Bradford) Project

Yasir Hamid Community member

Cynthia Light. SDP

Karen Stothers Bradford City CCG

9

Speakers/facilitators

Becky Mears Development worker - Healthwatch Bradford and District Max Mclean Lay board member for City CCG Waheed Hussain GP board member for City CCG Fiona Stephens Associate Director of Corporate Affairs Mohammed Sharif Associate Engagement and Patient Experience Rob Mooney Senior Associate Engagement and Patient Experience Sasha Bhat Senior Associate Engagement and Patient Experience

Summary of abbreviations used in this document CCG – Clinical commissioning groups GP – General Practitioner PPG – Patient participation groups

If you require further information or would like a printed copy of this document, please contact: Sasha Bhat Email: sasha.bhat@bradford.nhs.uk Tel: 07956 323 180