Welcome PPG Conference North and South Norfolk CCGs June 14 th 2018
Housekeeping
Packed Agenda! Quick feedback on the national patient participation conference Primary care general update and importance of self-care Break refreshments, networking viewing the stalls thanks to all the organisations who are here today Short plenary session issues faced last winter Open session to give us your views supporting patients and easing pressures on primary care Lunch more time to talk
Purpose of the day Sharing ideas Networking Gathering information Forward planning Collaboration between patients and practices
Communication: Improve communication between patient, practice and community Changing relationships and expectations between statutory services and the people who use them More online healthcare Increasing use of social media and texting
Self-care Helping people stay healthy and well and accessing the right services Enables GPs to see the patients they need to see Often non-medical solutions PPGs are key partners in supporting and delivering self-care Self-care can mean: Choose the right service Get the right advice at the right time e.g. NHS Choices, pharmacy, 111 Managing illness short term minor ailments Expert patient long term conditions (LTC)
Today is all about.. How you can help us develop the self-care messages How you can help us plan for winter Developing local resilience Improving communications and networks between PPGs
National Association of Patient Participation (NAPP) Conference 2018 Janet Eastwood, Chair of Sheringham PPG
National Association of Patient Participation (N.A.P.P.) 40th Anniversary Annual Conference Saturday 9 th June 2018 Held in Nottingham About 120 attendees
PROGRAMME Welcome by Chair Keynote talk 1 by President of RCGP Keynote talk 2 by Patron Stands Workshops (2) Soapbox Corkill Award AGM
Top tips to engage young people in PPG s NHS England Youth Forum
PPG s influencing quality improvement CQC recognises that patient engagement is an integral part of good quality PC services. PPG s and CQC can work together Influence CQC to shape guidance for inspection teams CQC can be contacted at anytime with good practice events as well as concerns Make sure your PPG is part of the CQC Inspection
Primary Care A history of Primary Care Commissioning Where we sit in the Clinical Commissioning Group How we support our membership practices
Sustainability and Transformation Partnership The 5 Norfolk and Waveney CCGs are working together as an STP Primary Care and Prevention workstream currently being refreshed 2017/18 achievements: Improved Access One CCG taking the lead in coordination Reporting and assurance to NHS England done once Joint stakeholder and engagement events Shared learning and support Services benefit from STP wide input, but are also tailored to meet the needs of the local population Workforce Large area of work, one CCG leads in coordination and each CCG progresses a workstream on behalf of the STP Greater education opportunities for a larger pool of clinicians Bids developed on a larger area (such as International GP Recruitment) are stronger
NHS Vision Improving access to primary care services Workforce Estates and premises Collaborative working/working at scale Online consultations Social prescribing 10 High Impact Actions to improve efficiencies
Challenges Ageing population Rurality Long term conditions South Norfolk North Norfolk
What We re Doing Social prescribing Active signposting Integrated working Improving access At scale working Self care guidance and support
Social Prescribing Social prescribing is a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. Social prescribing seeks to address people s needs in a holistic way, and aims to support individuals to take greater control of their own health. Social prescribing schemes can involve a variety of activities which are typically provided by voluntary and community sector organisations, e.g. volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports. Many different models for social prescribing, but most involve a link worker or navigator who works with people to access local sources of support
Norfolk Model A County wide offer funded through Norfolk County Council and Public Health until March 2020. Services delivered via CCG locality for any adult over 18 Time-limited service encouraging self-service and empowering individuals to take charge of their next steps. Focus on improved wellbeing and individual s potential to reduce or delay more formal packages of care and or unwanted admission to care facilities. Aims to reduce demand and reliance on Primary Care and other statutory services including the acute hospitals.
Health and Social Care Outcomes Reduction in the proportion / number of GP appointments of patients that could be better served by social prescribing Decrease in the number of hospital admissions following referral to the service, and reduction in the number of outpatient appointments Reduction in use of A&E, Ambulance, 111 and Out of Hours services Trends in access to mental health services for people supported through a connector People remain independent for longer and receive targeted information, advice and support Reduction in number and costs of formal packages of support
Wellbeing Connectors Living Well Connectors will provide one-to-one holistic person centred needs led assessment Identify and triage an individual s needs and connect to a wider range of other organisations/groups/activities/advice, monitoring the progress of these connections. Create and develop links between Social Prescribing and Social Isolation and loneliness delivery in each locality.
Locality Models South- Lead Partner South Norfolk District Council Existing model in operation currently Wellbeing Connectors linked to GP Practice covering all 18 surgeries Links to Early Help Single referral access for Social Care and wider referral using NCAN referral system Single evaluation framework
Locality Models Breckland Model- Aligned to the West locality Lead provider- Community Action Norfolk Living Well Connectors- linked to GP Practice Delivery via 7 VSCE organisations Expected go live date 2 nd July 2018 Single referral access for Social Care and wider referral using NCAN referral system Single evaluation framework
Locality Models North Norfolk- Lead Provider North Norfolk District Council Delivery across the North Norfolk District Council area. Living Well Connectors linked to Early Help Referral routes through Integrated Care Co-Ordinators Single referral access for Social Care and wider referral using NCAN referral system Single evaluation framework
Locality Models Broadland and Norwich Model- Lead Provider Norfolk CAB Model aligned to the Norwich locality offer Living Well connectors hosted by 5 VSCE organisations- CAB, Shelter, Equal Lives, Mancroft Advice Project and Age UK Advice led model using quality-assured Living Well Workers. Single referral access for Social Care and wider referral using NCAN referral system Single evaluation framework
Active Signposting Receptionists are fully aware of available services Patients are asked the reason for their call to enable receptionists to direct them to the most appropriate clinician or service This frees up GP time, and the patient is often seen sooner Signposting events in North Norfolk allow receptionists to share experiences and build confidence South Norfolk practices benefit from locally delivered education packages
Integrated Working The CCGs continue to make sure the general practice team is as integrated as possible: Enhanced Summary Care Records Integrated teams Multidisciplinary team meetings within practices Development of hubs
Improved Access What is Improved Access? Aims to improve equality of access for all through extended appointment times and new ways of accessing primary care The service will provide routine and on the day appointments outside of core primary care hours (currently weekdays 08:00-18:30) All patients in North and South Norfolk will be able to access additional non-core hours appointments by 1 st September 2018 Each area will be developing pilots to fit the local population needs, based on stakeholder feedback
Examples of Current at Scale Working North Norfolk Primary Care (NNPC) All 19 practices have come together to form North Norfolk Primary Care Ltd (NNPC), a provider organisation to support and further the primary care agenda in North Norfolk by acting as a single provider voice for the 19 practices. Progressing working at scale and transformation of primary care, including identifying opportunities to encourage collaborative working across practices, promote working with other providers, improve primary care resilience and to provide additional services within the local community. 4 South Norfolk (4SN) The four CCG localities have come together to transform local services for their patients, with the following objectives: To provide a united voice of primary care for South Norfolk to influence clinical pathways and contribute to the Norfolk and Waveney STP; Sharing information from Practice level; Reflecting the four localities of South Norfolk, who all have different needs; Be able to respond to national directives, if and when they arise; Point of liaison with key local providers and the CCG.
Patient Benefits Patient Benefitting From Local Care A patient has multiple long term conditions that require regular GP and nurse appointments. The patient has transport issues and cannot travel far. Appointments at their local GP practice mean that travel is not an issue As local GP time is freed up through at scale working, booking appointments will become easier allowing patients to see the most appropriate clinician, building a relationship that helps the patient feel confident in managing their conditions. Patient Benefitting From At Scale Work A patient of working age has a non-urgent problem that they would like to consult a GP about They are happy to see any GP, not just their registered named GP They would prefer an appointment outside of normal working hours so that they do not have to take time off work Transport is not an issue The patient can benefit from attending an Improved Access appointment in a hub location. They will see a GP, which may not be from their own practice, during the evening 18:30-20:00 or at weekends.
Self Care Effective self care means that patients aren t accessing healthcare services when they can manage their own condition or temporary illness It is also about educating and encouraging patients and communities to make the right choice about where they access advice and support This allows GPs and healthcare professionals in Primary Care to focus on diagnosis and treatment of patients with greater health needs
Self Care North Norfolk and South Norfolk CCGs worked with the Self Care Forum to produce posters and social media resources for Primary Care Directs patients to pharmacies for a range of lower level health conditions, like indigestion or hay fever http://www.selfcareforum.org/ Self Care Week 12-18 November 2018 Choose Self Care for Life
Self Care Choose the right service demonstrating the levels of care available locally Displayed in Primary Care, but targeted at non- NHS venues for greater impact Supports active signposting
Winter Pressures
Winter Pressures The pressures on A&E are well publicised in the local media, but primary care also feel the significant pressures of winter. Majority of patients were there because they were old and frail demand and vulnerability is rising
Winter Pressures Winter last year was challenging but we did well. Now we are building on the good work for this coming year.
Winter Pressures Local practices reported rise in patients arriving with respiratory problems coughs, colds, flu PPGs can help by helping us to spread communications and by using their existing networks e.g.: Have your flu jab & make sure your friends and family do Stock up your home medicine cabinet Talk to pharmacists about minor ailments Plan ahead for prescriptions Everything that we have been speaking about this morning already applies to winter, we need to plan for year-round, system-wide resilience
Any Questions?
Open Feedback Session Based on what we have heard, this is your opportunity to give feedback on the following key areas: Self care and choosing the right services Communications Community links and resilience Pressures on Primary Care (and how to alleviate)
Open Feedback Session From this point forward, please use the time to contribute your thoughts and ideas to each of these areas Use post-it notes or write directly on the charts Each section will be supported by a CCG representative to answer any questions Network and share ideas amongst PPGs in North and South Visit the stalls and speak to organisations
Open Feedback Session Your feedback will be collated and shared back to PPGs Ideas on planning for winter 2018-19 will be reviewed alongside wider feedback from Practices, and developed into a plan Links established between PPGs will grow beyond today s event!