NOTES
NHS Merton CCG Patient Engagement Group
Date: 22ndMarch 2017
Time: 10am. – 12pm p.m.
Venue: Merton CCG 120 Broadway
In attendance:
Michelle Wallington (MW) / Clare Gummett (CG) - chairAbbas Mirza (AM) / ChelliahLohendran (CL)
Steve Bowman (SBo) / Graham Barker (GB)
Patrick Browne (PB) / Chris Edge (CE)
Kay Bourne (KB) / Sally Burns (SB)
Wayne Busbridge (WB) / James Holden (JH)
Rebecca Blackburn (RB) / Lyla Adwan-Kamara (LAK)
Karen Worthington (KW)
Paul Cordy (PC)
Apologies:
Hannah Neale / Roy TrankleTy Ashby / Elspeth and Gillian Clarke
Sue Batley / Margaret Hunt
ITEM
No. / AGENDA ITEM / WHO
1. / Welcome and Introductions
CG welcomed the group to the meeting and apologies were noted.
2. / Notes, action log and matters arising
Minutes from previous meeting held on 22ndthJanuary were agreed PB suggested there were some additions that needed to added to the notes. AM asked whether these could be sent through to him. GB asked where do the notes from the PEG go? He said they should go to the senior management team so they can review the comments and concerns of the group. SB asked if the PEG was a committee of the board, CG said the PEG is an advisory body, PB suggested that there should be an item on the board and be discussed by the board.GB said we should ensure the PEG has a link to the CCG’s Clinical Quality Committee.
CG agreedthat the process would be that the notes of the PEG meetings will be reviewed by the Clinical Quality Committee (which she chairs) and this review will then be noted at the Board meeting, where a Chair’s verbal update is provided to the Board.
3. / Update on the Referral Management Service(RMC) / PC
PC, Commissioning Manager Merton CCG, gave an update on the RMC. From April 2017 the service will operate from Lambton Road with test sites that will refer and test the process and system. The test sites include the following practices: Morden Hall, Central Medical, Figgs Marsh and Merton Medical. The service would be rolled out across the other practices from the 2ndMay. PC would like the PEG to give feed back on the Patient leaflet that has been drafted. PB and CE would be happy to provide feedback to PC.
SB asked PC who makes up Merton Health? PC said they were the GP federation.
WB asked how will this save money? PC said that the Service was part of a Demand Management programme that will contribute to overall savings and support the CCG financial position. In addition the Service would improve access to other services for patients and improve their experience andfollow the principle of” best care at the right place”.
CE asked thatwhen we are contacting patients by phone we ensure it is not from a“withheld number” as many people do not answer. PC agreed to discuss this with the Service. Could the CCG use email and text to ensure that patients can confirm their appointments? PC informed that at this stage it was agreed that the Service would telephone patients however as the Service evolves alternative communication channels would be explored.
SB suggested we should ask patients how they would like to be contacted by the RMC.
WB highlighted that under the Disability Discrimination Act we should ensure that those with disabilities can access services. PC said the GP or health care professional should ensure that these issues are highlighted as part of the referral process.
The group felt that for the scheme to be seen as successful excellent patient experience should be one of the indicators that prove the scheme is working and provides a good service to patients.
GB asked whether the project team should have an implementation team that also includes a patient rep. PC informed that the implementation of this project is nearing a close however the Service would undertake patient satisfaction surveys as part of their key performance indicators. This information would be vital to support the CCG and Provider to future develop the Service
Cancer 2 week waits were a particular concern raised. It was confirmed that these would not go through the RMC.
Action
PC to discuss withheld number with Service
PEG to support development of Patient Leaflet
4. / Lyla Adwan-Kamara Merton Centre for Independent Living / LW
MCIL had been in existence for approx. 10 years. It is a user led organisation which works with those with disabilities from Merton to enable its clients and service users to widen their participation in their own health and wellbeing. There are two different views on independence for disabled people: the medical and social model. MCIL is training Merton social services staff to help them work with clients with disabilities.
The medical model accepts that a disability is a concern for the individual rather than the wider society, while the social model sees society that puts barriers in front of disabled people and there is a great deal it can do to remove these barriers.
Access to health and healthcare services were highlighted as concerns for CIL service users, this was combined with the added problems of travel and accessing appointments.
GPs and healthcare professionals need to understand how the benefit system that supports patient, LAK explained that GPs play a significant role to support patients with disabilities this includes writing letters to support a patients for benefit claims and also supporting patients who have had claims rejected, GPs often had a better understanding of a learning disability than a benefits advisor.
5. / Update on the East Merton Health and Wellbeing Project / KW
An update on the EMHW Project was given to update the PEG on plans for future healthcare services at the Wilson site.
As part of the changes to primary care in Merton two hubs have been created to provide extended hours and weekend appointments. These improvements will hopefully lead to improved access and a better experience for patients. The hubs are currently based at Cricket Green GP practice and the Nelson GP Practice. It is planned that when the EMHW centre opens the hub will move to that site. mobilisation locally in Mitcham the Cricket Green GP practice will act as a hub and then the hub would transfer to the to the Wilson site when it opens (the other hub is based at the Nelson), the improvements would hopefully lead to improved access and a better experience for patients.
A key part of any future development for the site willalso to look at how improvements to workforce will improve primary care in Merton.
There will need to be integration with local services provided by the council and other providers; this will include working with our voluntary sector partners.
The group felt that work needed to be done to tackle practice variation, there had been feedback from patients that the care and the treatment they received was different depending on where they were registered.
SB said that we need to provide assurance to the local community of Mitcham that in the future will be open to provide access outside the normal 9-5 hours, KW said that the new hubs would likely be open 8-8.
LAK was interested in the changes as CIL had been part of the community conversations into the Wilson development, it would be useful to integrate learning disability into any future plans for the Wilson development, and it would be useful to have a specialist in learning disability that a GP could refer to.
CL said the idea of integration was very good he suggested it would be useful to have a link with the boroughs nursing and health visiting team; this would help to ensure patients had a coordinated approach to their care and treatment.
WB said that his experience and others with disabilities had shown that the first contact for many patients was with practice staff as this often led them to having a bad experience as part of their overall care. KW said it was difficult to get the balance right between providing information to patients or providing signposting them to other agencies.
It may be useful to provide care navigation training for practice staff
WB felt from his experience that the statutory laws often become tick boxes for NHS organisations as they are not addressing the real need to patients, he gave an example of the PALS department at a local hospital who he had spoken to about some issues, he felt that nobody understood his condition and this was probably reflected in the experience of most patients with disabilities. LAK the action to change and improve services has to be more strategic.
CL felt that a simple solution may be to get NHS staff to colour code letter or records highlighting a disability
JH we need to have an approach that is led by the Health and Wellbeing Board
PB it would seem sensible to have MCIL involved in the development of the Wilson.
PEG members were also given an update on the social prescribing project which they had given information on at the last PEG meeting.
6 / Choose Wisely Engagement Update / AM
AM gave an update on the work that he had been undertaking as part of the engagement work on the “choose wisely” proposals. Since January he had been to see over 40 local groups and organisations who work with or represent patients across the borough. This included carer’s organisations, BME groups, communities who may be on benefits or low incomes, families and parents who use the borough’s children centres.
We also had involvement with national organisations such as Coeliac UK who we met to discuss the impact on their clients if the CCG decided to withdraw gluten free products.
AM reported that on the whole the case for change was understood by those he had gone to see and people were aware of why we had to make the changes.
There had been concern from some groups on the impact on certain groups of patients and communities this included those with long term conditions or low incomes, how would the CCG mitigate the impact on certain groups.
The biggest concern was around raising the thresholds for IVF. The majority of the concerns focused on the proposals creating a two tier system for those who could or could not afford to go private.
There would also be a need to ensure couples had access to counselling services if they were not able to access IVF services.
The surgery readiness proposals had led to a bigger debate about how public health should be helping people to stop smoking or lose weight. Disability groups had expressed concern about the proposals particularly on patients who could not exercise due to mobility issues or had gained weight due to the medication they were on. GPs and healthcare professionals would need to take such considerations into account for this particular group.
AM thankedthe PEG members that had helped him engage groups and communities across Merton as part of the campaign.
7 / Wilson List Dispersal / KW
KW gave an update on the WilsonGP practice list distribution. CL suggested that 1500 patients had not been registered and he was keen to find out what we are doing to make sure this happens.
KW said that one of the priorities of the closure had been to make sure that all vulnerable patients that may have difficulty in registering themselves would be given assistance to register at surrounding practices. This had been achievedand primary care had done as much as they could do to make sure that patient had been supported through the process
Primary Care Update
KW went through the update that had been sent round the PEG members.
GB said it would be useful if we got patient reps involved in the primary care work as this would enable the changes to be driven by service users
SB said we need to be careful in terms of referral rates, KW referral rates should not be seen as a marker for good care, A large number of referrals could bring to the attention the possible up skilling of GPs and training needs a low number of referrals may show that GPs are not aware of the existence of alternative clinical pathways
PEG update
CG & AM had met with PB regarding some of his concerns about the PEG and agreed that it needed to be more focused towards bringing about change and improvements for service users.
The work to review the ToR for the PEG was still on going and the membership had been reviewed recently and we are keen to ensure we have a good cross section of reps on the PEG CG suggested that for the PEG to work we needed to get the right people round the table. WB said it is important that we ensure that views and suggestions of the PEG are considered by the CCG senior management team. / AM
Date, time, location of next PEG meetings
24th May 2-4 pm Merton CCG 120 Broadway Wimbledon 6th Floor
July 26th 5 – 7 Venue TBC
Sept 27th 10 – 12 Venue TBC
Nov 29th 2 – 4 Venue TBC
Action Log: Merton CCG Patient Engagement Group Meeting
Meeting Date / Note No. / Description / Lead / Target Date / Comments
T:\Sutton and Merton Organisation\1- Merton CCG\Patient & Public Engagement\PEG\2016\November 2016
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