Name of meeting Date and time Venue MINUTES/ACTION NOTES Patient and Public Engagement Group Stakeholder Meeting Tuesday 5 th May 2015 12.30-2.30 pm Boardroom, Dominion House, Woodbridge Road Chairman Phelim Brady (PB) Lay Member PPE Members Sian Jones (SJ) GP Governing Body Member End of Life Care Liz Patroe (LP) Mark Twomey (MT) Simon Laws (SL) Paul Davey (PD) (Until 1pm) Sam Patmore (SP) Carol Dunnett (CD) Margaret Dunne (MD) Julie Grist (JG) Anne Meredith (AM) Terri Walter (TW) Gill Haworth (GH) Policy & Engagement Manager Deputy Director of Governance & Compliance Website Co-ordinator Communications Manager Business Administrator & Events Co-ordinator (Note Taker) Voluntary Action South West Surrey University of Surrey Patient Participation Group Representative Carers Representative National Childbirth Trust Surrey Coalition for Disabled People Lorna Marsh (LM) Norman Davies (ND) Surrey Independent Living Council (SILC) CAB Waverley Apologies: Betty Moxon (BM) Patient Participation Group Representative Wanda Jay (WM) Helen Collins (HC) Frank Clement-Lorford (FCL) Jason Davies (JD) Jonathan Cross (JC) Fiona Morris (FM) Veronica Payne (VP) Lorna Clark (LC) Rita Hess (RH) Patient Participation Group Representative Associate Director for Quality & Improvement Patient Participation Group Representative Healthwatch Surrey Patient Participation Group Representative Practice Manager Representative Practice Manager Representative Carers Representatve Student Representative (Guildford High School) Present: Julie George CCG Governing Body Member Public Health Consultant with Surrey County Council 1
Hannah Yasuda CCG Clinical Change Pathway Manager Nikki Hislop CCG Age UK Programme Manager Quorum and Voting A quorum shall be three members, which must include the Committee Chair, or replacement and at least one Clinical Representative. Any decisions put to a vote at a Committee meeting shall be determined by a majority of the votes of members present. In the case of an equal vote, the Committee Chair shall have a second and casting vote. 1. Welcome, Introductions and Apologies, and Declarations of Interest Welcome, introductions and apologies were completed. Introduction to group of new members Gill Haworth, Surrey Coalition of Disabled People and Lorna Marsh Surrey Independent Living Council (SILC). Declaration of Interest/Conflict of Interest PB asked the committee if anyone had any declaration of interest No new declarations of interest were made. 2 Minutes of Patient and Public Engagement Meeting 3 rd March 2015 Amendment made to item 4 Updates from Stakeholders for Julie Grist sentence should read They are creating a foot check Leaflet. SP to amend minutes SP 12/05/15 Otherwise, minutes were agreed as accurate for the meeting held on the 3rd March 2015. 3 Action Log Review of Items not Completed SP to circulate the Quality Schedule for Royal Surrey County Hospital once HC confirms it is completed and can be shared with the group. SP 4 Suicide Prevention Strategy Julie George, Public Health Consultant, gave an overview of the suicides across Surrey and in Guildford and Waverley and how 2
agencies across Surrey have come together to develop and implement the Surrey Suicide Prevention Strategy. A copy of her presentation is attached with these minutes. Key points were:- In Surrey there are approximately 84 deaths from suicides every year. The suicide rate in Surrey is 8.3/100,000 is lower than the national rate 10.4/100,000 and has declined over the last 20 years. Over the two years of 2012 and 2013 there were a total of 30 deaths in Guildford and Waverley which in broad terms is in line with the overall rate for the Surrey area. The Suicide Prevention Group is a multi-agency partnership which meets quarterly and reports to the Emotional Wellbeing and Mental Health Partnership. AM mentioned that South West Trains were not on the list of those in the partnership. Julie G agreed to take that up with her colleague The Suicide Prevention Group has developed a prevention plan, the priorities of which link to the advice given in the national suicide prevention strategy:- 1. Suicide audit and research 2. Suicide prevention training 3. Prevention and management of self-harm. 4. Prevention of suicide amongst children and young people 5. Prevention of suicide amongst those experiencing financial difficulty. The Detroit Model of Suicide Prevention was also highlighted, the key features of this model are:- 1. Assess the suicide risk of every patient seen by psychiatric service (low, medium, high) and use appropriate pathways. 2. Increased access to clinicians and other patients for support (web based, weekly drop in sessions). 3. Electronic health care records, plus access to guidelines. 4. Staff training every year. 5. Adopting continual quality improvement approach to care. SP JG 31/05/15 3
Julie G confirmed that Surrey and Borders Partnership NHS Foundation Trust is engaging with this model and are actively asking these questions. JG asked about funding for the Expert Patient Programme, the CCG does not currently fund it. It was agreed that PB would take this up at the next Quality and Governance Committee which is Tuesday 2 nd June 2015. LP will ask Danny Bailey (Deputy Director of Clinical Commissioning) Whether Expert Patient Programmes have been considered by the Clinical Commissioning Team. SJ added that the GPs are trained on depression awareness and that depression is discussed with patients that have long term conditions. However she admitted that sometimes the GPs may need to dig a little deeper and that it would be useful to know the data for attempted suicide. JG does not have that information but will check with her colleague and report back. LM suggested that sometimes it is assumed that disability is the cause of any depression, but that may not be the issue behind the person feeling depressed and so clinicians need to see beyond the disability. SP to email Catherine Croucher at Surrey County Council to request that diagnostic overshadowing (assumptions regarding the causes of depression and anxiety in people with disabilities) is covered in the suicide prevention training being carried out as part of the strategy implementation Julie G will report back to the PPE Group at some point in the future on the outcomes from the Suicide Audit. 5. Updates from Stakeholders PB advised that we had asked for written updates to share with the group for those not in attendance in order to provide a more representative view. Wanda Jay Patient Participation Group Representative Austen Road Surgery Written Update - PPG practice report completed PB LP JG SP JG ALL 02/06/15 22/05/15 07/07/15 22/05/15 TBC WEEK BEFORE NEXT MEETING 4
2nd quarterly meeting in place for patient group mid-may - Out of Hours Service - speaker Care UK Carol Dunnett Voluntary Action South West Surrey Recently held their Annual Conference which went very well, received over 100 voluntary sectors better together working. They are a charity that helps other charities network and build capacity and are known as a LDO (Local Development Organisation). Norman Davies CAB Waverley Using surgeries to provide easy access to their advice and where they can for low level depression, offer advice rather than tablets, the key to this project will be the ability to link the results with the work outreach. It is believed that the CAB are in the following surgeries across Guildford and Waverley CCG:- Wonersh, Dapdune, The Mill and Cranleigh. Age UK Surrey is also involved in this guidance. The CAB is installing self-help terminals in their bases for people to look at and find advice on various matters. It was discussed that Action for Carers Surrey should link in with the CAB. CD to progress and ensure Debbie Hustings is also involved. SJ confirmed that self-help books are available on prescription rather than pills. Waverley CAB are producing a survey one month on social care:- - What is your experience of the service you receive? - Is it easy to get to? - Relevance to Care Homes Terri Walter National Childbirth Trust (NCT) The NCT will hold its AGM on Wednesday 13 th May 2015, all are welcome to attend. TW raised the issue that women are being asked at their 12 week appointment, to make a choice of where they would like to have their baby, which can feel too early and is too early in terms of knowing whether a pregnancy will become complex or not, which affects CD 5
choice. TW suggested that a discussion should also take place at 32 weeks in order to remind women of the options they have such as home deliveries home birth, birthing pools as these are part of the new maternity unit at the RSCH.(the birthing pool can only be used if the pregnancy is deemed to be low risk). It was agreed that Helen Collins would discuss the matter with the Royal Surrey County Hospital to clarify at which stages expectant mothers are asked about where they would like to give birth and report back to the group. Margaret Dunne University of Surrey MD has had a meeting with Jo Barker from the CCG in regards to the Safe Bus. The idea was presented at the last meeting. The meeting discussed how the university could get involved and a discussion has been had with the Student Union. 10% of Guildford and Waverley population are students. The proposal suggested that the bus would be in the town centre on a Friday/Saturday night and on the campus on a Wednesday. Funding for the bus needs to be ascertained and is it was suggested that students could volunteer to manage it. MD reminded members that students at the University are only part of the younger age group in Guildford and so a range of mechanisms need to be used to reach all young people. SJ suggested that students might wish to volunteer to staff the Safe Bus once it has been established. Julie Grist Patient Participation Group Representative Witley & Milford Surgery Running a first aid event for carers in conjunction with the Red Cross which has funding for this activity until December 2015. The courses are open to anyone but they do need Volunteers. JG to send SP the link for circulation to the PPE and PPG Groups as they may wish to apply for funding for the same initiative in their own practices. Lorna Marsh Surrey Independent Living Council (SILC) SILC will be holding an exhibition on the 25 th June 2015 at Epsom Race Course they ran the same event last year and had up to 900 HC JG/ SP 6
visitors on the day to view a range of stands. The event runs all day and there will be limited transport available to help those that want to attend get there from train or bus station. Would like help in promoting the event. SL to advertise on Twitter/Facebook. Gill Haworth Surrey Coalition of Disabled People GH has undertaken an audit of her village (Normandy)looking at access for people with physical disabilities as she felt it was poor and needed attention drawing to it. This included access at the train station as well. Anne Meredith Carers Representative Operating many schemes through Surrey supporting carers as those that were supporting carers are no longer doing so. Raised the issue of IAPT and self-referral for carers. NHS Surrey Heath CCG allows patients to self-refer to increase early intervention. This is publicised amongst carers. This was highlighted in the Equality Delivery System review of IAPT. LP will discuss amending the referral criteria for the IAPT services provided for patients in Guildford and Waverley to include selfreferral with Danny Bailey (Deputy Director of Clinical Commissioning). Guildford Carers Support (GCS) is hoping to provide direct input on the ground at RSCH. The member of staff from Guildford Carers Support will concentrate on the two care of the elderly wards. This initiative is being funded by Guildford Poyle and Guildford Carers Support are just awaiting final confirmation. AM to confirm whether received or not. As AM is leaving the group. PB thanked her on behalf of the group for her contribution and efforts over the last 2 years. 6 Integrated Care Partnership Hannah Yasuda, Clinical Change Pathway Manager and Nikki Hislop, Age UK Programme Manager gave a presentation which is also attached. Key points were:- My Care My Choice Vision: LM/SL LP AM SP WHEN PROVIDED 07/07/15 7
Health, social care and voluntary sector partners working to create an older peoples integrated care service that wraps care around the frail older person in the community. 5 localities across the geography of Guildford and Waverley are under development GPs will identify patients at risk of crisis or admission and if required, refer to a locality multidisciplinary meeting Integrated Proactive Care Service teams are under development for each locality The five locality groups have been established involving partners from across health and social care, the localities are based around GP practices with all other services wrapping round :- East Waverley Haslemere Guildford East The Mill Haslemere East Horsley Binscombe Grayshott Merrow Park Cranleigh Chiddingfold The Villages Wonersh Witley Shere Springfield North Guildford Fairlands Guildowns Woodbridge Hill Central Guildford Dapdune Austen Road St Lukes Guildford Rivers New Inn Locality GP Leads are in place to lead the development work on behalf of the Locality. Locality MDTs will provide integrated, person centred care discussions. What will this mean for the patient? Keeping people independent at home longer. Maximising medical and social care support Multidisciplinary team including voluntary sector support Supporting Carers 7 day support Admitting people to hospital only when necessary Maximising urgent medical, social and voluntary care support. 8
Discharging patients from hospital as soon as medically stable Hospital and community teams will work much more closely together to support the patient Co-ordinating hospital and community knowledge and risk assessment Better End of life care Age UK Integrated Care Pilot 500 patients across Guildford and Waverley in the initial wave to be referred onto this programme through the localities For patients who require support in a non-medicalised way Volunteers will be recruited, and will be seen by a Personal Independence Co-ordinator (PIC) Role of the Personal Independence Co-ordinator (PIC) Place the individual at the centre to ensure they can take control and reduce their dependency acute and primary care services where appropriate Targeted, wrap-around support motivating at risk older people (but not those close to crisis who are classified as high risk and in need of multidisciplinary care) to achieve their aspirations through guided conversations e.g. describe their usual day, what things do they enjoy doing? The Personal Independence Coordinator is to be part of the Locality MDT s service model How you can help Primary Care Secondary Care Community Care Voluntary/Faith Sector Identify local groups who may wish to engage in the programme s development Identify local voluntary services that may wish to be connected with Age UK PIC, GP lead of the locality or the programme for future collaboration. Any additional comments or concerns to be emailed to either Hannah.yasuda@nhs.net or kathleenandrews@nhs.net both are integrated care partnership managers. 9
CD commented that she would be the link for volunteers and that community connectors have Nicola Vissarni. AM commented that she was excited about the link in with carers but disappointed that they were not previously consulted and that there was no co-design. HY acknowledged this gap and explained that the engagement is planned to start end of June 2015. LP explained that this is intended to allow people across the CCG, including those in seldom-heard groups, to contribute to the ongoing development and design of the locality models. A communications and engagement plan involving all providers will be going to the ICP Steering Group on 20 th May 2015 and then engagement will commence through a wide variety of forums. It is hoped that members of the PPE group will inform the CCG of different groups that should be included in this engagement. Outcomes from the engagement events will be reported to the ICP Steering Group at the end of September to inform development of the ICP localities. If was suggested that the PPE Meeting on the 7 th July be used to discuss this further with the possibility of this meeting happening at a different venue to facilitate a larger attendance. SP and LP to look at options and keep the PPE group informed so that they can invite additional members of the public. LP/SP 31/05/15 JG commented that the ICP model looked good on paper and congratulated the CCG on getting so far with developing the model of integrated care. PD left the meeting at 1.00pm. 7. Equality Delivery System (EDS) 2015/16 Liz Patroe, Policy and Engagement Manager gave a presentation regarding the 2015/16 strategy for reviewing chosen services that the CCG commissions against the relevant EDS goals and objectives The main points were:- The CCG is responsible for commissioning local health services for the populations of G&W. Encapsulated in our vision, is the need to consider equality in everything we do. SP 10
To ensure that innovative, quality driven, cost effective health and social care is in place. We will deliver services which reflect the needs of the local population and improve the health and wellbeing of people living in Guildford and Waverley. Who does it cover? The EDS is designed to make improvements for patients and staff The EDS offers a framework for organisations to measure themselves against in terms of how well their services are meeting the access and outcomes needs of people afforded protection by the Equality Act 2010 from unfavourable treatment because of specified protected characteristics. These are:- Age Disability Ethnicity / Race Gender Gender Reassignment Marriage & Civil Partnership Pregnancy & Maternity Religion & Beliefs Sexual Orientation Organisations analyse and grade their equality performance against 18 outcomes grouped into 4 objectives:- 1) Better health outcomes for all 2) Improved patient access and experience 3) Empowered, engaged and included staff 4) Inclusive leadership The top two being better health outcomes for all and improved patient access and experience. LP asked the group to consider with the people that they represent two new services that they would like the CCG to review, taking into account that the CCG is the host commissioner for the following:- The CCG is the host commissioner for: - Royal Surrey County Hospital NHS Foundation Trust 11
- Children & Adolescent Mental Health Service (CAMHS) undergoing procurement so not able to review these services this year. - Locally Commissioned Services provided currently in primary care e.g. Anticoagulation monitoring, Ambulatory Blood Pressure Monitoring, Minor Surgery, Wound care. Consideration should also be given to the following:- Other services that are commissioned by other CCGs on our behalf - e.g. 999; NHS 111; community services; mental health services; patient transport service etc. Please email samantha.patmore@nhs.net by the 31 st May 2015 with your choices. The two most frequently chosen services will be reviewed in 2015/16. Any services that are commissioned by other CCG s we will ask them to review in their own EDS review of 2015/16. ALL 31/05/15 8 Strategic Objectives It was agreed that this item be carried forwarded onto the next meeting on 7 th July 2015 as we were running out of time. SP/LP to ensure item is on next meeting agenda. SP/LP 07/07/15 8 AOB No items were raised and the meeting was closed. Date of next meeting: Tuesday 7 th July 2015 12.30-2.30 pm, Boardroom, Dominion House (or venue may be changed to enable more people to attend a wider discussion regarding the ICP localities SP will keep all informed). Date 07/07/2015 12