Patient Reference Group 08 November 2016 Room BG.01, Woolwich Centre, Ground floor. Name Job Title Organisation

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1 Patient Reference Group 08 November 2016 Room BG.01, Woolwich Centre, Ground floor. PRESENT: Name Job Title Organisation Dr Greg Ussher (GU) (Chair) CCG GB Lay Member CEO, Metro Dr Sylvia Nyame (SN) CCG GB GP Executive NHS Greenwich CCG Director of Integrated Governance NHS Greenwich CCG Diane Jones (DJ) Head of Communications and NHS Greenwich CCG Angela Basoah (ABa) Engagement Stakeholder Engagement Officer NHS Greenwich CCG Patricia Kanneh-Fitzgerald (PK-F) Shirley Gibbs (SG) Lay member QEH Patient User Group Angela Burr (Angie) (AB) Lay member Local Resident/Ferryview Practice Paul Richardson (PR) Lay member PPG Plumstead HC Carol Berry (CB) Compliance Manager NHS Greenwich CCG Frank King (FK) Lay member PPG Ferryview Gilles Cabon (GC) Clive Mardner (CM) Chief Executive Officer Representative Volunteer Development and Outreach Officer Greenwich Inclusion Project (GRIP). Greenwich Equalities Organisations Forum (GEOF) Healthwatch Greenwich Frances Hook (FH) Lay member PPG Manor Brooke MC Jo Murffitt (JM) in attendance Chief Officer NHS Greenwich CCG Will Smith (WS) in attendance MSK service for Circle Circle Kat Dixon (KD) in attendance Busayo Beyioku (BB) in attendance Project Manager for Circle Greenwich Business Support Officer - Minute taker Circle NHS Greenwich CCG 1. Welcome and Introduction GU opened the meeting and welcomed everyone. Chair: Dr Ellen Wright Chief Officer: Annabel Burn

2 GU advised that everyone should be clear about the organisation/group they are representing 2. Apologies Eileen Smith (ES) Jenny Dyson (JD) 3. Conflict of Interest Clive Mardner is a councillor RBG (Royal Borough of Greenwich) 4. Minutes of previous meeting Minutes were accepted with this minor change: Pg 3. SG noted that it was not her that was seen by physician associate but it was her neighbour that came to her and was concerned of who these people were. In addition: PR would like to see section of matters arising added to the agenda. Also members want to see Primary Care & Estate Strategy carried forward to be discussed further, especially the patient engagement relating to this. Patient Care and Estate Strategy to be added to next agenda. Minutes from the PRG are available on the website. 5. Action Log Action 2 To make PRG minutes on the website into pdf. Action 11 PR whilst attending the CI there was a lot of voluntary sectors who said that they had not been invited to the stakeholder s providers and that they have had their money cut. Concerned that this didn t come through the PRG. The incontinence service is only being cut for children All Finding a way of making the Estate strategy more user friendly alongside the CFO The number of people at the workshop CI workshop. Staff v public A list of decommissioned services 6. Introducing Joanne Murffitt JM originally trained as a nurse and has worked in the NHS for over 35 years. Before joining Greenwich CCG, Jo worked at NHS England as Director of Public Health Commissioning, Health in Justice and Military Health. She has previously served as Director of Commissioning and then Chief Operating Officer at Ealing PCT. She takes over the helm of Greenwich CCG at a time when we face a number of challenges. She will lead the CCG as we continue to make steady progress on our financial recovery and her experience as a national-level commissioner will be invaluable as we manage demand for urgent care services during the winter period. Questions were raised around what she will do for the elderly and the community. How will she evaluate the GP s in terms of them calling the blue light? Also what will her input will be in terms of improving staffing quality? JM I will be looking around the areas of prevention, screening with older people, mental health & wellbeing, discharge services and what is the nature of support to older people. In terms of auditing the GP s calling the blue light 2

3 this is absolutely right. I will have to look into this. SN it is a complicated question because there are several factors to consider not just necessarily poor inventions or delayed treatment. You get a lot of people who don t want to go to the hospitals and come very unwell to the GP s but they may be far gone from what the GP can do for them resulting in FH the messages that are coming out from the NHS that say don t go to A&E. JM I don t think the message is there to tell people not to go to A&E but more to tell those who may have issues that can be managed at home to try this first before approaching A&E. AB if there was a way of managing care in the community I think the rate of people that go to A&E will decrease but we don t have the qualified staff to handle this. SG is concerned with the care in the community with less appropriate qualified nurses assessing patients. CM when considering cuts to the services are decisions based on factors other than the financial aspect? JM We need to be aware that the CCG and NHS financial position is not looking to get any better soon. So tough decisions will have to be made. There are ways to make the decisions and we have to live with the consequences. GC How can we ensure that there is transparency and how can the PRG be effective to the CCG? JM being here only 5days I need some reflection on this. But I understand the need for more engagement and I hope I can achieve this. 7. Circle Health Presentation Re-Introduction of everyone presented in the room. KD Hand-outs that cover a bit about their model, who they are, what they are hoping to do in Greenwich, what patient engagement they have schedule in Greenwich and local engagement with GP s, ideas for the future and getting a sense of what patients would like from the service. Model WS Circle are an integrator; we are not coming to run the health care services. We want to work alongside local providers in a partnership style to achieve the overall objectives of the model of care. Circle will be capturing all referrals through a single point of entry and we call that the integrator providers hub which can come in electronically or via paper. Clinicians will be triaging within 24hours and then the patient is placed on a pathway. Every stage within the pathway offers patients choice: choice of 3

4 provider within the borough and giving them different metrics. Hopefully Circle will be setting up community hubs around 5-7 hubs in these hubs we are looking to provide additional clinical care for patients that might not need to be seen in the secondary care setting. We are here to help providers if they have issues meeting their 18week targets. So from the model we are hoping for shorter waiting times. Questions on the Model SN how will you adapt this model to someone e.g. may have dementia. How do you insure that they can navigate the system? How do you make sure they get to that appointment if they live alone? KD we are exploring the idea of care navigators especially with patients with those types of needs. We want them to have a single point of contact within the Greenwich service. So they will be calling up the patient and being that one point of call. If the need for more care navigators is needed we will provide this. GU there are different communities that have different needs with the service that they are receiving currently and there are communities that have difficultly accessing the system currently. Will Circle work be monitoring the access as a whole, assessing that against the need of the community within Greenwich? WS we want to understand the access issues and address them. We will work on that and getting feedback will help us make adjustments to the model and pathway. DJ it is the CCG s responsibility in understand the needs of its local population, that is what comes out of our JSNA. If we see a gap in who is being referred in it is something that the commissioners need to respond to. CM how will you provide information to the patients in ways that they can understand WS we provide information on websites, via videos, patient choice information, patient information leaflets, app etc. SG concerned with the need for more diagnostic locally? WS we won t have full diagnostic capability in every hub because it is not practical, certain places like Eltham will be commissioned to have diagnostic support, and some will have lower level diagnostic. We need to understand what capacity each of the local providers have from a diagnostic capacity perspective. Engagement Segment KD Patient and local engagement and GP engagement. 4

5 We have meet with: Healthwatch the voice of the patients and how we can provide transparency and information sources; putting up Q&A s, a description of service and availability and a link between us. The Pensioners forum. 2 next week Plumstead health centre and Eltham community hospital available via Healthwatch bulletin Met with key GP s in the area and local GP federation board. Ideas for the future We are hoping for a patient group just based on MSK services, linking into the different communities to get diverse feedback. Putting together information packs and working with GP s. JM The current status of the contract is that the scrutiny committee have asked the CCG to commission with Lewisham and Greenwich an impact assessment and go back to them with it. Then we need to understand the next steps. We are not in a position to sign until it is agreed. FH would like to see what the service is now to what it is going to be to understand one from the other. Also geographical location of the potential hubs and what they will contain. 8. Engagement Update ABa The Stroke workshop there is a commitment from the project team to look at the feedback which is currently being put together so hopefully by next meeting we should have a report. Looking forward we are hoping to have a report after every engagement session, then go back to the project team so that they will look at how they are going to respond to that feedback. 9. The Source Picker Report DJ this was the final findings of the public engagement which took place We had the 3 sessions at the Source and this report is collecting the engagement feedback. The draft report went to members of the recovery board. The situation remains the same that the CCG felt that it wasn t for them to fund The Source, we did look at other alternatives to fund the source but was unsuccessful. The key area which we saw as the biggest failure was the access to GP s and practice nurses at the GP surgery. PR the report was very useful, to date this is the best engagement we have had happened it is just a shame that it happened too late. What happens next needs with the 5000 visits/ patients that were using the source? DJ it was actually 5000 visit made by 450 patients which they were going there repeatedly FH The Source did a lot of public prevention but how will the CCG monitor the effects of this closure? 5

6 DJ explained that the CCG looked at all the needs and it was shown that people can be mobile. I cannot promise a full audit due to capacity although we will be monitoring if the list increases for practice nurses due to the source being a nurse led practice and are the challenges of getting to see the practices nurses. 10. AOB DJ would like to have a rep on the panel for impact assessment relating to Circle MSK GC will be the representative from the PRG. 16 th November Treatment access policy pre consultation discussion. GU invited JM to come and meet with some of the voluntary sectors and for JM to understand the needs of the other diversity groups within the borough. Stables have good rooms for meetings to be held. PR suggested the PRG going straight to the board instead of the quality committee. GU it is up for discussion at the December meeting. Dates of future meetings: 06/12/2016 6

Patient Reference Group 04 April 2017 Room BG.01, Woolwich Centre, Ground floor. Name Job Title Organisation

PRESENT: Patient Reference Group 04 April 2017 Room BG.01, Woolwich Centre, Ground floor. Name Job Title Organisation Dr Sylvia Nyame (SN) (Chair) CCG GB GP Executive Greenwich CCG Angela Basoah (ABa)