Brent Clinical Commissioning Group GP Extended Access Communications and Engagement Plan

Brent Clinical Commissioning Group GP Extended Access Communications and Engagement Plan Version v.1 Date 12 th October, 2017 Author Michelle Johnson

Scope This document outlines the plans for engaging with patients, the public, statutory and non-statutory partners on Brent GP Extended Access. This is currently a live document as it will be updated in response to potential new avenues for engagement as the plan is implemented. This document outlines the aims for engaging on this piece of work only providing an overview of planned engagement activity. PPE to inform decision making for Brent GP Extended Access and will come to a close on 22 nd December, 2017. Background and Context GP extended access services in Brent currently consist of the delivery of two models of care the GP Access Hubs and the Wembley GP Access Centre. The GP Access Hubs were initially established upon securing funding under the Prime Minister Challenge Fund, to improve access to primary care in May 2013. Upon successfully piloting the service from May 2013 to March 2015, the GP Networks in Brent were granted a 3 year contract to continue provision of extended access outside of core hours (with half an hour overlap on weekdays) and on weekends. The GP Access Hub contracts are all due to expire on the 31 March 2018 and the GP Access Centre Contract is a 1 year contract (there is the option to extend this contract by 1 year) that began on April 2017: GP Access Hubs Harness GP Access Hubs Kingsbury and Willesden GP Access Hubs Kilburn GP Access Hubs Wembley Wembley GP Access Centre option to extend until 31 March 2019 Findings from reviewing the services: The existing GP extended access services have been reviewed against the context of: Changes in national requirements for extended primary care access The Integrated Unscheduled Care model developing in Brent and Harrow The model of care in line with patient, provider and stakeholder feedback Reviewing the non-compliant Walk in Centre service Aligning the model of care with future strategic direction of travel The review work has uncovered that patients currently access primary medical services outside of core hours through a number of services, these include: Primary Care Access Centre (walk-in) GP Access Hubs Out of Hours service providers

Urgent Care Centre s(ucc) Northwick Park, Central Middlesex Hospital & others Accident and Emergency departments Walk in Centres cross boundary NHS 111 Service Pharmacists The availability of unscheduled and urgent care through a range of venues and sites, with many providing the same type of service and care, is at times confusing for patients, leading to patients accessing more than one provider for the same condition which results in duplication of costs, services, time and consistency in delivery model. Many of the services are also in the main seeing patients with a range of minor conditions, t he majority of which are for ear, nose and throat problems, coughs and colds, and skin problems such as infections and rashes. In addition, it is also worth noting that there are a significant number of pharmacies located within the area which are well staffed by appropriately trained professionals offering self-care advice and dispensing relevant treatments for many of the cohort of patients who use these services. The review has also identified that there are a number of issues with the current set up of GP extended access services: The GP Access Centre is non-compliant with the national GP out of hours access requirements 1 as the centre currently only provides a see and treat function. The access centre does not have the ability to view results of diagnostic tests or order diagnostics therefore does not provide continuity of care. Furthermore, the centre can only prescribe medication that is immediately necessary and cannot refer people for more tests. There are 9 GP Access Hubs located across Brent and many of the hubs are underutilised, especially on the weekend. There are more hubs in Brent then in any other borough in North West London and we believe across London. In June 2017, GP Access Hub utilisation was at 66%. Guidance to CCGs recommend one top-up hub per 150,000 population (Access Hub modelling by NHSE) There is variation in the model of care across GP Access Hubs. Nurse-led appointments are only available in some GP Access Hubs meaning that there are issues with equal access to care across extended hours GP services in Brent. These issues suggest that there is potential for improvement in the commissioning of GP access services in order to: Remove the overlap in the care provided by the current services Achieve a more equal distribution of services Gain better value for money for the residents of Brent Improve the quality of care of primary care services for Brent residents 1 Integrated Urgent Care Commissioning Standards Guidance (Amanda Doyle & Keith Willetts, September 2015)

As the local commissioner of health services, it is our role to ensure that we fully engage our communities in the decisions we make. Involving people in developing and evaluating health services is at the heart of everything we do and we believe it is integral to making sure that local services meet the needs patients. Purpose of this Plan The plan outlines how we will engage with local communities in Brent, including statutory and non-statutory bodies. The key objectives of this plan are to: ensure that patient experience and insight help shape GP Extended Access provision, and that effective feedback mechanisms are in place to demonstrate that we are a listening, learning organisation; continue to build meaningful engagement with our public, patients, carers and partners to influence the shaping of health and care services in Brent; increase confidence, with patients, public, provider and partner organisations in our CCG as an effective and responsive commissioning organisation; develop a culture within Brent CCG that promotes open engagement and communication within and outside the organisations to optimise the design and delivery of the health and care services we commission; and ensure that our behaviours and activities meet the standards expected of NHS organisations and that we fulfil our commitments, as set out in national legislation and through locally published intentions. In relation to our communications and engagement activities, we should aim to: reach a representative cross section of our population when engaging, including people with a disability, minority groups, LGBT groups and those not traditionally engaged with NHS services (e.g. working age males); hold our meetings and events in accessible venues that comply with the requirements of the Equality Act 2010, particularly with respect to disability access; publish our materials in different formats and languages where a need is identified; and adherence to the requirements set out in the Accessible Information Standard (AIS) with regards to communications and materials. In paying due regard to equality under our public sector duties, we will ensure that feedback from people who share protected characteristics, or those

representing them, will form part of the GP Extended Access decision making and equality analysis process, which is embedded in the governance of our CCGs. Approach to Patient and Public Engagement Brent CCG will also draw on existing patient experience feedback that has been collected nationally and by the current providers, as well as, from previous engagement events locally on GP Access Hubs. Targeted engagement The changes being proposed have potential to impact all Brent GP registered patients (370,000). The communications and engagement plan will ensure as wide a geographic coverage as possible. It is recognised that there are patient groups which are more likely to access out of hours services than others. Therefore, the main focus of our communications and engagement will target these groups. Our methods will be tailored accordingly to include: 1. Digital Survey CCG and partners websites, link to be sent via CCG email stakeholder and partners email lists, practice lists 2. Tweets to raise awareness and signpost to online survey 3. Community group meetings 4. Locality level PPG events 5. Street canvassing 6. Drop ins at GP Access Hubs, the GP Access Centre Colleges and Organisations around the borough 7. Printed survey widely distributed across GP practices, libraries, barber shops, hair dressers, news agents etc Timescales Engagement activity will commence in 6 th November and run through to 22 nd December 2017 to meet the 6 week engagement period recommended by the OSC. Materials Booklet contents - Background, case for change, survey, how to get involved, equalities monitoring form Online survey - Survey Monkey - Add to CCG website - Raise awareness by emailing link to all partners for cascading on their email lists

Slide deck Four versions of slide decks will be created, tailored to key audiences titled: - public slide deck - GP Slide deck - Staff (Practice managers/pc staff) slide deck - Provider/s slide deck Summary of Engagement Activity Date Stakeholder Group Activity 25.10.17 (start Press date) Press release announcing engagement period and how to get involved - local mediala, HW, CVS, other VCS newsletters - GP email via localities - CCG and partner s websites - Email to public stakeholders lists Next meeting Health and Wellbeing Board Presentation for discussion - Public slide deck - Survey: printed copies Next network meeting OSC Healthwatch CVS (network level and individual CVS groups Anju Bhatt to advise) Keep informed and flag issues - Meeting booked Presentation for discussion - Public slide deck (HW Advisory Board; HW Board) - Survey: electronic circulation and printed copies Presentation for discussion (network level) - Public slide deck - Survey: electronic circulation and printed copies Presentation (service user level outreach) Week 3 & 4 PPGs Locality level meetings x 3 public slide deck Wks 1 through 6 GP access hub users Drop ins x 9 hubs Community groups Meeting agendas public slide deck Children Centres Drop ins x?4 College of NWL Drop in Parent and Carer Forum Meeting agenda - public slide deck GPs members Presentation for discussion GP Slide deck General public General public Practice Nurses Forum Youth Parliament Multi-faith forum Stalls: Asda, CMH, WIC, Civic Centre reception, Vale Farm leisure centre, stone bridge leisure centre Canvassing: Wembley Park/Wembley Central/Kingsbury/Queensbury/Kilburn tube stations local shops, barber shops; Traveller site; Presentation for discussion Presentation - public slide deck Presentation - public slide deck

Communications Key messages - Register with a GP - GP Access hubs exist hubs what s your view? about the change about the GP Access Centre (walk-in) - what s your view? GPs and Practice managers Staff slide deck - Email via localities to raise awareness of upcoming engagement exercise - GP locality meetings - Practice Managers Forum GP Access Hub Providers and GP Access Centre Provider Provider slide deck - Meeting Health and Wellbeing Board public slide deck - Meeting to present engagement plan Community and Wellbeing Scrutiny Committee - Meetings for updates and flagging issues

Equality Group Young people Men (Especially young white males) working aged people Reason (national equality insight) Known to be frequent users of urgent care services Known to be frequent users of urgent care and out of hours services Known to be frequent users of urgent care and out of hours services High level messages - Register with a GP - GP Access hubs exist about GP Access hubs what s your view? - GP Access hubs exist hubs what s your view? - GP Access hubs exist hubs what s your view? Community links (to advise on how to reach) LA - Nicola McClean LA Children s Board LA engagement Caroline Powls CVS Anju Bhatt CVS General routes Methods Dates - College - Youth Parliament -Access Hubs - Urgent Care Centres - WICs -Asda -Kingsbury stn (evening) -Queensbury stn (evening) -All GP practices to have to send to patients -Access Hubs - Urgent Care Centres - WICs -Barber shops -Asda Kingsbury stn (evening) Queensbury stn (evening) -Access Hubs - Urgent Care Centres - WICs -All GP practices to have to send to patients Stall Meeting agenda Drop in

Job centres Survey link to local businesses and organisations Parent groups Carers (young and adult) Emerging communitie s/refugee/a sylum seekers Parents with young children known to be frequent users of urgent care and out of hours services - May access out of hours services/urgent care services with person they are caring for - May need to access out of hours services for themselves Known to be frequent users of urgent care and out of hours services - GP Access hubs exist hubs what s your view? - GP Access hubs exist hubs what s your view? - Get registered with a GP - GP Access hubs exist Brent Carers - Anne Marie Morris CVS LA Genevie George -Children Centres -Parent Forum (LA) link to survey and/or presentation on their agenda - Access Hubs - Urgent Care Centres - WICs -All GP practices to have to send to patients -All GP practices to have to send to patients - Access Hubs - Urgent Care Centres - WICs - Urgent Care Centres - WICs

Travellers Known to be frequent users of urgent care and out of hours services (however, given the need for local GP registration will need to target more permanent sites in Brent) Disability - Mobility - Sensory impaired Older people hubs what s your view? If permanent - Get registered with a GP - GP Access hubs exist hubs what s your view? - GP Access hubs exist hubs what s your view? - GP Access hubs exist about GP Access hubs what s LA- Caroline Powls LA Genevie George HW Ian Niven CVS to advise - Urgent Care Centres - WICs - Traveller sites in Brent All GP practices to have to send to patients All GP practices to have to send to patients BHeard older peoples forum

LTC your view? CVS to advise on access to local groups Care navigators to help distribute All GP practices to have to send to patients BAME groups LGBT Mental illness Known to be users of urgent care and out of hours services Known to be users of urgent care and out of hours services Known to be users of urgent care and out of hours services - GP Access hubs exist hubs what s your view? - Get registeredwith a GP - GP Access hubs exist hubs what s your view? - GP Access hubs exist hubs what s Multi-faith Forum to advise CVS to advise Brent User Group to advise Kath Fraiser support Group Brent MIND All GP practices to have to send to patients All GP practices to have to send to patients All GP practices to have to send to patients and carers HPF

your view? People less - Get likely to be registeredwith a GP registered - GP Access hubs with General exist Practice or face barriers accessing primary care about GP Access hubs what s your view? PPGs High interest group - GP Access hubs exist hubs what s your view? CVS to advise on homeless charity/community links PPG chairs to advise and help deliver messages - Urgent Care Centres - WICs All GP practices to have to send to patients and carers

Communications plan GP Access Hubs Project leads Michelle Johnson Meena Mahill Spokesperson / clinical lead Ethie Kong, Clinical Chair, Clinical Director Communications lead Christian Cubitt, Communications Director Programme The programme has three parts: Engage local people on proposal to change WIC into GP Hub and reduce the number of GP hubs Encourage people to register with a GP Encourage better take up of GP hub appointments Communications objectives Inform all patients that they may be offered appointments at GP Hubs in the evening or weekend Encourage people to ask for GP Hub appointments Encourage get registered with a local GP if they live in the Borough Encourage a culture change to one where people value NHS resources & treat them responsibly Seek people s views on the proposed model Stakeholders GP clinical Directors/leads LMC GP practices/gp receptionists Community services (eg in GP Access Centre and GP Access Hubs, urgent care centres x 2, 111 provider) Community and voluntary services across Brent /OSC Local councillors

Patient groups & lay members: PPGs Neighbouring CCGs (where out of borough patients using the WIC) Seldom heard groups and others as highlighted by EIA work Healthwatch Patients and public Carers Core messages Increased/improved access to GP appointments at more convenient times across Brent Hub service more responsive to changes in demand Decreased number of Hub locations Walk in service may change to Access hub Get registered with a local GP if you are a Brent resident Under-utilised appointments Only 57% of Hub appointments being used Stream line opening times so they are less confusing Hub service more responsive to changes in demand Additional messages

Timeline Stakeholder Activities Launch Governing body Letters by email (letter to exec informing of start of engagement period, with comms and engagement plan attached) internal engagement letter Send Monday 13th GP clinical leads CCG Chairs CCG MDs Email letter - internal engagement letter GP Federation/Network leads CCG staff Email letter - External provider letter Internal staff email simple letter including link to webpage Mon 13th Joint / Overview and Scrutiny Committee Councillors H&WBB Cabinet members for health Stakeholder letter official start Politicians letter MPs letter 13 th As above Healthwatch Stakeholder letter official start Newsletter copy for cascade to networks As above LMC Stakeholder letter for information engagement letter As above

Stakeholder Activities Launch GPs Practice managers GP practice staff Hub drop ins Engagement letter with ask to send on info to patient lists As above Letter to GPs As above Community services staff (111, Urgent Care Centres) Community and voluntary services Stakeholder letter for cascade to their internal comms and patient facing newsletters (same letter as LMC) Stakeholder letter Newsletter copy for cascade to their networks As above As above Patient groups & lay member groups: PPGs, Stakeholder letter Newsletter copy for cascade to their networks As above Patients and public Local schools Faith communities Local mother and baby groups Patient groups & lay members: PPGs, Patients who use WIC (Neighbouring CCGs) - Mini comms plan CCG Website Stakeholder letter Social media Twitter PPG channels CCG engagement channels Local media releases - CC Copy for GP websites Patient group channels Posters digital copies - MJ Leaflet (digital copies) Easy read leaflet - MM Local media releases SMS to patients using WIC and/or Hub services As above Council magazine editorial

Stakeholder Activities Launch and advertising Newspaper editorial and advertising -CC Posters in practices and pharmacies

Materials required 1. Proposed changes Letter to GPs Letter to stakeholders Letter to WIC Provider Letter to Hub Provider Copy for CCG and GP websites Newsletter copy for CVS networks, PPG newsletters, etc Copy for internal staff bulletins (providers) Google words advertising Facebook advertising Local media releases see media plan - Christian GP website copy - Nick Social media copy - Nick Council magazine - Nick waiting room screen advertising 1. GP Access Hubs Poster Poster How to book GP Hub appointment Easy read version Engagement booklet GP Practice text message get involved GP practice patient letter Newsletter copy for cascade to provider internal comms and patient facing newsletters Patient guide how to register in primary care Banner for GP practices