Redbridge Clinical Commissioning Group Patient Engagement ...€¦ · Redbridge CCG PEF, November and December 2014 Page 1 of 4 . Redbridge Clinical Commissioning Group . Patient

Redbridge CCG PEF, November and December 2014 Page 1 of 4

Redbridge Clinical Commissioning Group

Patient Engagement Forum (PEF)

Tuesday, 27 January 2015 Becketts House, Ilford

Minutes of the meeting

Present: Lorraine Sliver Boba Rangelov David Hall Shushila Patel Michelle Greene Christine Lewis Jon Abrams David Lyon Anne Bertrand Raina Gee Jean Goody Tahir Mahmud James Edwards Bridget Okhiorgbe Jon Abraham Dee Data Dr Jyoti Sood

PEF Chair PPE Advisor BHR CCGs PEF member, Cranbrook and Loxford PEF member, Cranbrook and Loxford PEF member, Wanstead and Woodford PEF member, Wanstead and Woodford Redbridge Disability Consortium PEF member, Fairlop Redbridge Healthwatch and WW PEF rep Redbridge Youth Council Co-ordinator PEF member, Fairlop PEF member, Seven Kings Youth Council rep Youth Council rep Redbridge Concern rep Cranbrook and Loxford Clinical Director, Redbridge CCG

Apologies: Barbara Stuchfield PEF member, Fairlop Shani Fooker PEF member, Seven Kings Swati Vyas Health Partnership manager, CVS Redbridge Khalil Ali Lay member, Redbridge CCG Howard Clarke-Melville Redbridge PEF, Vice-Chair, Seven Kings Absent: Martine Carter PEF member, Seven Kings John Elliffe Learning disability rep Atia Kazmi Fairlop Rakesh Dutta Wanstead and Woodford

In attendance: Sarah See Director of primary care improvement BHR CCGs


Item Action 1 Welcome and apologies Chair welcomed everyone, introductions were made and apologies

accepted.

2 Minutes and matters arising 2.1 2.2 2.3

2.4

2.5

2.6

2.7

Minutes were noted as correct record of the meeting. Matters arising DD pointed out that CQC is not dealing with the individual issues submitted to them by the public. JS would still like to invite Jane Burt to give presentation about cancer work. Extra PEF meeting was suggested but it has been decided to continue having usual PEF meetings and only in exceptional circumstances to organise extra PEF meeting. LM would like to talk to PEF about commissioning intentions and date was agreed as 10th February to hold this meeting. ACTION: BR to send Louise’s presentation to PEF before 10 February. DL will send the flyer to BR about care.data presentation to forward to PEF and PPGs. ACTION: BR and DL ACTION: BR to send an email to PEF members asking them if they happy to share their email address with other members DH asked why we ask for PEF opinion if documents sent have been already approved. LM replied that there are some national guidelines about this and they should always state “draft” if document is still for consultation.

BR BR, DL BR

3.0 Redbridge Youth Council-report 3.1 Two young people presented the report to PEF about their recent projects.

They had youth debate held in 2013 when they elected members. In 2014 the Redbridge Council gave 100.000 pounds funding for the Youth Council. They produced and distributed leaflets for young people about mental health. They produced wristbands in four colours, and they were great success. One of the priorities they worked on was safety, and they worked with 8 schools on this. They attended Carers’ conference at Redbridge college. In February they voted candidates for Cabinet. They could vote for 10 candidates. KA congratulated the young people on their work. The CCG would like to hear more about their work. SW suggested inviting them again to see the progress of their work. Everyone agreed. DD asked how they interact with the MPs and how they address to them what they want from the system. They replied that the main interaction is through the Youth Parliament and the local councillors. DH asked if they experienced any resistance from the schools. They said that the YC members are all from the local schools, so they are asked to liaise with their schools and encourage them to participate. CL asked if there are any services that they would like to be more accessible for young people. They replied that they found out that many young people didn’t want to have counselling because it would be on their records. JS advised that the young people could choose what to share or not to share with their GPs. ACTION. RYC to share with PEF any relevant reports and any other questions from PEF to be sent to BR to forward to the YC.

RYC

4.0 Feedback from the localities


4.1

4.2

4.3

4.4

Medication branding: It was noted that one medication has the same generic name but difference branding names. Dr always issue generic name of medication but it depends which branding is given at the pharmacy counter. DD mentioned that he heard about the current increase of TB in the UK and there are new strands of TB resistant to treatments. SW informed everyone that last week collaborative TB strategy was launched. There is a pilot in London and GPs are trained about this. ACTION: SW to send a summary of current developments and BR to distribute to PEF Phlebotomy and information about clinics was also raised. LS reiterated to send our list to the practices and there should be a poster or other visible info for the patients. A&E performance: There is a BBC web link to monitor daily and weekly performance. Action: BR to send a link to PEF

5.0 Strategic Commissioning Framework for Primary Care Transformation in London-Sarah See, Primary care improvement programme director

5.1 SS gave presentation about the topic. There is application for GP they can apply to improve GP practices premises. ACTION: Any comments about Framework document sent prior to this meeting, PEF to send to BR SS stated that there are variations in GP performances and quality of services provided. A new Transformation Board has been established. This board will look at the current state and what need to be done to improve any gaps identified. SW stated that there are many pro-active things happening currently and that CVS is happy to contribute to this work. There are a lot of components in this document inherited from the PCT time, and she asked if there is anything taken off or followed up in this new document. SS replied that there are national drivers, tailored towards CCGs. DD noticed that GPs are swamped with a lot of paperwork and there is a lot of wastage, so in his opinion GPs have been “abused” with unnecessary paperwork. He asked how to address this issue. SS replied that the CCGs went through assessment process. They voted for full delegations from NHS England. CCG can make decisions for some contracts and there is a lot of conflict of interest. There is enhanced service. In order to review national guidance we have local committee. Healthwatch and Health and Wellbeing board are non-voting members on this board. It is important to manage demands. DH mentioned Broadway surgery and they don’t take any longer telephone appointments. DL noticed that Drs seem to be self-employed. SS stated that they are independent contractors, and it is a challenge, a lot of scepticism but also a lot of enthusiasm. SS also stated that we have to be realistic and there are different ways of working. CH asked why young people don’t want to go into the medical profession. Dr JS replied that a lot of blame for this goes to the media, as they never mention positive things about medical profession. DH stated that CTT service is short staffed and does not respond, as they should. LM replied that this service is provided by NELFT and that we can pick up any issues and discuss further. LS thanked SS for her presentation.

PEF


Dates of the PEF meetings in 2015 are: Tuesday, 17 March 2015 5-7pm Tuesday, 12 May 2015 5-7 pm (changed from 19th May to 12th May) Tuesday, 21 July 2015 5-7 pm Tuesday, 8 September 2015 5-7 pm Tuesday, 17 November 2015 5-7 pm All meetings are in Becketts House, Boardroom a, 2nd floor.

5.0 AOB 5.1 CT reminded everyone about pharmaceutical needs assessment and

distributed some hard copies to members. The YC already submitted a lot of responses. So far, they have 20% responses, which is good. The Healthwatch also work on phlebotomy services and what else could be done in relation to usage of this service in Redbridge. They are also doing a telephone survey about GP practices and complaint process. The report will be sent out. They are looking if there is a generic complaint procedure and they sign post to the Healthwatch. They will hold two focus groups about this in February. JA informed everyone about focus groups they held with 200-300 disabled people. They heard some serious issues about interpreting services. YC suggested sending the report to the CCG. ACTION: CT DL raised an issue regarding Drs in practices taking away District Nurse services. LM replied that the CCG is aware of this issue. LS suggested having an update at the next meeting. ACTION: LM CL suggested inviting Dr Hayes and Dr Ali to the next PEF meeting when Barts Health will be guest speakers. ACTION: BR

CT LM BR

6.0 Close and next steps 6.1 LS thanked everyone for coming and the meeting was closed.

The next PEF meeting is on Tuesday, 17 March 2015 5-7pm. BR informed everyone that the PPE workshop on 17 February has not been confirmed yet.

Redbridge CCG PEF, 17 March 2015 Page 1 of 6



Tuesday, 17 March 2015 Becketts House, Ilford


Present: Lorraine Silver Boba Rangelov Shushila Patel Michelle Green Christine Lewis David Lyon Anne Bertrand Jean Goody Esah Bannister Umar Chowdhury Mohamed Yusuf Jenny Norwood Dee Data Dr Jyoti Sood Khalil Ali Howard Clarke-Melville

PEF Chair, Fairlop PPE Advisor BHR CCGs PEF member, Cranbrook and Loxford PEF member, Wanstead and Woodford PEF member, Wanstead and Woodford PEF member, Fairlop Redbridge Healthwatch and WW PEF rep PEF member, Fairlop Youth Council rep Youth Council rep Youth Council rep Youth Council support worker PEF member, Cranbrook and Loxford Clinical Director, Redbridge CCG Lay member, Redbridge CCG Redbridge PEF, Vice-Chair, Seven Kings

Swati Vyas Health Partnership manager, CVS Redbridge Shani Fooker PEF member, Seven Kings Christine Merritt Redbridge Forum John Ellife Redbridge Forum, PEF member Jay Solanki PEF member, Cranbrook and Loxford In attendance: Martin Sheldon Deputy Chief Officer, BHR CCGs Apologies: Barbara Stuchfield PEF member, Fairlop Jon Abraham Redbridge Concern rep Louise Mitchell Redbridge CCG COO David Hall Cranbrook and Loxford Raina Gee Redbridge Youth Council Co-ordinator Tahir Mahmud PEF member, Seven Kings Absent: Martine Carter PEF member, Seven Kings Elaine Freedman PEF member, Seven Kings Atia Kazmi PEF member, Fairlop Rakesh Dutta Wanstead and Woodford


Item Action

1 Welcome and apologies Chair welcomed everyone, introductions were made and apologies

accepted.

2 Minutes and matters arising 2.1

2.2 2.2.1 2.2.2

2.2.3 2.2.4 2.2.5

ACTION: BR to amend the list of attendees, as some PEF members names were left out. The rest of the minutes were noted as a correct record of the meeting. Matters arising PEF had an extra meeting on 10 February. The topic was about commissioning intentions for the next year. PEF members all confirmed both verbally and via email that they are happy to share their email addresses with other PEF members The Redbridge Youth Council provided an update about their work at this meeting and it is now a standing agenda item. BR distributed a summary of current developments regarding TB, produced by the CVS and sent by SV. As requested, BR had sent to PEF a link to BBC website if members would like to see live A&E performance status across London.

BR YC

3.0 Barts Health presentation cancelled-Martin Sheldon, Deputy Chief Officer, in attendance

3.1 In the absence and cancellation of Barts Health representatives at today’s meeting (for the second time), MS kindly agreed to attend and give an overview of the current situation at Barts Health NHS Trust. MS stated that this NHS Trust has been heavily scrutinised by the CQC and a very unsatisfactory report had been published regarding Whipps Cross hospital’s performance. Therefore, the Trust has been put under special measures by the CQC. This is the second time that Barts Health cancelled their presentation for Redbridge PEF, and everyone agreed this was unacceptable. MS gave the most recent update on Barts Health developments, including the most senior staff turnover and resignations. Barts Health operates from six sites and it is difficult to manage such a big organisation. DD asked why and how Chief Executive was allowed to carry on with his job when the Trust was seeing multimillion pounds deficit a day. DD also stated that he was not competent to carry out his job. DD asked what confidence the patients can have in this Trust given the current state and poor performance. The Chair, LS stated that Barts still wants to meet with her/ PEF and asked members who would like to join her for this meeting. LS also stated that she spoke with their Deputy Chief Nurse and informed her that the patients felt hurt and there was a big issue around accountability. AB mentioned high costing of the advisors employed by the Trust. DD mentioned issues with the Trust’s IT system. MS replied that it is not appropriate to put the IT systems in place until redundancy processes are completed. HC-M asked if the issues raised by PEF regarding Whipps Cross have been addressed adequately to relevant people and what actions have been taken as a result of it. He also asked whether PEF should be more “aggressive” in raising those issues. SP stated that issues raised by PEF, in her opinion, have not been addressed and there was no clear accountability structure. SP also stated that in her opinion, there is no feedback to the Governing Body regarding


the issues raised by PEF and she asked what happens if the funding for one of the services (i.e.) was pulled out, what happens to patients/service users who are left without the service. SP mentioned that the NHS lacked efficient accountability structures when the group were discussing the huge deficit of Barts Health Trust. In her opinion, NHS does not monitor performance and standards adequately to improve services and also to hold individual/s accountable. NHS is not good at responding to patient’s feedback on failing standards. MS reassured everyone that issues raised by PEF are addressed at the Governing body meetings. Our CCGs have withheld some funding from BHRUT because of poor performance and regarding Barts Health each commissioner has different view on it. Our CCG withheld one of the contracts with Barts and MS said he would be happy to provide figures to PEF, if needed. MS also assured the group that the accountability structures in the NHS are in place and the BHRUT has used the contractual levers on at least 6 occasions-withheld funding to improve services. SP thanked MS and stated that he enlightened PEF about actions taken on failing standards ACTION: SP, CL with the Chair asked that the CCG on behalf of the PEF to get information about the contractual levers used in the previous occasion's, what services, how much funding was withheld and over what period of time was the levers used? CL mentioned issues regarding appointment system and patient transport. There was a serious incident, so what is Barts doing about it, this is not clear. KA also said that the lay member’s reports and other reports are easily accessible on the website and there is a clear reporting mechanism back to PEF. ACTION: As suggested by HC-M, BR to create a separate log only for PEF issues. DL asked who can sack the CEO. MS replied that the Trust Development Agency (TDS) is authorised to do that and that usually they are not sacked but given an opportunity to improve their performance. MS also stated that it is important to know what you are accountable for to be able to perform and deliver appropriately. JS expressed concerns regarding feedback to the locality about issues raised, no feedback received and he also stated he was concerned that patients are not receiving the right care and treatment, including young people. MS suggested that PEF write their questions regarding Barts Health or any other issues and he would send response/feedback to PEF. ACTION: PEF to send questions to BR and BR to pass them on to MS. MS reiterated that it is a shame that Barts Health failed to turn up today for this meeting and that the CCG will keep pushing this Trust to improve in the future. DD asked if there is a mechanism to deal with the issues raised as “fast track”. MS replied that a lot of activities are happening at present with Barts and the CCG working closely with this Trust. 70% of the CCG activities at present are taken by Barts Health. SP thanked MS and stated that he enlightened PEF about current developments. AB asked what the patients will do if the service they need to use is not commissioned by the CCG. MS replied that the CCG is not commissioning all the services, only some

BR and PEF MS, LM BR PEF, BR and MS


of them. DL stated that there are variations regarding what the CCG commissions. MS stated that the providers have to provide services up to the certain standards that the CCG requires from them. We have to make it as safe as possible. HC-M noted that the NHS is not funded properly and it is underfunded. JN from the Youth Council noticed that when they go to young people and take information back to them they usually say that they now understand the issues/services explained to them. MS concluded that the NHS came up at the top on the recent world survey and it is a great institution which needs to continue.

4.0 The Redbridge Youth Council report-Esah Bannister, Umar Chowdhury and Mohamed Yusuf (support by Jenny Norwood)

4.1

4.2

Redbridge YC produced four different colours wristbands with different straplines. They held the career’s conference, which was a great success and they will organise another one on 31st March 2015. On 21st January they had the conference attended by 13 schools and they had debate of mental health. The next school’s council will be held in July. Health services issues are re-occurring at the YC. DD congratulated the YC on their work. SP asked about mental health and sexual health and how the young people work on this. The young people replied that they have dedicated member/young person who is committed to mental health issues and they are developing positive relationships regarding these topics. ACTION: JN suggested that the YC return to PEF once they visit all the schools and feedback. KA suggested that it is important to point out actions from the YC work to the right people. Dr JS stated that it would be very beneficial to work together in schools on diabetes type 1 and how to improve update of tests for this condition. ACTION: To attend one of the YC meetings or to send an email to Raina or Jenny about diabetes project. SF suggested inviting YC to attend their locality sessions. JN stated that they will have exams time until the end of July, so it would be the best to invite them after the exams.

YC Dr JS

5.0 Feedback from the localities (localities log) 5.1

5.2

5.3

5.4

IT system: BR forwarded to IT department further issues raised by Mr Chris Oliver and DL. Response is due. ACTION: BR and IT dept (Rob Meaker and Dave Game) DL stated that there should be a good broadband used in the practices and this is not the case. DL asked if this could be improved. There should be a clear IT strategy with a good broadband for all GP practices. There also should be a clear structure of who is doing what in IT department. PM Challenge fund update: Only one practice met criteria (Glebelands) and this is in progress at present. The Care.data: Following recent meeting with NHS England, LS and DL expressed concerns that they are still not listening to patients and their concerns regarding this and they are going ahead with this project. ACTION: To draft a letter on behalf of PEF for NHSE, send it to Dr Mehta, CCG Chair, and then the CCG would send it to NHSE on behalf of PEF. GPs protective learning sessions (PLE): There was a concern that the practices are shut during those sessions without informing the patients, no voicemail message when patients call the surgeries.

BR, IT BR, LS and Dr Mehta


5.5

5.6

5.7

5.8 5.9 5.10

5.11

ACTION: To have posters in the practices with the dates for the whole year when the practice will be shut because of those sessions. Also, to put this on PEF log and monitor how it is taken forward (newsletters, posters etc) Diabetes: Loxford and Cranbrook locality have the highest rates of Diabetes in Redbridge which is on the increase and in addition the onset of diabetes is dropping in age. This has been a major concern over many years and is one of our locality priority concerns. Dr JS stated that we are working closely with Diabetes UK and CVS to develop Diabetes strategy. They also work with the Public health. Diabetes screening uptake is not good enough but Dr JS encouraged PEF to send her any feedback about this topic. ACTION: The CCG should support all GPs in the Cranbrook locality to undertake adequate prevention measure such health checks and screening for diabetes. At present not all GPs are offering routine screening for Diabetes and Health checks. From 1st April NHS England will delegate which roles the CCG will be responsible for and perhaps through this role the CCG can use its influence in managing GP services. PEF would like Dr JS to prepare the report for the Governing body about this project. TB increase in Redbridge: Figures gone down at present. However, PEF suggested inviting Gladys Xavier from the Public Health to present current developments regarding TB. BR sent report to PEF written by CVS. ACTION: BR to discuss with PEF planning group. Training for PPGs: PEF members asked what kind of training is available for PPGs; it very much depends on what kind of training they need. BR informed everyone that is has been agreed by the CCG to allocate funding to provide training for PEF members. This is the company used recently to provide training for Newham PPGs/PEF and the feedback was excellent regarding the quality of this training. Phlebotomy: LS informed everyone that she sits on the BHRUT patients’ panel and they are looking to provide better service. BR circulated the PPE request form completed by Tina, one of the project leads on phlebotomy project. SF put her name forward to participate in this work and represent PEF. ACTION: BR to link SF and Tina, for further steps and info. Access to GP practices and difficulties making the appointments (Seven Kings) Dr JS explained that there is a lot of work going on regarding this. A new Transformation Board has been established to look into this and other primary care issues, including access to GPs. Recycling medication: HC-M stated that there is a registered charity that collects unused medication and send them abroad to the countries that need them. BR pointed out that following her conversation with one of the colleagues at Medicine management team, it is general view that the CCG has to follow NICE guidelines and other relevant policies regarding export of medicines abroad. ACTION: BR to clarify this further with the CCG and feedback at the next meeting “Message in a bottle”: This scheme has been going on for many years and it is very valuable method to alert emergency services of medication and contact details of patients they visit at home. The bottle is usually kept in the fridge and everyone was asked to promote this excellent scheme.

BR to discuss further PEF and Governing Body BR SF, BR and Tina BR

6.0 AOB 6.1

SV from the CVS stated that they are arranging community visits for the lay member and PPE Advisor. The next visit taking place will be visiting the Daffodils project. In terms of questions sent by ASSAR, it has been agreed to organise a focus group to discuss any issues they have.


Dates of the PEF meetings in 2015 are: Tuesday, 12 May 2015 5-7 pm (changed from 19th May to 12th May) Tuesday, 21 July 2015 5-7 pm Tuesday, 8 September 2015 5-7 pm Tuesday, 17 November 2015 5-7 pm All meetings are in Becketts House, Boardroom A, 2nd floor. Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group NICE National Institute of Clinical Excellence CQC Care Quality Commission YC Youth Council IT Information Technology CVS Council of Voluntary Sector organisations PPE Patient and Public Engagement BHRUT Barking, Havering and Redbridge University hospital NHS Trust PPG Patient Participation Group TB Tuberculosis

6.2

6.3

ACTION: BR to include glossary of terms and abbreviations at the end of the minutes. Health passports for people with learning disabilities: JE stated that despite raising this issue with the Health and Wellbeing board many people with learning disabilities still don’t have their health passports. BR stated that she attended the focus group with the young people who have learning disabilities and their opinion was that those passports are useful for “older” younger people and younger people-teenagers and younger would lose them.

BR

7.0 Close and next steps 7.1 LS thanked everyone for coming and the meeting was closed.

The next PEF meeting is on Tuesday, 12 May 2015 5-7pm.




Tuesday, 12 May 2015 Becketts House, Ilford


Present: Lorraine Silver Boba Rangelov Michelle Green Christine Lewis David Lyon Anne Bertrand Jean Goody Dee Data Khalil Ali Bridget Okhioigbe Valentina Veltore Raina Gee

PEF Chair, Fairlop PPE Advisor BHR CCGs PEF member, Wanstead and Woodford PEF member, Wanstead and Woodford PEF member, Fairlop Redbridge Healthwatch and WW PEF rep PEF member, Fairlop PEF member, Cranbrook and Loxford Lay member, Redbridge CCG Redbridge Youth Council Redbridge Youth Council Redbridge Youth Council Co-ordinator

Swati Vyas Health Partnership manager, CVS Redbridge Barbara Stuchfield PEF member, Fairlop David Hall PEF member, Cranbrook and Loxford Jay Solanki PEF member, Cranbrook and Loxford Jon Abraham Redbridge Concern Tahir Mahmud PEF member, Seven Kings Elaine Freedman PEF member, Seven Kings Jiwain Jain PEF member, Fairlop In attendance: Andrew Strickland Head of communications, BHR CCGs Apologies: Louise Mitchell Redbridge CCG COO Dr Jyoti Sood Clinical Director, Redbridge CCG Shani Fooker PEF member, Seven Kings Shushila Patel PEF member, Cranbrook and Loxford Christine Merritt Redbridge Forum John Ellife Redbridge Forum, PEF member Howard Clarke-Mellville PEF member, Seven Kings Stephen Colman PEF member, Fairlop Absent: Martine Carter PEF member, Seven Kings Atia Kazmi PEF member, Fairlop Rakesh Dutta Wanstead and Woodford



accepted. Andrew Strickland, Head of communications was welcomed and he provided a brief background of his role. Mr Jiwain Jain, PPG member from Fairlop locality was welcomed to PEF.


2.2 2.2.1 2.2.2

Action: BR to replace on the page 6 “the Council of Voluntary Sector organisations” with “the Council for Voluntary Service” Also to amend on page 5 ASSAR with the STAAR and add it in the glossary. The rest of the notes were recorded as a correct record of the meeting Actions/Matters arising, including PEF log All actions were completed. PEF log Commissioning levers and decisions made which services to commission: LM’s presentation has been re-sent to the PEF. ACTION: Martin Sheldon, Deputy Chief officer, is preparing a summary regarding contractual levers. Care.data: The chair stated that it would be helpful to see the results of the 4 pilots. The pilots should finish in September this year. CL suggested to DL speaking with his local MP, as in her opinion this is a political issue. The safety of stored data and its use were the main concerns that PEF mentioned. Protective learning events (PLE) and information for patients regarding closing down the practices during these events: A comprehensive response was provided by all four Redbridge locality teams. There was the suggestion to bring maybe a locum Dr while practices are shut. KA stated that each practice operates differently and there is no uniform procedure. However, practices are using different methods to inform patients about PLEs (website, posters, voicemails etc) This is continuing process. In conclusion, PEF agreed that it is important to ensure that patients are informed adequately about the PLEs and practices’ closing times. TB: to consider inviting Public health representative to talk about current situation regarding TB in Redbridge. Unused medication: BR consulted Head of Medicines management team and it has been confirmed that any unused medication that is dispensed in the community cannot be sent to other countries. This is due to the safety and relevant guidelines that all staff have to follow. Funding of the overseas visitors: The host commissioner is responsible for the payment of charge Exempt Overseas Visitors (CEOV). This applies for acute and mental health. For BHR CCGs this is B&D CCG hosting NELFT Mental Health and havering hosting BHRUT-Acute services.

BR MS

3.0 Redbridge Youth Council’s report-update Bridget Okhioighe-YC member Valentina Veltore-YC member Supported by Raina Gee-Youth Council Co-ordinator

3.1 BO and VV presented the report update. They gave an update of youth Council Cabinet £100 000 Priorities Fund. This fund has been allocated to improve the experience and well being of young people in relation to the issues prioritised by them. Areas covered at the meeting were: mental


health well being, safety workshop, career conference, webpages for young people. The drama production is going ahead in the autumn term in schools. JA said that some of his colleagues from Redbridge concern would be interested to get in touch with the Youth Council. Action: RG and JA to liaise about this EF asked to which age group is the drama production presented. RG replied it is for secondary schools (11-19) years old. The Chair thanked young people for their continuing positive contribution to the PEF.

RG and JA

4.0 Redbridge CCG Lay member’s report-Khalil Ali 4.1

KA provided a comprehensive report to the PEF about recent and current CCG work. Some of the topics covered were: phlebotomy services, individual funding requests, Barts Health-Patient administration systems, outpatient appointments and eye clinic appointments at Whipps Cross Hospital. Other topics included the care.data, intermediate care, TB, warfarin clinic, BHRUT improvement plan. Action: Anticoagulation services survey results to be sent to PEF. DD said that when he needed to do his blood tests instead of being taken to the Queens’ hospital he was taken to the Whipps Cross A&E department. KA stated that the phlebotomy list has been compiled and shared with the PEF and GP practices. The commissioners are undertaking review of the phlebotomy services. The work done by Havering CCG was noted. The Chair is liaising with the colleagues from Barts Health and is arranging a suitable date for them to attend PEF meeting. BR pointed out that it would be most appropriate to invite colleagues at the suitable time, when some improvements have been agreed and carried out. If necessary, a separate PEF meeting will be organised. Action: LS and BR The Chair, LS, thanked KA for his report.

BR LS and BR

5.0 PPG Awareness Week-PEF and BR 5.1 BR informed everyone that there is a PPG Awareness week 1-6 June and

she said that it is entirely up to the PPGs how they would like to mark this week. The activities can include holding an information stall in the practice, recruitment day to raise awareness about the PPGs, survey, information in the newsletters and practices’ website etc. The NAPP has produced the PPG resource pack to help PPGs with this. BR also mentioned that we have now PPG flyers in A5 format for each CCG that can be enlarged into A3 format, as some practices requested bigger format. Action: BR to send to PEF via email the NAPP resource pack and the PPG set up guidance. Hard copies of the poster will be sent to TM.

BR

6.0 Feedback from the localities (localities log) 6.1

IT system: DL and Mr Chris Oliver had a meeting with our colleagues from the IT department. Recommendations from the meeting were:

CCG IT offer 2 platforms: local server with appropriate applications and remote server with appropriate applications

Identify and explain the best applications and how they integrate Reorganise CCG IT to give it control and responsibility. This may

require changing practice contracts CCG to own the IT budget and assign it

Action: KA to check if IT is included in the GP contract. CL stated that there should be joint IT strategy for primary care. KA also mentioned the current Transformation board work and that there

KA


Dates of the PEF meetings in 2015 are: Tuesday, 21 July 2015 5-7 pm Tuesday, 8 September 2015 5-7 pm Tuesday, 17 November 2015 5-7 pm All meetings are in Becketts House, boardroom A, 2nd floor.

are plans to increase the number of GPs. Funding for the PPGs: Currently there is no additional resources for the PPGs. Ratio between rising number of houses and the number of GPs in Redbridge: New extra appointments have been offered to the residents, two hubs have been opened now, one in Newbury Group practice and the second in Fullwell Cross Medical Centre. Access Issues Resolution Services (AIRS): This is the Barts service and the GPs and patients who have difficulties accessing Barts services can use it. The AIRS team strengthens, support and complements existing Trust resources by providing a dedicated channel that patients or GPs can contact. BR circulated a brief summary of this service with the contact number. Other issues raised were relating to the acute providers: Barts Health: duplicate appointment letters sent to patients and Orthopaedic clinic in Whipps Cross not triaging patients appropriately Where to get boxes to dispose EpiPen/needles? The Environmental Health is responsible for the boxes. The patients can contact them directly on 020 8554 5000. Only infected clinical waste and sharps are meant to be collected by this department and they provide new bags. BHRUT issues included delay in sending patient medication instructions following hospital discharge

7.0 AOB 7.1 DD stated that at Whipps Cross hospital sometimes patients’ health

records are missing. This and other Barts’ issues will be addressed when Barts Health attends PEF meeting. JJ stated that health seminars should be organised to talk about holistic approach to the care and treatment. He also said it should be more guidance for the patients to prevent illnesses. EF raised issues regarding patient transport at Barts’ health. DH stated that there is a fully equipped gym in Loxford but it is not used very much by the public. BS returned to the PEF following her recent care and treatment. She said that the experience she had in all three hospitals was excellent and she was very happy with the treatment received. JA circulated copies of the Redbridge Voices report. 200-250 people with disabilities participated in this project and it was mainly negative feedback. LS suggested sending the report to the Redbridge Healthwatch. Action: JA

JA

8.0 Close and date of the next meeting 8.1 LS closed the meeting and thanked everyone for coming,

The next meeting is on Tuesday, 21 July 2015 5-7pm in Becketts house, 2-14 Ilford Hill, Ilford, IG1 2QX, 2nd floor, boardroom A.


Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group NICE National Institute of Clinical Excellence YC Youth Council IT Information Technology CVS Council for Voluntary Service PPE Patient and Public Engagement BHRUT Barking, Havering and Redbridge University hospital NHS Trust PPG Patient Participation Group TB Tuberculosis STAAR Supporting Those with Autism and Asperger’s PLE Protective Learning Event AIRS Access Issues Resolution Services

Redbridge CCG PEF, 17 June 2015 Page 1 of 7



Tuesday, 17th June 2015 Becketts House, Ilford


Present: Lorraine Sliver Howard Clarke-Melville Boba Rangelov Shushila Patel Michelle Green Christine Lewis Anne Bertrand Jean Goody Dee Data Dr Jyoti Sood Khalil Ali David Hall

PEF Chair, Fairlop Redbridge PEF, Vice-Chair, Seven Kings PPE Advisor BHR CCGs PEF member, Cranbrook and Loxford PEF member, Wanstead and Woodford PEF member, Wanstead and Woodford PEF member (W/W) and Redbridge Healthwatch PEF member, Fairlop PEF member, Cranbrook and Loxford Clinical Director, Redbridge CCG Lay member, Redbridge CCG PEF member, Cranbrook and Loxford

Swati Vyas Health Partnership manager, CVS Redbridge Jay Solanki PEF member, Loxford and Cranbrook David Hall PEF member, Loxford and Cranbrook Elaine Freedman PEF members, Seven Kings Tahir Mahmud PEF member, Seven Kings Louise Mitchell Redbridge CCG COO In attendance: Deborah Kelly Deputy Chief Nurse, Barts Health NHS Trust Lyn Hill-Tout Managing Director, Whipps Cross hospital Apologies: Jon Abraham Redbridge Concern rep Raina Gee Redbridge Youth Council Co-ordinator and the YC David Lyon PEF member, Fairlop Absent: Martine Carter PEF member, Seven Kings Atia Kazmi PEF member, Fairlop Rakesh Dutta PEF member, Wanstead and Woodford John Ellif Redbridge Uniting Friends Shani Fooker PEF member, Seven Kings Barbara Stuchfield PEF member, Fairlop



accepted.

2 Barts Health NHS Trust-Deborah Kelly, Deputy Chief Nurse and Lyn-Hill Tout, Interim Managing Director, Whipps Cross hospital Questions and answers session

2.1

2.2

2.2.1

2.2.2

The Chair introduced and welcomed the guests from Barts Health, DB and L-H T. Wanstead and Woodford locality questions: Q1: Leadership and senior staff: There is a rapid turnover of senior staff with three directors of Whipps Cross hospital being appointed during the last year. What is the Trust board doing to address this? A1: L H-T stated that there was the failure of the senior leadership. The staff felt distant from the management. There is the fifth report of St Margaret’s centre. The Trust brought the site management and the new posts will be permanent. New medical director is Professor Mike Roberts. There will be reconfiguration of clinical services. They are trying to appoint permanent members of staff as soon as they can. L H-T and DK are based at Whipps Cross. The clinical academic groups have been established. The Trust is looking at the reconfiguration of the clinical services. The new Trust Chair will be announced this or next week. Alwen Williams has been appointed as an interim CEO for the Trust from the National Trust Development Agency (NTDA). Both L H-T and DK stated that they are trying to stabilise the current staff situation and to build up relationships. Q2: Appointment system 2014 saw two major issues at Whipps Cross which led to Barts Health itself reporting a serious issue. L H-T handed out the Improvement Plan for Whipps Cross. A2: L H-T stated that the Care Quality Commission identified some IT problems regarding patients’ records. Last year a new IT system was introduced to the Trust (Cycle Millennium). Patients were getting multiple letters and not getting satisfactory consultation. L H-T admitted that this is a huge problem and she welcomed the feedback from our PEF. It is important when the patient arrives for the appointment the medical notes are with the doctor. They are tracking now medical records. This helps them to locate the records. Trust employed extra staff at the medical records library in order to find duplicate records. A number of medical records have been audited. They still need to work on this. In normal situations about 20% are located in the clinical areas. At the Barts Health this is 40%. The clinicians are keeping the medical notes because they think they will be lost. Patient transport L H-T was unable to answer this question. She stated that last year they had problem with transport and the contract changed. ACTION: PEF to send more specific questions regarding this to BR with dates when these incidents happened.

PEF, BR and LH-T/DK


2.2.3

2.2.4

2.2.5 2.2.6

Q3: Sale of old nurses’ home at SW Corner of housing Will the proceeds of this land be reinvested in the Whipps Cross estate? I understand that 200 parking spaces for staff and patients will be lost. How will you attract staff if they cannot park? A3: L H-T stated that Whipps Cross hospital building is in a poor state. As the result of the patients’ and public concerns, Trust board reconsidered and decided to pause the selling of the land. The future of this has been included in the Transforming services, changing lives programme. They have to see if any new developments would fit in the current land structure and existing buildings. Patients’ Panel at Whipps Cross hospital raised this concern too. The Trust Estate manager is Richard Paine, who will attend the Patients’ Panel meeting. Q4: Phlebotomy services at the old ‘Wanstead Hospital’ site This service is highly valued by Wanstead and Woodford patients. Can you give a guarantee this will continue? A4: L H-T stated that children’s blood test service was mixed with the adults’ service, which was not good. There is an outreach blood test service, visit GP practices in the community. There will be no change regarding this service. However, the pathology service will change, which was taken over to Royal London hospital and Newham hospital. CL stated that there is a small phlebotomy service at the Heronwood and Gallions units and asked if this service be closed down in the future? L H-T met the Director of social services recently. He recognised that those units are very good and he did raise if Whipps Cross could use it for something else. ACTION: L H-T to feedback after the meeting and send reply to BR The Margaret’s centre at Whipps Cross hospital - the main issue is estates: there are no on-suites. The CQC reports came out four weeks ago addressing this. The centre will not be good enough to provide an efficient palliative care service. Q5: PALS service The PALS service was discontinued at Whipps Cross hospital, but reinstated for November’s CQC inspection. What are your future plans to retain a presence of this service on the Whipps Cross site? A5: DK stated that the Trust centralized PALS service at the Royal London hospital site - the wrong thing to do. The service was not accessible and it gave wrong message to the patients. This was also raised by the Patients’ Panel. PALS are now based at the Whipps Cross office. More work is needed in terms of consistency and how to support patients when they want to raise their concerns. The complaints’ system is too bureaucratic. They are trying to understand better how the PALS service relates to patients’ pathway when they raise their concerns. Much more work needs to be done regarding this and also complaints’ service. The external experts have been commissioned to do this work. Jan Stevens is now the Trust Chief Nurse and she is doing a complete review of PALS. Q6: DD noted that there is the same management structure. So, how can you assure patients that the trust will improve? DD stated that he lost the faith in Barts Health. Someone was waiting 22 weeks for an operation. DD also stated that the CCG was very good and they provided private treatment. DD found the whole current situation with

L H-T


2.2.7 2.2.8 2.2.9 2.2. 10 2.2. 11

Barts Health very disappointing and frustrating. A6: L H-T replied that the health secretary, Jeremy Hunt, stamping down on agency staff. L H-T sympathized with DD and stated that the scale of problem is enormous. L H-T also stated that it would take time to recruit new directors. Staff have low morale and the current situation is very difficult. Q7: DH raised concerns regarding agency staff and the cost of using them. His PPG is very unhappy about this. A7: DK replied that they rely on agency staff - some are good, some not so good and it’s a national problem. They have recruited some specialist nurses in A&E, paediatrics and critical care. The Trust had gone internationally to recruit staff. DK also stated that the CQC report did not put off staff applying for the jobs at Barts Health. Q8: DD asked how the Trust would assure that the clinicians at Whipps Cross hospital would deal effectively with the winter pressure, as in winter the waiting times at A&E in Whipps Cross can be up to 8 hours. A8: DK replied that previously they had 2-3 consultants in A&E; now they have 8-9. L H-T added that they are looking at having consultants available 7 days a week in A&E, which is a big step forward. They are also looking at how to change the rota of current and substantive posts and put the junior staff in place. L H-T explained the consultant’s weekly work plan. 7 days service in hospital means having the same level of care 7 days a week. Q9: LS asked if they are planning to recruit their own bank staff not agency staff? A9: DK replied they changed the contract recently. They moved to the Bank partners. There is reluctance for nurses to do extra hours and it is important to do things at the establishment level. DD stated that the nurses and consultants are doing excellent job despite all the problems they have at present. Q10: Transforming services changing lives How do they ensure that the needs of Redbridge patients are included in your planning? A10: LS stated she is involved in this work. LS reassured everyone that The Trust is taking into account all patients’ views and concerns regardless of where they come from, including Redbridge residents. L H-T also stated that Conor Burke, our Accountable officer sits on the Board, so it is another way to find out about this work. The report was published in December 2014. They look at the whole health economy now not only providers. KA stated that it would be good if Barts Health could provide some kind of assurance that they will take into consideration issue raised by the Wanstead and Woodford residents. L H-T stated that this is probably for the CCG to answer this question. LM confirmed that this would be something for our CCG to take forward. ACTION: LM Q11: AIRS- Is it consistent and is it reliable? A11: DH stated that it is a good service, as he used it recently. The staff helped him to resolve his issue quickly. BR circulated the information about this service at the last PEF meeting. This is a new liaison service between GPs and the hospital appointment service.

LM


2.2. 12 3.0 3.1 3.2

Q12: The Orthopaedic clinic in the Whipps Cross hospital is not triaging people, so one could be waiting 2-3 hours only to be told they need to be seen elsewhere. A12: ACTION: BR to clarify the question and L H-T to send reply to this question to BR Loxford and Cranbrook locality Q13: Financial situation and staffing: Given the scale of debt with respect to the Trust, how can the Trust guarantee neither operations nor front line staff will be scaled down? A13: This question was replied above. The current deficit is 134 million. DK also added that the Trust is concentrating on safety and quality. DK is doing the review of the whole nursing staff across the Trust. All the ward managers will be super numerated and they will be overseeing the clinical standards and managing wards on daily basis. The staff sickness is high. Increasing % for sickness, extra nurses and wards managers to super numerate. A new interim CEO wants to have emphasis on quality and safety. DD stated that it is not acceptable to have the same management structure bearing in mind huge deficit and that he lost faith if the Trust, as a patient advocate. L H-T agreed with DD and that the scale of problems is enormous. The part of the problem is turnover of the senior management staff. The problems need to be resolved and everyone should receive decent health service. DH highlighted the huge expense on the agency nurses. DK stated that they rely on the agency nurses and some of them are good but it is not something that they would like to continue in the Trust. There is a national crisis regarding the recruitment of the nurses. They are looking to recruit nurses from other countries as well. Retention rate is not good at the moment. Quality and safety team has been established and they are putting clinical measures in place at present. DD mentioned long waiting time in A&E during winter time and how they are going to recruit more consultants. DK stated that they have currently 8-9 consultants in A&E department and will continue recruiting more consultants for medicine. L H-T is looking at changing the rota of existing consultants and change junior’s rota. DD asked about the consultation time of the consultants. L H-T explained their job plan in detail. 7 days service in hospitals is in the pipeline and they are looking into this. They moved to a new bank contract with Bank partners. It is important to make sure to build up resilience for nurses. DD stated that despite all the problems the nurses and doctors are providing an excellent service. Q14: The discharge process at the Royal London hospital: A patient was severely disabled and could not move without assistance. She had just spent a week in the Royal London hospital. The discharge was all part of the week’s planning but it all went wrong. Carers arrived at her house at 4pm and the patient was discharged at 6pm; then she had to wait an hour and a half for a porter. A14: L H-T replied that they are trying to arrange for planned discharges to

BR and L H-T


4.0 4.1 4.2

be carried out early in the day with carers involved. They are looking at the number of discharges that take place in the morning and in the afternoon. Last week L H-T met with the Head of Social services of the local authority. They discussed what else could be done and how they can work together to improve the discharge process. The large number of delayed discharges. The Trust is getting better regarding complex discharges. They are integrating social workers with the discharge hospital team. A lot of work needs to be done but there is improvement from the last winter. The want to have robust plan for the winter. JG stated that it is not just getting the social worker in place but the matter of when discharge can actually happen. It is the whole package, not just the discharge itself. L H-T replied that the pharmacy in now preparing the medication a day before hospital discharges. DH stated that his wife was waiting 10 days for people to be put in place, which was far too long. L H-T replied that they have now the Delayed discharge expert who is dealing with the cases like this. The social workers are located on the hospital sites. DH stated his own experience regarding the transport. ACTION: DH to send an email to BR regarding his question. Seven Kings locality Q15: What will Barts Health do to ensure results of tests will be available digitally to doctors, whether in the Trust or for instance in Redbridge? EF stated that if the patient has tests done at King George hospital, the results are not available at Whipps Cross hospital. The consultants have problems accessing the results from BHRUT because the systems are not compatible. EF could not clarify to which service this relates. IT services are not compatible and do not talk to each other. A15: ACTION: L H-T to send response to this question to BR Q16: How will they ensure that the policy of DNAs and then being discharged is applied fairly? EF stated that if you have 2 DNA (did not attend); you are discharged from the service which was wrong. EF also stated that if patients arrive with their own transport and are late would not be seen. But if they use hospital transport and are late, they will still be seen. The patient transport system worked well until April but then the contract changed and it went down. A16: L H-T replied that the staff shouldn’t be using a DNA system. If the patient is delayed, the staff should accommodate patients and they still should be seen despite being late for their appointment. L H-T also stated that Waltham Forrest Healthwatch is doing a questionnaire regarding outpatient appointments. L H-T will ask the Waltham Forrest Healthwatch to add a question regarding flexibility of hospital transport in regards to the appointments. ACTION: L H-T will address this issue with the transport colleagues and the WF Healthwatch regarding their survey. PEF members to send any other questions regarding this to BR.

DH L H-T L H-T


Dates of the PEF meetings in 2015 are: Tuesday, 8 September 2015 5-7 pm Tuesday, 17 November 2015 5-7 pm All meetings are in Redbridge CCG, 2-14 Ilford Hill, Ilford, IG1 2QX, Becketts House, Boardroom A, 2nd floor. Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group CQC Care Quality Commission YC Youth Council CVS Council of Voluntary Sector organisations PPE Patient and Public Engagement BHRUT Barking, Havering and Redbridge University hospital NHS Trust PPG Patient Participation Group DNA Did not attend AIRS Access Issues Resolution Service PALS Patient Advisory and Liaison Service A&E Accident and Emergency CEO Chief Executive Officer

DH stated he has been turned down for his appointment being late only few minutes and had the same concern as EF. DD added that someone should be centrally responsible to address the question regarding medical records. L H-T replied that previously medical records were not available at the clinics. This issue has been addressed in the Trust Improvement plan and they are auditing this now. JS suggested inviting Barts Health in next couple of months again to the PEF meeting and to give an update about improvements made. Other members agreed. DK invited PEF members to get involved with the Trust. They would like to be open and transparent in the process of improving the services they provide. Both DK and L H-T agreed to attend PEF meeting again in next couple of months. ACTION: L H-T and DK Copies of the Whipps Cross hospital Improvement plan and the presentation were handed out to the PEF members. Any further questions to be sent to BR. ACTION: PEF DK invited members to participate in different work streams that she is currently involved in and they would like to be open and transparent. SP asked for the actions taken and the outcomes to be submitted to PEF again in next couple of months. ACTION: L H-T and DK agreed to attend PEF meeting again and give an update in September.

L H-T and DK PEF L H-T and DK

5.0 Close and next meeting 5.1

LS thanked everyone for coming and the meeting was closed. The next PEF meeting is on Tuesday, 21 July 2015 5-7pm in Becketts House, 2nd floor, boardroom A.

Redbridge CCG PEF, 21 July 2015 Page 1 of 8



Tuesday, 21 July 2015 Becketts House, Ilford


Present: Howard Clarke-Melville

PEF Chair (for this meeting)-Vice-Chair

Boba Rangelov Christine Lewis David Lyon Anne Bertrand Jean Goody Dee Data Khalil Ali Jiwan Jain

PPE Advisor BHR CCGs PEF member, Wanstead and Woodford PEF member, Fairlop Redbridge Healthwatch and WW PEF rep PEF member, Fairlop PEF member, Cranbrook and Loxford Lay member, Redbridge CCG PEF member, Fairlop

Swati Vyas Health Partnership manager, CVS Redbridge David Hall PEF member, Cranbrook and Loxford Jay Solanki PEF member, Cranbrook and Loxford Jon Abraham Redbridge Concern Elaine Freedman PEF member, Seven Kings John Elliff Uniting Friends Samina Dyer Support worker for Mr Elliff Shani Fooker PEF member, Seven Kings Dr Jyoti Sood Clinical Director, Redbridge CCG In attendance: Sarah See Director of Primary Care Transformation Rebecca Farmer Talking Straight, teenage parenthood Emma Wykes Parent-Straight Talking Apologies: Louise Mitchell Redbridge CCG COO Shushila Patel PEF member, Cranbrook and Loxford Lorraine Silver PEF Chair, Fairlop Michelle Green PEF member Tahir Mahmud PEF member, Seven Kings Barbara Stuchfield PEF member, Fairlop Raina Gee and Youth Council The Youth Council Co-ordinator Absent: Martine Carter PEF member, Seven Kings Atia Kazmi PEF member, Fairlop Rakesh Dutta Wanstead and Woodford Stephen Colman PEF member, Fairlop


Item Action

1 Welcome and apologies Chair welcomed everyone, introductions were made and apologies

accepted.

2 Minutes and matters arising (May and June’s minutes)-PEF log 2.1

2.2

The May’s minutes were accepted as a correct record of the meeting. The commissioning leavers paper was produced by one of the colleagues from the Financial department and sent to PEF members. The June’s minutes to amend DH comments on page 6 and 7. The rest of the minutes were accepted as a correct record of the meeting. Outstanding answers from Barts Health were supplied prior to the meeting. Actions/Matters arising All actions were completed. KA noted that the questions asked at the meeting with Barts Health were of a high quality and it would be useful to prepare a summary of all questions for the Governing body meeting, as an Appendix of the notes. ACTION: BR PEF log: The issues stated on the PEF log were reviewed.

BR

3.0 Redbridge CCG Lay member’s report-Khalil Ali, lay member 3.1 KA presented his latest report to PEF. The CCG Primary care

Transformation Board has a very prominent role at present in our CCGs, looking at all the services we commission and he attends those meetings. KA also attends Primary Care Commissioning Committee on behalf of Redbridge. This group is taking over now from NHS England and will be looking at the GP contracts in the future. The GPs are not members of this committee, as there would be conflict of interest. There will be a review of the Quality strategy, which oversees the improvements to be made to improve the quality of services we commission. KA is hoping that we will be consulted during this review. Looking at the current draft, KA assured everyone that the strategy shows that the patients are in the centre of everything we do. There is also a Case of change, stroke project, led by Dr Sarah Hayes, one of our clinical directors. This project is going to be across all three CCGs. All three CCGs approved additional funding to work on some of the key areas in mental health, Improving Access to Psychological Therapies, early intervention in Psychosis and dementia and Crisis response. KA stated that he attended the Urgent care conference. BHRUT had the CQC visit recently, and although there were some improvements, this Trust is still under special measures and we will be monitoring this progress. DD stated that there was a case of long waiting time (30 weeks) for specific procedure at Whipps Cross hospital. ACTION: DD will forward an email that he received and KA will fast track forward this with the commissioners. DH asked regarding the urgent care if the Care UK has been involved because there was a damaging report into this agency recently. KA replied that the Care UK is not involved in provision of the urgent care for us. DH also stated that his mother-in-law was waited 8 weeks to receive her hearing aid. When you phone up they said they will call you back but nobody rings back. DL asked if there is interaction between the Council and the health. KA replied that there is a representative from the Council on the Transformation board and they have full membership. Dr Sood stated that the issues mentioned should be addressed to the GP liaison officer, the

DD and KA


Clinical Support unit (CSU) and the Quality board and she asked how we could best resolve those issues. DD stated that according to the Referral to the treatment time (RTTT) waiting is 18 weeks. When patient filled the form and when he goes to another Trust, they should be able to see that the patient has already waited 16 weeks and act accordingly. ACTION: DD to send an email to BR regarding the waiting time and BR to address this issue to the GP liaison officer. The Chair stated that the trusts mentioned in those cases obviously have a reason why they are under special measures. The Chair stated we have to differentiate between the individual issues raised and how to log it because we cannot have individual issues at those meetings. It is important to look rather at processes. JJ and everyone agreed that PEF should not be concentrating on the individual issues but more looking at the processes and how and weather improvements have been made. The Chair stated that there is a value in individual issues but not for this group. KA also stated that there was development of the Diabetes strategy and Dr Sood is heavily involved in this. In Redbridge there was no strategy for this illness. Dr Sood stated that Diabetes is a huge issue for Redbridge. Dr Sood suggested that Diabetes UK attends the next PEF meeting in September when the strategy should be ready. ACTION: BR to liaise with Dr Sood and agree with the PEF Chair/Vice-Chair to have Diabetes as a main topic for September meeting. ACTION: BR suggested adding the operations waiting time onto the PEF log and then liaise with relevant colleagues in BHRUT and Barts Health about this. DD stated that Barts health does not have any systems in place to monitor the operations’ waiting time. DH stated that he had a good experience using AIRS service recently. DH also stated that some obvious things need to improve i.e. above hospital bed there is a blank board with no names on it. It is important to have this information and also name of the designated consultant and department. Everyone agreed.

DD and BR BR, Dr Sood, PEF Chair/Vice-Chair BR

4.0 Primary Care Transformation programme-Sarah See, Director of Primary Care Transformation Programme

4.1 The chair welcomed SS. She gave a presentation about this programme. There is a Primary Care Transformation board now established with all major key stakeholders on the board. SS stated that there is draft strategy and it is important to hear from the PEF members about their views and suggestions. They are getting comments from some LD and other groups in Redbridge. This project is across the three boroughs and they have their commonalities but also differences as well. There is a growing aging population in some boroughs, premises issues, IT issues, significant financial difficulties (cuts in the Council), workforce challenge (lack of GPs), lack of practice nurses, healthcare assistants. We are also facing healthcare inequalities as well. Out of hours GP service is operational in two sites in Redbridge and hopefully the third one will open soon in Wanstead and Woodford area. They are working to resolve and improve IT issues. It is also about patient expectations and what it could be offered to them when they go to their GP. 33% if GPs work in Redbridge, they are looking to retire, but also younger generations of GPs don’t want to stay in the post. In Redbridge there is the worse whole time equivalent for the practice nurses and GPs per patient, so we need to work on this and it is a difficult task. There is now operational Framework for London and SS talked about this last time at this meeting. There are 17 indicators and we are working on those. We need to be reviewing those indicators. We are looking at the integrated care and how to deal with the complex patients.


There is in London Strategic commissioning framework. We are looking at the workforce, level and quality of care provided, how we access different services and how to improve access, looking at the premises. There is a lot about proactive prevention (i.e. diabetes), lifestyle choices, using voluntary sector i.e., greater co-ordination of the long-term conditions. The NHS reached crisis point and we need to find solutions. PC Transformation board is looking at some key areas. We are looking at the average patient and what it means for them. SS said she would like to hear from PEF about three statements they came with so far for the vision of the Primary Care in Redbridge. There is a Primary Care Commissioning board, and Dr Sood sits on that board. They made decisions regarding commissioning. There are also five objectives they came up with and PEF comments would be welcomed about those too. Number of the patients’ and carers’ groups will be part of the process. DD sated about poor communication between the hospitals and that the patients with the long-term, conditions conditions could be treated better. Those communications could be improved if communications is better. SS that the strategy will address what does it mean regarding the practice nursing, community nursing and the strategy will look at how we should be doing things but in two three year’s time we will review if the processes stated in the strategy are working. DH showed the newsletter he received and questioned the opening times of the hubs. SS clarified this and stated that they are open Monday to Friday 6.30pm till 10pm. BR circulated the copies of the press release from the Redbridge CCG website with the most updated information. SS also stated that the times stated in the newsletters are times for the call centre not actual opening times of the hub. SS and BR both stated that the information stated on our website is the most accurate and they asked PEF members to look at this website if they need to have the latest update from the CCG. EF stated that in terms of access is transport, which is designed around hubs. There is 10 minutes drive and if you stuck on a bus you won’t be on time for your appointment. EF also highlighted the importance of the health education, raising awareness of various health conditions. JJ asked if there is a special unit focused on IT issues. SS replied that there is a team that works around hubs and they work on IT system in hubs to be able to read patients’ records from their own GP and share information. There is a local team and it is a part of PM Challenge fund. There will be a shared record summary. CL asked about premises that were put forward in the NHS improvement plans and what is situation with this. We are concentrating on the year 2 now and the NHS England want to have more information about it. SS stated that this hasn’t been managed best in the year 1. The resources are limited and it is important to address this. DL asked if the GPs have to have the practice nurse. SS replied they don’t under the contract. There are often questions asked why there is no practice nurse especially if there are patients with long-term condition. Generally, this is the provider’s decision. SS pointed out that she would like to hear what they would like to see as the outcome of this. SS that tonight’s meeting was very helpful and would like to hear more from PEF. ACTION: PEF to email BR with any points they would like to address to SS regarding this work.

PEF and BR

5.0 Straight Talking Teenage pregnancies-Rebecca Farmer and Emma Wykes

5.1 The Chair welcomed RF and EW. RF gave a presentation about their work.


They work in the secondary schools educating about parents’ parenthood. This issue is generational cycle. Poverty is linked into this and young parents who don’t go into education, domestic violence and the health conditions. The cost of teenage pregnancies is huge. The prevention is very important and peer education. They are employing peer-trained educators/parents who give talks in secondary schools. Peer educators helps young people to relate to different issues (time with friends, costs of pregnancies etc). Safeguarding and safe sex are included in their work. Straight talking encourages getting pregnant when financially stable and have all circumstances to have successful pregnancy. Loneliness and isolation is one of the issues the young parents face. They employ 54 people and 50 of those are teenage parents. They say they have difficulties accessing health services, they feel judged and intimidated. The report highlighted gap and it is important to build the bridge between the young people and services available. Open dialogue between two groups, peer educators address the issue that the young parents have to realise that the health services are there for them to help them. Peer educators come to say it is OK and the young parents don’t feel judged. There is a project “Risky business” in Rotherham where they refer young parents to the social services. There are grass routes communicators. Teachers and students value their work and believe in their results. More work needs to be done between peer education and education but they are booked every year in the schools, which proves they are doing a good job. EW young peer educator talked about their own experience being a young parent. EW is starting her nursing degree next year. EW got pregnant when she was 16. The partner was quite controlling. She went to all health services but she felt that while attending, she felt that the people were judging her, perception of people, especially when she came for a scan; she looked much younger than her age (16). EW said it is important to break down the barriers. RF asked PEF to promote their work in Redbridge, particularly among the school nurses. They can help to reach the young people, to make them aware of this project. Redbridge is doing well comparing with the London, it is lower than the London average, and so improvements have been made. The risk indicators, they look at the wards that have high-level deprivation, affecting children and high employment deprivation. They look at the number of children who receive free school’s meals. DD asked if the poverty is linked to high level of teenage pregnancies. RF said there is usually lack of education, domestic violence prevalent, lack of self-esteem as well and yes, there is a link between those two. EF asked if there is a correlation between the children who have bad experience in schools and choices they made, as the research found that some girls are already expressing this in year 7. RF stated that peer educators are not qualified teachers and there is a limit what they can do. There is a large amount of young mothers who belongs to gangs; it is important to open the communication and not just to sign post. The Chair thanked to RF and EW for their presentation.

6.0 Feedback from the localities (PPG localities log) 6.1 6.2

BR went through each of the points from the PPG log. Promotion of the GP protected learning events (PLEs): BR stated that all the practices will be supplied and will display posters with all the dates when those sessions are taking place. BR stated that she has regular meetings with the Practice improvement leads (PILs) and Deputy Chief Operating officer (COO) where they discuss and resolve any issues stated on the PPG log, which is very helpful.


BR said that W/W PPG Forum meets only quarterly, so that is why there are no issues stated on this log from this Forum. This locality would like to keep Diabetes on the log and also PPG training because of the importance of it. BR reminded PEF to put their names forward to attend PEF training which is taking place in autumn. The next PPG locality Forum meeting for the W/W is taking place on 29 July, which is after this meeting. Seven Kings locality issues: Repeated prescriptions: BR stated that she will have access to the Quality meetings minutes so she will be able to see the issues discussed and see the current trends. BR met with the GP liaison manager at BHRUT. Now they have a tick box for the continuing medication on the discharge letter, which they didn’t have before. They also bringing back discharge summaries and they redesigning the format of summaries, those summaries should include medication. There was delay between discharge summaries and repeated medication. This does not apply for Barts Health. SF asked if this applies to the Whipps Cross. BR replied that this relates to BHRUT. ACTION: BR to find out how is this working at Barts health. Phlebotomy issues: There is Cyberlab programme where the blood results are displayed and accessed by the GPs. This system is available at BHRUT. It will be rolled out soon at Barts Health. There have been some problems with the clinical system 1 linking with the Cyberlab system. This has been tested in one of the practices that don’t’ currently have link between those two systems and it worked, so it will be rolled out further to other practices. The Pathology team from BHRUT meets regularly with the CCG and there are monthly reports about the usage of this system. Dr Sood stated that time line for this is six months. The Chair stated that for whatever reason the record of the patient attending the blood test is not kept, so the patient has to go again to do their blood tests. ACTION: BR to find out more about this. DH asked about the locations where to go to do blood tests and stated that there was a survey about phlebotomy service but what is the current situation with this service. The Chair replied that the CCG is looking into commissioning more sites for this services and this project is happening now. Dr Sood stated that they looked at the data, they brought it back to the clinical directors and they will decide where to go from there. It does take time to do things and we now understand what GP and what the patients’ want, so it all goes together now, so they will work on it. DL stated that he receives from his surgery a letter stating that the mistake has been done and they invites him to attend the blood test again, so why the other GP practices don’t do the same. They should follow this practice. The Chair concluded that the issue is why the blood tests disappeared, to find out what the process is and why the process has broken down. ACTION: BR to find out about this process Choose and Book system: this system has been taken over by the e referral system; it is different system but with the same principal. BR also informed the group about buzzers which are used now in few departments in BHRUT and will be used in others soon. The buzzers are particularly good for people with learning disabilities or those patients who can not sit still in one place, so it enable them to walk around until its their turn, as the buzzer blips. E-system is exactly the same system as Choose and book. This system has been just rolled out three weeks ago. Ambulatory care pathways: BR showed copies of all ambulatory care

BR BR BR


Dates of the PEF meetings in 2015/2016 are: Tuesday, 8 September 2015 5-7 pm Tuesday, 24 November 2015 5-7 pm (new date) Tuesday, 19 January 2016 5-7pm Tuesday, 15 March 2016 5-7pm All meetings are in Becketts House, boardroom A, 2nd floor. Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group

pathways received from the BHRUT. There are different pathways. ACTION: BR to email all pathways to PEF. STAAR group-update: The crisis management for patients with autism and Asperger’s. The focus group will be organised in autumn with this group. BR met with a Joint Commissioning Manager recently and they discussed this issue and transition into adult services. BR printed information from the NELFT website for Mental Health direct-papers circulated. There is a lot of work happening now regarding mental health. In terms of raising awareness among our GPs, they had at the learning events about four months ago a session about Autism and Asperger’s, so there was a dedicated time for this topic. BR explained the GP alert system and the lines of reporting. From those alerts they can see trends of issues raised by the GPs. The alerts are collected centrally at Becketts House. Transition into adult services is very current work, and we would like to see more joint up services across health and social care. Our Joint Commissioning Manager would like to link up with STAAR group; there is a joint commissioning action plan and it is a very actual topic at the moment. BR reminded the paper prepared for PEF regarding the commissioning leavers, which was circulated prior to the meeting.

BR

7.0 AOB 7.1 AB asked BR to circulate to PEF the Healthwatch draft action plan for

information. ACTION: AB and BR EF said it would be good to hear experiences of using health services from people with the hearing difficulties. BR stated that the Healthwatch has done quite a lot of work on this. DL asked what is the position of the CCG regarding the closure of the A&E in King George’s and whether the CCG supports this. ACTION: KA to feedback at the next meeting. DH informed everyone about AIRS services’ telephone number and highlighted the issue at the Whipps Cross hospital of patients being recorded as DNA before they turned up for their appointments.

AB and BR KA

8.0 Close and date of the next meeting 8.1 H C-M closed the meeting and thanked everyone for coming,

The next meeting is on Tuesday, 8 September 5-7pm in Becketts house, 2-14 Ilford Hill, Ilford, IG1 2QX, 2nd floor, boardroom A.


YC Youth Council CVS Council for Voluntary Service PPE Patient and Public Engagement BHRUT Barking, Havering and Redbridge University hospital NHS Trust PPG Patient Participation Group STAAR Supporting Those with Autism and Asperger’s PLE Protective Learning Event AIRS Access Issues Resolution Services

Redbridge CCG PEF, 8 September 2015 Page 1 of 4



Tuesday, 8 September 2015 Becketts House, Ilford


Present: Lorraine Silver Howard Clarke-Melville

PEF Chair, Fairlop PEF Vice-Chair, Seven Kings

Boba Rangelov Christine Lewis David Lyon Jean Goody Dee Data Khalil Ali Shushila Patel

PPE Advisor BHR CCGs PEF member, Wanstead and Woodford PEF member, Fairlop PEF member, Fairlop PEF member, Cranbrook and Loxford Lay member, Redbridge CCG PEF member, Cranbrook and Loxford

Swati Vyas Health Partnership manager, Redbridge CVS David Hall PEF member, Cranbrook and Loxford John Elliff The Redbridge Forum Christine Merritt Support worker for Mr Elliff Michelle Greene PEF member, Wanstead and Woodford Dr Jyoti Sood Clinical Director, Redbridge CCG Raina Gee The Redbridge Youth Council Co-ordinator James Edwards Redbridge Youth Council Bridget Okhioigbe Redbridge Youth Council In attendance: Christine Potts Diabetes UK Apologies: Louise Mitchell Redbridge CCG COO Anne Bertrand Redbridge Healthwatch and WW PEF rep Tahir Mahmud PEF member, Seven Kings Barbara Stuchfield PEF member, Fairlop Jay Solanki PEF member, Cranbrook and Loxford Jon Abraham Redbridge Concern Elaine Freedman PEF member, Seven Kings Shani Fooker PEF member, Seven Kings Absent: Stephen Colman PEF member, Fairlop Jiwan Jain PEF member, Fairlop



accepted.


2.2 2.3

3.1 DL asked to remove the paragraph on page 3 stated under his name. 7.1 DH asked to amend the last paragraph to “At the Whipps Cross hospital the patients were recorded as DNA (did not attend) before they turned up for their appointments.” The rest of the minutes were accepted as a correct record of the meeting. All actions have been completed. Matters arising DD reiterated the issues relating to the Referral to Treatment (RTT) waiting times. BHRUT supplied the report regarding waiting times for elective operations but Barts Health are currently not reporting this nationally and therefore the report was not sent to PEF. LS pointed out that the figures regarding statistical measurements have to be correct before being made public. ACTION: To monitor this for the future meetings and follow it up KA also provided a statement from the BHR CCGs regarding the closure of the A&E in King George Hospital. DD asked if Whipps Cross could provide an update about the Improvement Plan in November. H C-M asked PEF if they want this topic for the next meeting. Only two members disagreed, all others agreed on this. ACTION: BR to contact Barts Health If Barts Health is unable to attend, then the main topic for November meeting will be TB in Havering.

BR

3.0 Redbridge CCG Lay member’s report-Khalil Ali, lay member 3.1 KA presented his report to the PEF.

Dr Sood stated that majority of GPs in Redbridge agreed to have longer appointment times for the patients over 75, including patients who are complex patients and the carers’ assessments. There are good examples where the practices engaged with their PPGs to feedback to the CCG. There is also a System Resilience Group in place. SP asked how and if the CCG is monitoring the management of the appointment system in the practices and what is the current situation in practices that are not performing well. Dr Sood replied that some practices have received the funding to improve their services. KA also confirmed that all practices have submitted and agreed to this. Some practices will receive the funding upfront to recruit staff. LS thanked KA for his report.

4.0 The Redbridge Youth Council report-James Edwards and Bridget Okhioigbe with Raina Gee, Co-ordinator

4.1

4.2

JE and BO highlighted the main achievements and activities since the last PEF meeting. On 13th November they will have a play presented to the young people and professionals. ACTION: RG to send BR details of this event for PEF. The young people carried out mystery shoppers in pharmacies, GP practices and Youth Centres. ACTION: The report from this activity to be sent to BR KA pointed out that the YC is raising awareness about mental health. RG said that they are designing the leaflet relating to helping a friend when they experiencing mental health problems. They also produced the

RG RG


wristbands. DD stated that there is still a lot of stigma about mental health and he commended the work of the Redbridge YC. DH asked if they are using social media regarding this work. BO replied that they use hashtag on Twitter so that young people can have their say about mental health. They also use Facebook to promote and raise issues relating to mental health. The Chair thanked JE and BO for their report.

5.0 Diabetes-current developments in Redbridge Dr Jyoti Sood, Clinical Director Redbridge CCG and Christine Potts, Diabetes UK

5.1 Dr JS gave a presentation to PEF. JE pointed out that more work needs to be done in the local schools to highlight the importance of healthy lifestyle and diabetes. The health buddies have been trained by the Redbridge CVS. SP stated that this health condition has been a major issue in Loxford and Cranbrook for many years and that the partnership with the local population is very important. Early prevention is also very important and the resources have to be allocated. SP also stated that the families who have members with high blood pressure should be targeted. CL stated that in her organisation there were two people who wanted to attend the Diabetes course; they could not be released from work as the course was held during working hours, so this needs to be borne in mind for the future sessions. Dr Sood said that they have two types of training; for Type 1 and for type 2 Diabetic patients. They can also do 1:1 sessions with the patients but it is always better to attend the group sessions. CL stated that for the PEF meetings it would be better to avoid biscuits. ACTION: BR CP stated that some GPs are not participating in Diabetic data. Only 13 GP practices provide information of Diabetes national data. PEF suggested sending this presentation to the PPG localities to raise awareness among them too. ACTION: BR CP circulated the leaflets what Diabetes UK can offer to patients. Next year, on 8th March, is Diabetes National Awareness Day and they will target Type 2 diabetic patients. CM pointed out that it is important to look at the number of people with learning disabilities who have Diabetes. Dr Sood agreed on this and said they are looking at this as well. ACTION: CP to send to BR the most current programme. Dr Sood concluded that a lot of work needs to be done and they are drafting the Diabetes strategy at present. It is important that all health professionals work in partnership and not in isolation in order to provide a seamless pathway for their patients. The Chair thanked Dr JS and CP for their presentations.

BR BR CP

6.1 Feedback from the localities (PPG localities log) 6.2 PPG log was circulated to the members.

DL asked for more explanation regarding the influx of residents in the borough and the infrastructure provided. ACTION: The CCG to provide more comprehensive response to this. LS stated that this is a planning issue and that she has seen some of the planning applications. H C-M stated that this has a major impact on budget. Dr JS stated that the CCG is fully aware of the population growth and our financial officers will put the application forward for more funding to be

CCG


Dates of the PEF meetings in 2015/2016 are: Tuesday, 24 November 2015 5-7 pm (new date) Tuesday, 19 January 2016 5-7pm Tuesday, 15 March 2016 5-7pm All meetings are in Becketts House, boardroom A, 2nd floor. Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group YC Youth Council CVS Council for Voluntary Service PPE Patient and Public Engagement PPG Patient Participation Group BHR CCGs Barking and Dagenham, Havering and Redbridge Clinical

Commissioning Groups

provided. 7.0 AOB 7.1 The date of the next meeting has been changed from 17th November to 24th

November. The time is the same, 5pm-7pm in Becketts House, Boardroom A.

8.0 Close and date of the next meeting 8.1 LS closed the meeting and thanked everyone for coming,

The next meeting is on Tuesday, 24TH November, Becketts House, Ilford, IG1 2QX, 2nd floor, boardroom A.

Redbridge CCG PEF, 24 November 2015 Page 1 of 5



Tuesday, 24 November 2015 Becketts House, Ilford


Present: Lorraine Silver Howard Clarke-Melville

PEF Chair, Fairlop PEF Vice-Chair, Seven Kings

Boba Rangelov David Lyon Dee Data Khalil Ali Shushila Patel Vivien Nathan Elaine Freedman Shani Fookeer

PPE Advisor BHR CCGs PEF member, Fairlop PEF member, Cranbrook and Loxford Lay member, Redbridge CCG PEF member, Cranbrook and Loxford PEF member, Cranbrook and Loxford PEF member, Seven Kings PEF member, Seven Kings

Swati Vyas Health Partnership manager, Redbridge CVS John Elliff The Redbridge Forum Christine Merritt Support worker for Mr Elliff Michelle Greene PEF member, Wanstead and Woodford Dr Jyoti Sood Clinical Director, Redbridge CCG Raina Gee The Redbridge Youth Council Co-ordinator James Edwards Redbridge Youth Council Bridget Okhioigbe Redbridge Youth Council Ayesha Alohan-Eke Redbridge Youth Council Navnit Dhaliwal Redbridge Youth Council Louise Mitchell Redbridge CCG COO Anne Bertrand Redbridge Healthwatch and WW PEF rep In attendance: Fiona Smith Managing Director, Barts Health NHS Trust Felicia Kwaku Director of Nursing and Governance, Barts Health Vicky Mason Joint children’s commissioner, Redbridge CCG Apologies: Tahir Mahmud PEF member, Seven Kings Jay Solanki PEF member, Cranbrook and Loxford Jon Abraham Redbridge Concern Christine Lewis PEF member, Wanstead and Woodford Jean Goody PEF member, Fairlop


accepted.


2 Minutes and matters arising (including PEF log) 2.1

2.2

Minutes were noted as a correct record of the meeting. On page 2 (4.1 third paragraph) to amend the date- “on 9th November” instead of “on 13th November”. All actions have been completed. PEF log: Care.data: BR reported that no feedback has been received regarding four pilots and we will have to wait to see this before PEF send any recommendations. ACTION: CT will send some information from the National Healthwatch regarding this.

3.0 Redbridge CCG Lay member’s report-Khalil Ali, lay member 3.1 KA presented his report to the PEF. KA praised the PEF for its

achievements over the last year. He said it is important to recognise and acknowledge the work of PEF and he congratulated the three winners, SW, LS and Dr JS on their awards. Photos have been taken of three winners with the awards which will be publicised in the local press. Other update was regarding the Vanguard project, Personal Medical Services (PMS) Contract, Stroke work, Transformation programme, mental health, phlebotomy, diabetes strategy and also forth coming work on the PPE strategy, in which PEF will play an important role. The Chair thanked KA on his report.

4.0 The Redbridge Healthwatch report-Cathy Turland 4.1 CT was introduced to the PEF. The main points were related to the

following: Deaf Inclusion project, Enter and View report about complaints processes in GP practices and the Intermediate care consultation. The Healthwatch are now active participants in the Ombudsman complaints’ steering group. CT handed out invitations to members to attend their AGM and the conference about dignity. This takes place on Friday, 4 December 9am to 2pm. In terms of Intermediate Care consultation CT stated that the CCG should have involved Healthwatch and the patients in a better way. LM replied to this confirming that they have carried out a very comprehensive consultation and they have involved the Healthwatch and the patients from the beginning of the consultation. The Chair thanked CT for the update.

5.0 The Redbridge Youth Council report-James Edwards, Bridget Okhioigbe, Ayesha Alohan-Eke and Navnit Dhaliwal with Raina Gee, YC Co-ordinator

5.1 The RYC had a great success with the play “Help Me! I’m normal” that highlights young people’s mental health issues. They also spoke about Local Democracy Week - Question Time Style- Schools Debates. In total 6 schools participated in those debates. They also held an Annual Youth Debate, Council Chamber on 19 October 2015. Other activities included British Youth Council Annual “Make Your Mark” Campaign and Children Looked After Event Day at Loxford Youth Centre held on 28 October. Prior to the meeting, RYC distributed the report of the Mystery shoppers in the local pharmacists. The Chair thanked young people and their co-ordinator for their report and congratulated them on their excellent work.

6.0 Feedback from the PPG localities 6.1

PPG Chairs advised which sections should be taken out from the log as they have been addressed and clarified. ACTION: BR to amend the PPG log.

BR


6.2

6.3

The issue raised by Seven Kings regarding the use of the syringes instead of the white pots to collect the urine sample will be taken forward with the colleagues from BHRUT Pathology team. This caused concerns mainly because the syringe is fiddly to use especially for older people, and they would prefer to use the white pots as before. ACTION: BR to address The issue with relevant colleagues and feedback at the next meeting. Another issue raised by Seven Kings was regarding the forms that need to be completed for the cervical smears. Apparently the forms are not completed correctly in the GP practices and then the hospital would request another smear to be done. EF suggested having a list of requirements to fill in to remind staff to fill the forms correctly. LS stated that against each item the date that it was logged should be included which would help with the length of time items took to complete. ACTION: LM to remind GPs to fill the forms correctly. This could be done via GP newsletter.

BR LM

7.0 Barts Health NHS Trust-The Improvement plan-update Fiona Smith and Felicia Kwaku

7.1 The Chair welcomed FS and FK. They gave a brief overview of the current management structure (a new CEO appointed and a new Chairman). They have reviewed all CQC findings. They are working on 7 different workstreams. Whipps Cross hospital now has in place an Integrated Discharge Team. PEF raised an issue about waiting time for the elective surgeries. They identified that 948 patients are currently waiting over 18 weeks. 2093 patients are waiting under 18 weeks and in September 23 patients were waiting over 52 weeks. They now know waiting times at Whipps Cross and they hope to clear the backlog up to December of all operations with over 52 weeks waiting time. The PEF members’ questions for Barts Health colleagues had been sent prior to the meeting to Barts Health and also our PEF Chair, Vice-Chair and CCG senior directors. DD stated that it has been identified by Dept of Health that Barts Health does not have reliable information and the statistics are not published. DD asked what they are doing about it. FS replied that Barts Health is not the only Trust who doesn’t publish the statistics. At present they do not report on 18 weeks waiting time but they are trying to validate all data. They have Serna system with BT. They are planning to join up IT systems in different hospitals, so that when the patient goes to Royal London hospital from Whipps Cross, staff at RLH will be able to see patients’ information from W/X. Currently they cannot send X ray images but they can send the reports of the images. Q1 and 8: The PEF members said that there are no appointments available when they want to book them via Choose and Book. FS responded saying that they only make an appointment available on Choose and Book when they know they can meet 18 week target. GPs can refer patient. They talk to the patient and see if they agree to wait longer than 18 weeks for their appointment. GPs create the code which is then given to the patient to book their appointment via Choose and book. Fiona thought that it was only GPs that could make Choose and Book appointments but it was made clear that Patients could also once information had been generated by their GP. Q3: Eye and cardiology appointments cancellations: FS said that two clinics were cancelled, one on 6 October and another one on 9 November. This was due to the consultants being on sick leave. The cancelled appointments were re-booked.


VN pointed out the case of an elderly man whose appointments were cancelled twice and he will have his new appointment in April 2016. ACTION: VN to pass details of this patient to FS to look into more details and clarify for the patient. Cardiology services provide service at W/X. 9.8% is the cancellation rate and in October this year it went down to 4.4%. They are going to employ the third registrar, the sixth consultant and a clinical nurse specialist. DD stated that another patient was waiting 11 months for his Urology appointment. FS replied that most urologists spend their time at W/X. The current waiting time for non-urgent referrals is 6-7 months. Very complex patients usually go to UCLH for their treatment. Cancer patients are seen very quickly. Q5: Patient transport services at Barts Health inadequate. FS replied that they are fully aware of the poor service provided by the company ERMS and this has been raised at board level. There are a number of contractual issues and it will be dealt by the highest management level in the Trust. EF asked what happens if the patient is late for the appointment because of the transport being late. FS replied that they have log of incidents and they will also deal with those issues with the company. FS also apologised and accepted the mistakes made. There are some contractual penalties but this could not be shared at present. Another concern raised was that the elderly patients are sometimes discharged too late in the evening. Q6: PEF also addressed concerns regarding large number of potholes in the hospital ground which makes unsafe for the wheelchair users and other patients and visitors. FS replied that they work on this now with the estates. More work will be done in W/X. EF said that there is a wheelchair shortage and that they should be using supermarket trolley system with the coins to be inserted, which would help to reduce number of lost or stolen wheelchairs. FS replied that they have coin and chain system in place and that they bought more wheelchairs which are stored around many hospital entrances. EF also suggested having clearly marked location of the wheelchairs and to have posters around hospital. Q7: PEF stated that there is a delay in X-ray and blood tests results between W/X and the GPs and they asked why this is happening. FS replied that there ae some issues with the IT system and they have formed Task and Finish group to deal with those and similar issues. 96% of tests results are sent to the GPs within 24 hours. Q9: Patient expert groups: FS stated that there is a Patients’ Panel at W/X hospital and they would like to recruit patients who are experts in certain specialities and they invited PEF members to join in those groups. BR has arranged a meeting with Head of Patient Experience at W/X Julia Briscoe and they will discuss this further. Q10: Is there a Discharge policy? FS replied that the Trust does have a Discharge policy and the Integrated discharge team is in place to ensure that the patient has everything he/she needs following hospital discharge. DL said that the patient don’t have the telephone number to call if something goes wrong with the discharge or care package at home. The Chair thanked FS and FK for their contribution to the PEF meeting.

VN and FS

8.0 AOB 8.1 BR thanked everyone for their commitment and their work for PEF over the

last year.


Dates of the PEF meetings in 2015/2016 are: Tuesday, 15 March 2016 5-7pm Further dates in 2016 TBC All meetings are in Becketts House, boardroom A, 2nd floor. Glossary: PEF Patient Engagement Forum CCG Clinical Commissioning Group YC Youth Council CVS Council for Voluntary Service PPE Patient and Public Engagement PPG Patient Participation Group BHR CCGs Barking and Dagenham, Havering and Redbridge Clinical

Commissioning Groups

9.0 Close and date of the next meeting 9.1 LS closed the meeting and thanked everyone.

The next meeting is on Tuesday, 19th January 2016, Becketts House, Ilford, IG1 2QX, 2nd floor, boardroom A.

Documents

Redbridge Clinical Commissioning Group Patient Engagement ...€¦ · Redbridge CCG PEF, November and December 2014 Page 1 of 4 . Redbridge Clinical Commissioning Group . Patient