Minutes PPI Committee Wednesday 5 th April 2017, Chappell Room, Arnold Civic Centre Present: Janet Champion (JCh) (Chair) Deborah Bellamy (DB) Hazel Buchanan (HB) Francis Henman (FH) Helen Horsfield (HH) Terry Lock (TL) Sharon Pickett (SP) Lay Member, NNE Governing Body Patient Representative NNE Director of Operations Westdale Lane PPG Complaints Manager Park House PPG Deputy Chief Officer (attended half way through) In Attendance: Antonia Smith (AS) Corporate Communications Manager Emma Whatson (EW) Transformation Engagement Manager Louisa Hall (LH) Corporate Admin Officer Apologies: Sharon Bentley (SB) Bruce Cameron (BC) Elaine Maddock (EM) Kathryn Sanderson (KS) Patient Representative Independent Patient Rep Governing Body GP Representative Torkard PPG Item Action PPI 17/008 Welcome and Apologies Janet Champion (JC) welcomed the group and requested brief introductions. Apologies were noted above. Quoracy was confirmed. PPI 17/009 Declarations of Interest The Chair reminded committee members of their obligation to declare any interests they may have on any issues arising at Governing Body meetings which might conflict with the business of the CCG. Declarations of the Patient Participation Involvement Committee were listed in the CCG s Register of Interests. JC noted that the Register was available either via the secretary to the PPI Committee or the CCG website at the following link: http://www.nottinghamnortheastccg.nhs.uk/contact-us/freedom-of-information/conflicts-ofinterest/ No Declarations of Interest were made in relation to the agenda. PPI 17/010 Minutes and Actions from previous meeting 17.01.2017 The minutes of the meeting held on 17th January 2017 were approved as a true and accurate record with the following actions acknowledged as complete: PPI 17/004: Alterations requested to the Terms of Reference were made by Hazel Buchanan
(HB) PPI 17/007: Copies of the Committee structure were distributed in the meeting as requested. PPI 17/011 Financial Turnaround HB informed the group that this item is to be deferred to the next (or a later) meeting as plans were not formed enough to be presented to this forum. In place of this, HB listed the different Project Management Officer (PMO) areas for discussion such as elective care, community care, urgent care, mental health and Continuing HealthCare. HB informed the group of the project around Prescribing and switching patients from a branded drug to a generic drug which could increase savings. A discussion took place on the potential of carrying out engagement for switching and it was acknowledged that this should take place due to apprehension from patients. It was suggested that a potential link to engage Pharmacies would be positive to explain what is regarded as normality to Patients. HB stated that this would need to take place across the 4 CCGs so this would have to be agreed. PPI 17/012 Defining a Substantial Change HB presented papers to the Committee to discuss the definition of Substantial Change. HB explained the link to the Service Review Update and that this has been to the Overview & Scrutiny Committee. HB raised the topic of changes being defined as substantial and informed the group that the CCG is engaging with the OSC and the need to jointly agree the definition of Substantial. HB added that consultation would be required if changes did fall under a specific definition. Janet Champion (JC) raised concerns of the subjectivity of how an agreement could be reached on the definition. The group agreed that value for and best use of public money needed to be considered as well. HB updated the Committee that a meeting took place with Legal to discuss each Service and reviews took place at a later date once more information was received which helped to decide parameters and when to carry out consultations. It was advised that the OSC can refer to Secretary of State but this would not benefit the CCG. A discussion took place around the lack of definition for deciding what is or is not a substantial change. The Committee suggested that this would be difficult to manage due to loose guidelines. It was agreed that the Committee was well-placed to identify when engagement was needed. HB referred to Pages 3-5 and highlighted the following list of characteristics that need to be considered and which help any discussion before defining if a substantial change is evident: Access and patient choice: inconvenience, transport, opening times etc. Patient outcomes to show impact: recovery, quality of life. Service delivery: equipment etc. Number of patients Cost: proportionality Sharon Pickett (SP) entered the room at 10.13am. Francis Henman (FH) raised a query on the sentence More than 25% of the registered population will be impacted on Page 4 and questioned if this should read of the patient population. HB confirmed this is the Nottingham North & East population. The Committee agreed the sentence needed to be changed to avoid misunderstanding. The Committee discussed the 25% figure as also seeming too high but it was acknowledged that different factors could affect the 25% figure. The Committee suggested that there should be a process in place to determine proportionality. SP suggested having a flow chart which included steps for consideration to get an end result. The Committee agreed this. HB HB?
HB asked the Committee for any other other comments related to the agenda item. Terry Lock (TL) added that there have been various changes in adaptive technology at Connected Nott s that could help and that could impact changes. Deborah Bentley (DB) referred back to the characteristics mentioned above regarding Access and transport and the issue of the general public using the free MediLink buses. SP explained that these are commissioned by NUH and a charge will soon be implemented. PPI 17/013 NUH Service Review Update HB explained that most of the Service Review Update had been covered in the previous agenda item and requested any further questions regarding next steps for the Service Review. No further questions were raised. HB explained that Emma Whatson will be doing the engagement and Exit strategies which will monitor the impact of any decisions and if they require further engagement. HB updated the group that TL had compiled a You Said, We Did paper which can be accessed on the website. PPI 17/0014 Over the Counter Medicines Update HB provided the Committee with an update on the Over the Counter Medicines engagement explaining that the Report had been distributed and a Presentation given on the engagement. HB praised the engagement and that National news has picked up on this and this is progressing well. HB informed the group that NHSE have launched a consultation on the prescribing of Gluten free products. Helen Horsfield (HH) queried where the CCG would stand if NHSE make a decision. HB confirmed that the CCG can also decide at a local level what they would prescribe. Antonia Smith (AS) shared that the engagement went well with all promotional materials sent out to Practices and that PPG representatives have been looking into practice newsletters to further promote Over the Counter. It was added that GPs have also been briefed. The Committee proposed working with the prescribing team to see results of the engagement. HB added that a list has been created of the drugs expected to decrease and the 2015/16 baseline will be used to monitor along with data tags at practices to monitor through prescriptions. The Communications team were praised by the Committee for the pitch and positive outcomes of the engagement and promotional leaflets. PPI 17/0015 PPI Annual Report-2016-17 AS gave a brief outline of the PPI Annual Report and the following items this covered: Surveys, engagement, meetings, events & fayres, case studies, network event for feedback and improvement. AS informed the Committee that the Big Health debate was still prevalent and Talking Therapies (IAPT) The Committee requested a copy of this to be distributed as this was not an attached paper. AS/LH PPI 17/0016 NHS Planning Guidance 2017/18 HB presented an overview of the NHS Planning Guidance papers explaining that this outlines what is going to take place over the next year based on the 5 year Forward View and does drive what the CCGs do. HB declared that Nottinghamshire have been mentioned under Integrated Care as part of the 9
sites that are being assessed as accelerator sites. The Committee were informed that if the CCG was successful, they would get funding to support and have further resources. HB gave an update on key areas within the Planning Guidance which included : Primary Care: practices to be divided into regional hubs with populations of 50,000 to improve control of practices. Elective care: media picked up on the 18 weeks target to release capacity to improve cancer care. HB identified this is unrealistic so this may be taken off. 150 new impatient beds for young people with mental health issues. GP and Nurses reformation and IT systems. Vanguard site for urgent care in place. PPI 17/0017 GP Access Engagement Plans AS outlined the engagement plans that have been presented at PPG meetings. This included an update from Rachael Rees based on a report on infrastructure for GP practices to federate and delivering services 7 days per week, reformed 111 and clinical hubs. AS confirmed that this is still with NHSE for sign off and highlighted the importance of getting feedback as services are shaped. AS informed the Committee that future engagements will include the following: Improved Access Online Consultations Triage Self-care management. Emma Whatson (EW) advised the Committee that engagement cannot take place until 5 th May due to Pre-elections. The group was informed that Sunday opening hours has been discussed and that the general consensus is for this not to happen, however, changes in employed people s working week highlight the need for continued engagement on this issue and also to look at costs, and need versus want. The Committee requested EW to bring further engagement plans to the next meeting when they are available. AS/EW PPI 17/0018 Upcoming Engagement Plans HB outlined current engagement plans: Medicines Waste event in May with expectation to do engagement. Linden lodge: been asked to consider: review on neuro services Still have the big health debate and to keep engagement on this. AS: OTC leaflet to be edited to reflect not just Doctors notes written on the back but also Pharmacists. AOB AOB: TL gave an update on health patients engagement and Connected Notts. The Committee was informed that they are currently looking at the next project phase. The GPRCC provides anonymised data to identify patients who are critical and if % is moving up or down. TL informed the group that the community portal was moving at Nottingham University Hospitals (NUH) TL is currently working on documents and has requested feedback from people involved on specific engagement projects. Promoting e-prescriptions and booking own appointments are taking place. TL is due to attend the PPI Senate. HB asked TL to present an Agenda item in the next meeting and invite Michelle Turpin. It was discussed by the Committee for the PPG group to have a regular standing item of a PPI TL/HB/L H
update from the PPI members who attend both meetings, so that the PPG group has information from discussions which have taken place and to raise specific points if needed. Details of the next meeting 9 May 2017, 1pm-4pm Committee Room, Civic Centre, Arnot Hill Park Meeting administrator: louisa.hall@nottinghamnortheastccg.nhs.uk All attendees should be aware that there is a requirement to comply with the Freedom of Information Act 2000. The minutes and papers from this meeting could be released as part of a request for information