Healthwatch Community Spokes notes

for the meeting on 19th May 2015(10am–12:30pm)

at Community Base

Attendees / Apologies
Nicky Cambridge (Healthwatch B&H CEO) / Pam Windsor/Chris Lau: The Carers Centre for Brighton and Hove
Magda Pasiut (Healthwatch B&H staff) / Linda Saltwell (The Trust for Developing Communities)
Rob Guile (Integrated Service Delivery Programme Manager, speaker) / Gillian Unsworth (Mind in Brighton and Hove)
Laura Williams (B&H Community Works) / Geraldine Des Moulins
The Fed – Centre for Independent Living
Joanna Martindale (The Hangleton and Knoll Project) / Jessica Sumner (Age UK Brighton&Hove)
Chloe Clarke (Brighton & Hove Food Partnership) / Lucy Bryson (Refugees and Migrants Forum)
Maria Antoniou (Brighton & Hove LGBT Switchboard) / Sarah Pickard (Brighton & Hove Speak Out)
Rebecca Barkaway (Brighton Women’s Centre)
Jo Ivens (Impetus)
Roisin Murphy (Age UK Brighton and Hove)
Mark Cull (YMCA DownsLink Group)
Helen Jones (MindOut)
ArranEvans(Sussex Interpreting Services)
Rachel Travers (AMAZE)
Michelle Gavin (Friends, Families and Travellers)
Maggie Gordon-Walker (Mothers Uncovered)
  1. General points
The meeting was started by Nicky Cambridge who provided an overview on the Community Spokes programme arrangements and informed attendees about what Healthwatch can offer to them. She pointed that:
  • As on 1st of April 2015 Healthwatch Brighton and Hove become a Community Interest Company, a limited company by Guarantee with an Asset Lock. The Asset Lock means that any surplus generated income has to be used to further the organisation’s work for the benefit of the community. Healthwatch is a not for-profit organisation. Spokes were encouraged to become Community Interest Company members.
  • There are 5 members of staff, but only one of them and CEO are working full-time. Besides that Healthwatch, as on 19th of May, has had 37 volunteers.
  • Healthwatch volunteers and Board Directors attend a vast number of meetings and forums across Brighton and Hove with the aim of championing the consumer voice, encouraging patient participation and influencing decision making using our patientexperience intelligence and data. This is currently being mapped and will be shared.
  • In addition, Healthwatch receives lots of requests to be present on various meetings, which often can’t cover. If Spokes have capacity and interest in the issues, they could consider engaging as Healthwatch representatives.
  • Healthwatch has a right to issue request for information which must be responded to by services providers and commissioners within 20 working days. Spokes are welcome to submit questions, which Healthwatch will pass on to the relevant stakeholder. For instance, this could be a question about a change to the service and its implications.
  • Spokes said that it would be good if Healthwatch could inform them about all meetings Healthwatch reps do attend, share with them relevant agendas prior to the meetings so they have enough time to think how they can contribute to it. It was also suggested to link this piece of work with Community Works Reps Council. Furthermore, it was said that there is a huge potential for future work on social care, especially on personalisation, care homes, Care Act, but there needs to be in places process for making this happen.
  • Healtwhatch can carry on ‘Enter and View’ visits to health and social care services to find out how they are being run and make recommendations where there are areas for
improvement. Healthwatch authorised representatives are allowed to observe service delivery and talk to service users, their families and carers on premises such as hospitals, residential homes, GP practices, dental surgeries, optometrists and pharmacies, etc. Healthwatch can do “Enter and View” visit to all health and social care services besides children’s social care ones.
  • Currently, Healthwatch have done 14 visits, most recently, 3 pilot visits to the GP practices andon 28th of May is holding planning GP Visits – Stakeholder Meeting on rolling programme of GP ‘Enter and View” visits, which Spokes are welcome to join. It was explained that it is an opportunity for Healthwatch to meet with Spokes and partner organisations so that we can consider questions and process in relation to our planned GP practice visits programme.
  • Mark pointed that there is an issue around child sexual exploitation as some GPs seems not to be trained on how to deal with it. Nicky, suggested that the issue could be brought up on CCG Safeguarding Board, but firstly we need to check what CCG Engagement Organisations are doing on this. Healthwatch can put a request on information on what training scheme are in place for GPs. It was suggested that it is a national issue and perhaps would be worth bringing this up to the attention of Healthwatch England, as GPsneed 4 days to complete the relevant training. It was agreed that Nicky and Mark would meet outside the meeting.
  • Jo Ivens informed that EPIC project has been extended till November; shealso provided an update on it.
  • Arran mentioned that doctor first scheme seems to be causing some trouble especially for people whose English isn’t their first language. He wants to know more about clusters, GP`s extending hours. It was suggested that Healthwatch could put a request for information on if the equality assignments of Doctors’ First Scheme was conducted. Working with the B&H CCG is seen as a challenge because of very short notices being given. Healthwatch should raise this issue with the CCG
  • There were some concernsand challenges raised about why the HW spokes programme hasn’t happened to date and more specifically why the £ allocated wasn’t spent and/or ring fenced for carrying forward.

Action / By who?
  • Share agendas of meetings attended by Healthwatch reps with all Spokes, so they have an opportunity to contribute
/ Healthwatch team
  • Share reps map
/ Healthwatch team
  • Share Health and Wellbeing Board Agenda with all Spokes
/ Healthwatch team
  • Talk to Sally Polanski how Healthwatch reps work could be linked with Community Works Reps Council, so duplication of affords could be avoided and we could make a better use of our influence role. Talk to Healthwatch staff about it.
/ Nicky
  • Provide input into “GP Enter and View” survey
/ Spokes
  • Establish mechanism for engaging Spokes in Reps and ‘Enter and View’ work
/ Healthwatch team
  • Fill in and return Partnership Agreement form as soon as possible. Also consider applying to be a formal membership of HWB&H.
/ Spokes
  • Distribute details on GP Visits – Stakeholder Meeting
/ Magda
  • Share with Spokes some sort of ‘report’ and/or meet to understand why the spokes project did not get off the ground earlier, so that we can learn for the future
/ Nicky
  • Discuss/progress issue around lack of GP training on child sexual exploitation
/ Nicky/Mark
  • Sent request for information to find out if equality assignments of doctors first scheme was conducted
/ Healthwatch team
  1. Future meetings
  • It was suggested that meetings should be about sharing whatprojects have been done and leaning from it. Eventually, it was decided that there is no need for regular meetings; instead Healthwatch could work with Community Works, perhaps run a session during Community Works Conference? It was also suggested that Tess Craven could develop a health and social care network in her new role.

Action / By who?
  • Feedback to CW
/ Healthwatch
  1. Feeding into Healthwatch & vice versa
  • Nicky reminded about sharing information via What are the big issues for your organisation? form. All Spokes where encouraged to share with Healthwatch hot issues as soon as they arise.
  • Attendees raised a question on how would Healthwatch feedback to them, so they can share that with people they work with.

Action / By who?
  • Share issues with Healthwatch
/ Spokes
  1. Time Scale
  • The projects need to be completed by the end of this calendar year (December 2015).
  • Applications will need to be received by 5pm Tuesday 23rd June, in order to be discussed by the HWB&H Board in July.
  • Spokes will be informed of the outcome of their application by 10th July 2015
  • If the fund is not fully spent, then a call will be made for late applications and details will follow.

Action / By who?
  • Submit applications by 5pm Tuesday 23rd June
/ Spokes
  • Fill in and return Partnership Agreement form as soon as possible
/ Spokes
  1. Funding/amounts
  • In total there is £20 000.Healthwatch can offer £200-£2000 for work that meets shared priorities.

  1. What to get out of this
  • Attendees raise the question on how would Healthwatch feedback to them, so they can share that with people they work with.
Action / By who?
  • Establish feedback mechanism
/ Healthwatch
  1. Specific projects
  • The money is for work that meets Healthwatch priorities, however we do trust spokes expertise and we are open to proposals of projects based on issues identified by them. For more details on criteria for funding please see: Community Spokes Information and Guidance Notes for Funding Applications and an application form itself.

  1. Links to CCG
  • Some Community Spokes have also been commissioned by B&H CCG as Engagement Groups and, as such, have signed a contract which requests them to work closely and share intelligence with us. We will continue to develop a close working relationship with these organisations to ensure that we don’t duplicate each other and work in partnership if there are any opportunities. We cannot fund work already funded by the CCG.

  1. Disability Engagement Partnerships
  • It was advised to investigate what they are working on, as it could be a good source of information for Healthwatch.
Action / By who?
  • Investigate what Disability Engagement Partnerships are working on
/ Nicky
  1. Process for decision making
  • Healthwatch will establish Community Spokes Application’s Review Panel, which will consist of Nicky, Magda, one of Directors and at least one person from outside of organisation.
  • Applications will to be discussed by the HWB&H Board in July. Spokes will be informed of the outcome of your application by 10th July 2015
  • Thequestion of whether the project will be re-run, was raised.
Action / By who?
  • Check with Healthwatch Commissioner if the programme will be re-run.
/ Nicky
  1. Care Act/Better Care discussions
  • Informal talk was delivered by Rob Guile, Integrated Service Delivery Programme Manager. He is employed by the B&H CCG.
  • Brief overview:In August 2013 the Government announced £3.8 billion of funding to ensure closer integrationbetween Health and Social Care. The purpose of the funding is described as a single pooledbudget for health and social care services to work more closely together in local areas, based on aplan agreed between the NHS and Local Authorities. Locally £20 million has been allocated.
  • Locally, the keyfocus is on dementia, proactive care, seven day working week.Rather than just focusing on older people who are ‘frail’, Better Care in Brighton & Hove is addressing the needs of people who are living with multiple long-term health conditions, such as diabetes, asthma or dementia, people with mental health problems and our homeless population. The aim is to provide a more co-ordinated approach to supporting these people in their own homes and in the community and to reduce unnecessary admissions to hospital and care homes. There is an emphasis on minimising the time people spend in hospital and on providing people with the support they need to recover and return home as soon as they are ready.
  • GP practices clusters are at the heart of co-ordinating care, supported by multi-disciplinary teams (MDTs) that include specialists from a range of local services, including community nurses, physiotherapists, social workers, mental health experts and substance misuse support workers. Each ‘frail’ person is given a designated care co-ordinator drawn from an MDT who will be responsible for co-ordinating support for all their physical and mental health needs. Better Care also involves exploring how to share an individual’s case history electronically between all those involved in providing care, with the person’s consent, and the development of a single care plan that is regularly reviewed and updated.
  • Over the last year the integrated MDT model has been tested around two clusters of GP practices. The first cluster consists of three practices in Hove (Wish Park Surgery, Sackville Road Surgery and Central Hove Surgery, serving a population size of about 22,000) and St Peters Medical Centre and Park Crescent Surgery (serving a population of about 24,000).
  • Attendees talked about potential ways of influencing this piece of work. It was said that Jess Summers from the Age UK is attending MDT’s meetings. Also, Tess Craven is about to start to work for Community Works and her role would be an advocate on Better Care. She will work streamline the communications. Arran asked if Tess would be the right person to share intelligence with, Rob responded that he needs to meet and talk to her first.
  • Rob provided an overview on Better Care governance. It takes in 4 different places and the processes are still not clear. We mentioned that one of our Directors already sits on one of these bodies - Primary Care Transformation Board. He suggested that community and voluntary organisations could put together a business case. Better Care Board evaluate business processes – possible action for Tess.
  • Spokes raised concerns that we don’t have the kind of evidence Better Care is looking for and there is no vision on how Community and Voluntary Organisation can get involve.
Action / By who?
  • Update briefing on Better Care and share with others. Old version is currently available at:
  • Ensure Tess Craven briefed on actions.
/ Community Works and Healthwatch
Healthwatch
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