Enclosure Lxi Greenwich Inclusion Project, Rooms 133 & 133A, Island Business Centre, 18/36 Wellington Street, Woolwich, London, SE18 6PF

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1 Enclosure Lxi Greenwich Inclusion Project, Rooms 133 & 133A, Island Business Centre, 18/36 Wellington Street, Woolwich, London, SE18 6PF PRESENT: Name Job Title Organisation Dr Greg Ussher (GU) (Chair) CCG GB Lay Member CEO, Metro-GAVs Dr Sylvia Nyame (SN)(Vice-Chair) CCG Governing Body GP Clive Mardner (CM) Volunteer Development and Outreach Healthwatch Greenwich Officer Debora Mo (DM) Mental Health Commissioning Support and Engagement Officer Frances Hook (FH) Patient Participation Group Member PPG Manor Brooke MC Gilles Cabon (GC) Chief Executive Officer Representative Greenwich Inclusion Project (GRIP). Greenwich Equalities Organisations Forum (GEOF) John Kenny (JK) Patient Participation Group Member Ferryview Practice Pamela Froggatt (PF) Patricia Kanneh-Fitzgerald (PK-F) Head of Communications and Engagement Senior Stakeholder Engagement Officer Paul Richardson (PR) Patient Participation Group Member PPG Plumstead HC Yvonne Leese (YL) Busayo Beyioku (BB) in attendance Roger Hendicott in attendance Virginia Morley in attendance APOLOGIES: Director of Quality & Integrated Governance Minute taker Commissioning Manager Planned Care and Cancer Director of Commissioning Development Carol Berry (CB) Compliance Manger Greenwich CCG Alexia Fergus (AF) Senior Manager of Public Health & Royal Borough of Greenwich Wellbeing Angela Burr (AB) Patient Participation Group Member Local Resident/Ferryview Practice Eileen Smith (ES) Patient Participation Group Member Vanbrugh Practice Shirley Gibbs (SG) Patient Participation Group Member QEH Patient User Group 1

2 2

3 1. Welcome and Introduction GU opened the meeting and welcomed everyone. ACTION 2. Conflict/Declaration of Interest CM local councillor for Royal Borough of Greenwich PF Director of Sentio PR Limited 3. Minutes of previous meeting Page 5 - gunning principles change to Gunning principles. AOB needs to state that PR an asked for Equalities Impact assessment on the Source and Over the Counter medicines to come to PRG months after implementation of the scheme to review impact. Minutes approved. 4. Matters Arising and Action log Action 1: YL to request the Estates Forum consider providing the PRG with quarterly updates and consider having a patient representative on the group. YL has spoken to Neil Kennett-Brown, chair of the Estates Forum, and he has agreed to a quarterly report to come to the PRG. Representatives from Healthwatch and from Metro-Gavs have been invited to become members of the group. FH asked if Healthwatch is for patients as it is part of the NHS England corporate structure. CM confirmed that Healthwatch are working for patients. JK suggested it would be a good idea to have actual end-users to sit on the group as well as maybe having someone as a backup in case a patient representative cannot attend a meeting. Action is closed. Action 3 carry forward. Matters Arising FH note that dermatology clinics are currently all over the 18 weeks wait target. CM expressed about not having a GP on the PRG when the new Governing Body GPs take up post in July YL Governing Body are considering making the GP roles more clinically focused. YL updated on current changes to the Governing Body. 5 GPs will be standing down from the Governing Body(GB) in July 2018 due to various reasons. The GB is moving to having 9 GPs on it rather than the current 7. The CCG is therefore currently out to recruit new GPs and applicants will be shortlisted against the job description and then be interviewed. The GPs who get through this intial selection process will then go out for election by GPs in Greenwich. 3

4 YL confirmed the interview panel consists of: current clinical chair, the managing director, lay member and external representative. There are approximately 162 GPs in Greenwich borough and all GPs can apply apart from locum. 5. Ophthalmology and diabetes RH provided the group with an overview of the assurance process to ensure patients were at the heart of decision making. Key areas highlighted included: Assessments Informing Engaging Involving Consulting Feedback Quality audit pre handover to business as usual (recommended) Performance monitoring : activity, clinical effectiveness, safety, complaints and experience Using this format and a prepared handout for the group, RH presented an update on both ophthalmology and diabetes. Ophthalmology Key areas highlighted were: Scheme overview and Assessment: Improvement of ophthalmology provision in Greenwich through a single point of access and clinical triage, to direct patients to most appropriate care setting. The scheme aims to improve access for those who do not need to be seen by a specialist in secondary care. The changes will have positive patient outcomes. An includes deliver short waiting times (maximum of 1 week) for assessment and treatment of ophthalmology conditions, ensuring that any onward referrals to secondary care can be managed within the 18 week Referral To Treatment (RTT) targets. There has been no negative quality impact and a positive inequality impact for older people and people with disabilities with faster access to care closer to home where appropriate Engagement and Involvement: A patient eye care survey was conducted via survey monkey. The aim was to engage and gather views from local patients on their experience and opinions of the current eye service in Greenwich and gather recommendations on how the service could be improved. The outcomes of the survey will be used to aid a new model for delivering eye care services, thus allowing patients to shape the way we commission services for them. Response rate poor but main points:90% would be willing to have their eye care closer to home in a community/high street setting where this is appropriate 90% usually go to their optometrist for their eye care first when they have a 4

5 concern. 90% would most like to be seen by their optometrist or GP first if they developed a new eye problem. 4. Impact of Patient Feedback: Feedback to date aligns with service design. An additional survey is to be undertaken Diabetes Scheme overview and Assessment: NHSE invited bids for Diabetes transformation to improve diabetes treatment and care at a local level across four interventional areas, namely, Improving update of structured education Improving achievement of the NICE recommended targets (HbA1c, cholesterol, and blood pressure) and reducing variation Reducing amputations by increasing availability of multidisciplinary foot care teams Reducing length of stay for in patients with diabetes by increasing availability of diabetes inpatient specialist nurses (DISN) Greenwich CCG did not submit a bid for DISN but were successful in their bid for funds in the other three areas. The NHS Right Care programme has highlighted the opportunity for improvement to diabetes care pathways This will support improvements across the Diabetes Pathway including multidisciplinary care and education. The impact assessments undertaken did not indicate any negative impact on quality or inequality. Inform: Discussed at commissioning intentions workshops in September 2017and with the GCCG Type 2 Diabetes Group Engagement and involvement: Currently looking for a patient representative to join the group. Mail and tele-conversations have been held with local Diabetes UK representatives. Questions raised by members GU advised that the public have not been informed and that the PRG need to understand how this will be achieved.. Inequalities impact and quality impact of diabetes states that it has no negative impact. Are there any plans to help reduce the inequalities between racial groups? RH advised that diabetes helps those who are at risk whilst looking at service provisions for all groups. GC would be nice to see where this has happened. Action: RH will draft an answer in response to these queries 5

6 CM noted that ophthalmology will be launching in July and asked how the CCG was planning to do engagement? RH advised that engagement is currently in process. CM asked who the CCG was looking to engage with? RH responded that this would be with service users. Outcomes Members provided feedback on their expectations from future presentations by Commissioning Managers. This included: Quality impact how this informed decision making? Inequality if present how we intend to reduce this. This needs to be broader than the protected areas and needs to incorporate variability in service, post code lottery etc. Case for change what is position now and what is proposed for the new position. What is currently wrong and how the change addresses these issues. Cost details Effects /impact on property and staffing Timelines for implementation and progress against these The CCG would review current reporting taking cognisance of the member s recommendations. 6. Clinical commissioning strategy GM reported back on the two stakeholder engagement events which took place on 21 & 22 nd March The feedback from stakeholders that was received from the two events was presented. The themes which came out of the events will be developed in the developing strategy. The strategy launch will be at the AGM in September 2018 but when the document is more developed it will be brought back to this meeting before the AGM. FH there is nothing about newborns, families and education. CM asked what the cost implications are. VM stated this feedback will assist in shaping the development of the strategy. Not all areas that will be in the document appear in the feedback that was given at the events in March. In relation to costings it is a real challenge to establish this as this is a development strategy to assist the CCG priorities for years Some of these will be QIPP schemes. GC was there any feedback relating to inequalities and if so why wasn t it included? GM the strategy will tie in with the inequalities strategy. 7. Terms of Reference Amendments from discussion at the last meeting had been captured. The updated ToR had been circulated for today. The group were asked to finish reviewing the ToR today. Feedback & Comments 6

7 Section 2 it is unclear what the legal duties are that PRG is meant to meet. How would we know we are meeting them? GU YL, PF and CB are here to ensure that we are achieving our legal duties that are required of equalities and patient and public participation. Section 7 - should be the second paragraph adding on the chair will have the casting vote. Section 12 change it to say overseeing PRG Section 14 there is no clear specification of what the PRG will do with regards to equalities. This needs to be spelt out. GU asked GC to help draft something up relation to section 14 equality and diversity. New draft with changes will be sent out to review again. PPG development Carry Forward to July meeting 8. ANY OTHER BUSINESS GC we should look at doing a session for understanding the legal duties that are required. FH event at Myceane House on the 1 July 2018 DATE OF NEXT MEETING: TUESDAY 3rd July pm 2pm Greenwich Inclusion Project, Rooms 133 & 133A, Island Business Centre, 18/36 Wellington Street, Woolwich, London, SE18 6PF 7

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