Draft Minutes –Patient Participation Group Network Meeting

Held on 23rd July 2013 1.30-3.30

Education Room, Billericay Medical Centre

Present:Marion Wilson (Chair)Billericay Medical Centre

Maureen DannBillericay Medical Centre

John WheelerBillericay Medical Centre

Charles NovisWestern Road Surgery

Cllr Ron LiveseyFelmores Medical Centre

Paul DownesNoak Bridge Medical Centre

Paula SaundersBasildon & Brentwood CCG

Louise ForrestBasildon & Brentwood CCG

Viv ClementsBasildon & Brentwood CCG

William Guy (from 2.30pm)Basildon & Brentwood CCG

Apologies: Malcolm Bigg

Len Green

Maureen Montgomery

Marlene O’Moura

June Palmer

Alison Reeve

Jan Spencer

Adrian Wild-Smith

Lesley Mitchelmore

Dawn Tyler

Notes: Pat Cook, BBCCG

1. / Welcome, Introduction & Apologies
Marion Wilson welcomed everyone to the meeting and introductions were made.
Apologies were received as listed above.
2. / Minutes of the last meeting and matters arising
  • The minutes of the last meeting were approved as an accurate record.
  • Marion Wilson noted that an update on developing a life style and balanced scorecard would be requested from William Guy later in the meeting.
  • It was noted that a formal review of Mountnessing Court will take place in October.

3. / CCG Update
Louise Forrest advised that a new Chief Officer (Accountable Officer), Tom Abell started on 4th July and the new Chief Finance Officer, Tracey Easton started on the 1st July. Louise explained that these were existing vacant posts and had been covered on an interim basis until substantive posts had been appointed.
Viv Clements is Locality Manager for Arterial locality. Adam Cronin has been promoted to a new role with a different CCG and interviews for the Locality Manager for Partnership/BIC as well as Brentwood are taking place this week.
Authorisation Update
It was noted that the CCG submitted further information in May and had met with the NHS England Area Team on the 7th June. All indications are that the number of red KLOEs (key lines of enquiry) will be reduced from 57 to approximately 10. Two directions around quality will be removed with 2-3 remaining as they concern Basildon Hospital. Formal notification of the number of KLOEs is expected by the end of July and details will be circulated to this group when received. It is intended that the CCG will take the lead on the Basildon Hospital (BTUH) contract from September this year.
4. / Proposal & discussion regarding patient participation in the CCG
Louise advised the Group that Brentwood locality already have a Patient Group and SEMC will hold its first meeting this month. Partnership/BIC is still in development.
Tonia Parsons and Alison Reeve took a paper to the Clinical Executive Group (CEG) of the CCG with an update on patient engagement and the proposals for the future. The paper was supported by the CEG and the Board.
One proposal was to develop a formal patient and community reference group to cover the whole CCG area. Evidence from other CCGs (Castle Point & Rochford and Southend) suggests there is value in formal patient and community input into commissioning activities. An initial meeting took place earlier this month involving Communications, Essex County Council and SEMC Locality Manager as well as CCG officers. Practice Managers were also invited to attend. Draft terms of reference were discussed and will be circulated once they are amended.
It was proposed that the Arterial Patient Engagement Group(PEG) is established by building on the current PPG Network Group. Partnership/BIC will set up their own group but any members of Partnership/BIC practices would be welcome to continue to attend the Arterial group until their own group is established. It was noted that there are some practices in the arterial locality that do not have patient participation groups and Viv Clements advised that she is working with practice managers to assist with setting up groups. Viv will also advertise the date of the next PPG Network meeting in all Arterial practices to encourage attendance.
Marion Wilson asked for details of how the existing Brentwood Patient Group works. Louise explained that this was originally set up as the Brentwood Community Hospital Patient Experience Group. Brentwood practices built on this group and now hold bi-monthly meetings which are attended by representatives from most practices and representatives from voluntary services. Two GP leads, Dr Arv Guniyangodage and Dr Ken Wrixon, attend the meetings in Brentwood.
It was proposed that Drs Simon Butler and Nehal Ahmad (Locality Leads and Board Members)be invited to attend Arterial PEG meetings and would feedback to the CEG/Board. New service development/service redesign would be a standing agenda item.
After discussion it was decided to defer a decision until the next meeting to give members the opportunity to discuss the proposal with their own practice. Information would also be circulated to members who had been unable to attend today’s meeting. The information circulated needed to include a diagram of the proposed patient engagement.
5. / New patient pathways and service development
The group were advised that there are several new pathways either developed or in development. Each Locality has been asked to develop a new pathway and these are currently being worked up:
SEMCCOPD
Partnership/BICHeart Failure
BrentwoodFrail Elderly
ArterialFalls
These new pathways will involve a number of services and have a big effect on patient lives to avoid patients being admitted to hospital.
Cellulitis Pathway
This has been relaunched following feedback from patients. The pathway will enable more patients to remain in their own home and be cared for by the community team rather than being admitted to hospital. By using best practice in prescribing and treatment, patients are supported to recover quickly and recurrence should reduce.
End of Life Pathway
This is being led by Karen Wesson, Senior Commissioning Manager. A South West Essex End of Life Collaborative Commissioning Group has been established. The Group is still in its early stages – terms of reference have been drafted and circulated for comment. There are six work streams which will require patient participation, e.g. communication, experience – awareness and access to services, nursing and residential care homes, non-cancer, including frailty. If any members of this group wish to be involved, please email .
MSK Hub
Karen Wesson and Lorraine Lockwood are working with Thurrock CCG to develop a new integrated pathway to avoid duplication and variation in services. Patients have been involved in this process, one of whom is Maureen Montgomery. Alison Reeve and Len Green have also been involved. A bidder event for procurement of this service was held last week and was well attended.
Lower Back Pain Pathway
This was launched recently and is the formalisation of an existing pathway. It focusses on the management in primary care.
Hypertension
There is a plan to put 12 blood pressure machines in GP Surgeries. Public Health is determining which practices should receive these.
Diabetes
Current community pathways will be reviewed in the near future.
Stroke
The setting up of five hyper-acute stroke units across Essex is being considered for patients for the first three days following a stroke. The SW Essex Unit is proposed to be at Southend Hospital. A similar service has been established in London with improved outcomes for patients. One of the key issues is the longer journey time although this should be outweighed by the better outcomes.
A recommendation will be taken to the CCG Board in September and, if agreed, there will then be a three month consultation.
Pathology
A number of concerns have been raised regarding the proposal to create a super pathology service in collaboration with a number of CCGs, with the service provided by Bedford Hospital. Due to the concerns raised and several outstanding issues, it is possible that this project may not now go ahead.
It is expected that a decision will be made in the next few weeks.
Marion Wilson requested that a list of the services where patient involvement is required be circulated, together with contact details.
6. / BTUH update
William Guy gave apologies from Lisa Allen, CCG Executive Nurse, who has been fully involved in the Keogh Review. CCG involvement has included providing information, attending the on-site inspections and participating in the subsequent risk summit to discuss the draft findings of the review.
Basildon Hospital is one of 11 hospitals who have been put into special measures. Full details of this are not yet clear but an external support team will be put into the hospital. The hospital will be “buddied” with a well performing Trust and the action plan will be closely monitored.
It is important to note that there were no surprises in this report – no newly identified areas that had not already been identified and action commenced.
We continue to work closely with BTUH on the action plans and believe it is a safe Trust. Training around infection control at the hospital is being addressed.
Lisa Allen will be asked to attend the September meeting to give an update on progress.
Paul Downes expressed concern at the increasing population in the area and asked how the hospital will manage this. William Guy advised that additional capacity has been factored in for this winter with an additional 75 beds. It is recognised that models of care need to change and we are working closely with Social Services and Community Services. The End of Life Group is working with care homes to avoid unnecessary admittances.
7. / NHS 111 Update
Unfortunately neither Emily Hughes nor Colinette Nichols were able to attend today’s meeting. It is expected that one of them will attend the September meeting.
The current call levels are being managed in South East Essex and are not impacting on the performance of the service. North Essex is not due to go live until later this year.
There are five NHS 111 complaints for South East Essex that have been upheld. One was a telephone issue. Three were human error and these have been brought to the attention of the call handler nurse and receptionist. The fifth complaint is currently being investigated.
The providers of the service in South Essex, Integrated Care 24 (IC24) have requested patient involvement in their meetings which address the quality of the service. Details will be circulated to this group.
8. / Round Robin – updates from individual PPGs
Paul Downs – Noak Bridge Medical Centreadvised they had held one meeting which had been attended by six patients, Dr Sharma and the practice nurse. This had been a very positive meeting and the doctor had agreed to respond to issues raised within a time-frame. Another meeting will be held later this month. They are trying to encourage more patients to join the group.
Cllr Ron Livesey – Felmores Medical Centreadvised he has been trying to encourage patients to join a patient group but is finding it difficult to get patients involved.
Maureen Dann – Billiercay Medical Centre advised their patient group meet regularly and the practice manager is receptive to any issues raised.
Charles Novis - Western Road Surgeryadvised the practice has involvement with the patient group and responds to issues raised.
He also advised the GP practice has been invited to have input into the Parish Newsletter which is circulated to all homes in the area to raise the profile of the Patient Group.
The practice is hoping to hold a diabetes event in September supported by Diabetes UK.
Charles Novis suggested publicising Patient Groups and events and advised he had recently seen “carrier bags” requesting support for a local PPG and felt this idea could be developed for use in this area to promote patient groups.
9. / Any other business
  • Marion Wilson requested a Glossary Sheet which would be helpful to clarify the acronyms used within the NHS. This will be circulated to the group.
  • Marion Wilson requested details of the Joint Strategic Needs Assessment (JSNA) life-style balance scorecard. William Guy advised a deep dive is taking place and he will investigate whether the scorecard is available.

10. / Date of next meeting
The next meeting will be held on 16th September2013 at 13.30 in the Education Room, Billericay Medical Centre.

Vision Statement: The CCG aims to deliver, in partnership with its patients, a local health service that continually improves to meet today’s demand and tomorrow’s need.

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