NHS Thanet CCG Communications & Engagement Update.

Firstly, my sincere thanks goes to Emma Burns (Principle Associate - Media and Communications) for bringing this report together.

The report covers a wide range of recent and current communications and engagement activity and also includes a revised and improved engagement flowchart, outlining the basic engagement process Thanet CCG will be using from now on.

Integrated care, self care and personal health budgets feature strongly in the recent work of the communications and engagement team and brief updates are also included on 'out of hours' services, the stroke services review, community equipment, wheelchair and patient transport services.

Good communications are essential to patient and public engagement and the report also details recent press, and social media activity.

The CCG's communications and engagement team continue to make significant improvements in the way we engage with patients, the public and the third sector, and although extra effort will always need to be made for 'hard to reach groups' on specific issues, we now have a firm foundation for excellent public engagement in 2016.



Communications and engagement progress report November 2015.


NHS Thanet Clinical Commissioning Group recognises that listening to and acting on what matters to local people is key to the delivery of our commissioning intentions and plans.

Engaging and communicating with patients and local people to jointly design and commission services will make them a more active and powerful resource. It will also help us to gain a much better return on the money we invest in local services.

A summary of recent activity is included below.

1. Patient and stakeholder engagement

1.1 Since the last Governing Body meeting in public, Lay Member Clive Hart

has met his fellow Lay Members for Patient and Public Engagement (PPE) from the other clinical commissioning groups in Kent and Medway and is pleased to report that all appear to be working to a similar brief / system / process.

He was also delighted to hear strong support for greater patient and public engagement from Tim Kelsey, Professor Paul Corrigan and Sir Bruce Keogh at national level, during a recent NHS England PPE Summit in London.

Locally, Clive continued to meet Thanet GP surgeries’ respective patient participation groups (PPGs). Further to earlier reported meetings with East Cliff PPG, Westgate PPG and St Peter's PPG, he has now met with Bethesda PPG, Minster PPG, Birchington PPG, Northdown PPG and Mocketts Wood PPG and he continues to be impressed by Thanet patient volunteers’ passion and commitment.

Clive is progressing arrangements to meet with the remaining PPGs across Thanet and has also promoted local PPGs through the Thanet press and social media.

Clive recently invited the chairs of all Thanet's PPGs to a 'brainstorming session’, looking for even better ways to work together in the future. Subsequently, a meeting has been scheduled for January to establish a regular reference group for the CCG to hear patients’ views Thanet-wide. These meetings will also provide networking opportunities for the PPGs and thereby help to promote best practice.

He attended a further Westgate PPG meeting which was open to the public. It proved to be very popular and Clive was very pleased to witness a clear desire by local residents for preventative solutions to their healthcare needs.

Indeed, self-care has been a prominent theme since our last Governing Body meeting in public. Clive supported the CCG discussions with social care and the voluntary sector at East Cliff surgery and, more recently, a workshop at Trinity Resource Centre.

He also supported our partners Healthwatch Kent with their local engagement event at Christchurch Campus in Broadstairs.

Clive attended the event held at Turner Contemporary on behalf of the CCG and NHS England to discuss stroke and vascular services. He is pleased to report he was later informed the Thanet event was one of the best attended in Kent. The NHS was looking for local people to share their experiences of and views on how to improve local stroke care, particularly in the vital first 72 hours after first symptoms are experienced and Thanet residents offered some very strong views.

Back in the summer, Clive chaired a very positive meeting with members of the third sector to discuss better two-way working relationships between the CCG and community/voluntary sector.

He attended the Thanet Community Support Partnership (TCSP) along with Thanet third sector groups and now regularly attends Thanet Adult Strategic Partnership.

Improving working relations with patients’ groups and the third sector is, and will continue to be, a clear priority for Clive and the CCG.

Below is a chart mapping the network of relationships that make up our patient and stakeholder involvement. Its complexity is an indication of how rich and wide-ranging our engagement is. It supports our commitment to listening to and acting on what local people tell us about what matters to them.

1.2 Integrated Care Organisation

The integration of health and social care has been acknowledged as the way forward, as the means of delivering better care and improving quality and outcomes for citizens, as well as efficiencies across the system. NHS Thanet CCG has formally agreed a compact which captures each organisation’s commitment to partnership working to deliver improved integrated health and social care for the populations they serve.

By working in partnership we can achieve much more than working apart and therefore in Thanet we have established a multi organisational partnership approach to developing and delivering a new model of health and social care provision.

Organisations signed up are: Thanet Clinical Commissioning Group, East Kent Hospitals University NHS Foundation Trust, Kent Community Health NHS Foundation Trust, Kent County Council, Thanet District Council, Healthwatch Kent, South East Coast Ambulance Service NHS Foundation Trust, Kent Local Medical Committee, the University of Kent, Integrated Care 24, Invicta Health, Avondale care and KIAC.

Five outcome areas for delivery have been agreed:

  1. People take greater responsibility for their own health

  2. People stay well in their own homes (wherever that home may be)

Developing services to support the people of Thanet in the community and provide people with an integrated point of contact which, for most people, will be general practice.

  1. People receive timely and appropriate high quality care

Concentrating hospital-based care on the provision of specialist, complex care and support and advice to primary care; ensuring timely access to urgent and acute specialist care.

  1. People receive safe care and have a positive experience of care

Patient safety and experience is at the centre of everything we do; improving outcomes for the people of Thanet.

  1. There is better use of the Thanet pound

Collectively, we can demonstrate value for money and delivery of cost-effective services. Through integration, we can reduce duplication and agree collaborative spend priorities in order to improve outcomes for the people of Thanet.

The GP practices are now working in four clusters covering Quex, Margate, Ramsgate and Broadstairs. They will be working with partner organisations to discuss how they can collectively work closer together to improve care, particularly community nursing. They are also exploring the potential for extending GP car so that it is available 8am to 8pm.

1.3 Self-care partnership working

Following the successful workshop with partners in September, the CCG has shared self-care marketing materials with practices, and provided links to resources via the CCG membership team. The CSU engagement and communication team supported the successful Big Thanet Health check, and made contacts with various voluntary and community sector organisations to continue raising the profile of the support that’s on offer to people locally to help them stay well.

The British Heart Foundation has been particularly generous in providing free information on various cardiovascular problems and how to prevent them or seek support to manage symptoms.

During self-care week (November 16 to 22), Thanet District Council ran events with students at Hartsdown Academy to promote sports activities and provide them with self-care information – including how to cope with stress, and advice on healthy life styles.

And Social Enterprise Kent sent out a daily e-mailshot focusing on self- care and support for the main long-term medical conditions with two simple helpline numbers. They also worked with Age UK Thanet, Citizen’s Advice Bureau and the job centre to promote health and self-care at various locations with advisors and stalls offering information and support. And helped support the work of the CCG with Thanet Senior Citizens Forum and other community networks to spread the word.

1.4 Personal Health Budgets

Self-care and personal health budgets were the topic of conversation with 40 Thanet residents on 19 November at Trinity Community Centre.

First, people discussed self-care and staying healthy, their reasons for accessing health services, and how they choose which professional/service they see.

Then the discussion moved to how the CCG and our partners could do more to support people to self-care. This will inform our next steps on increasing support to people to self-care and manage their health and mental wellbeing.

At the CCG, we are just starting to consider how personal budgets might be offered to patients and carers in Thanet from April 2016, so the group discussed developing an approach to support people effectively and having a phased approach which targets those who most need help in Thanet.

The meeting also looked at which conditions should be a priority to receive support, what support people would need to make the scheme work well for them, and the type of criteria which might be needed to make it work effectively.

Evaluation sheets show those present were enthusiastic about the opportunity to discuss this important topic, and wanted additional sessions to help work through the criteria. They valued the time taken to explain things, felt listened to, and found the group work was an excellent way of working through the subjects, although noise levels sometimes made hearing difficult and people had concerns over not knowing enough at the moment.

We will be feeding back to those who attended the workshop and taking this work forward over the next few months.

1.5 Re-procurement of integrated out-of-hours services – east Kent area

Over the last year, patients’ views and experience have informed a service specification for integrating NHS111 and urgent out-of-hours medical care. We are planning further engagement with patients about our plans which include using paramedics to support the out-of-hours home visiting service from 2016.

After a pause pending further guidance from NHS England, the procurement re-started in November. Patients continue to be part of the procurement dialogue and there is a commitment from all four CCGs involved to create a Patients’ Charter in the new year, working with patients and the public to set out their expectations for urgent care services. This will inform and influence the delivery of various services which offer patients help when they urgently need it.

1.6 Kent and Medway stroke services review

We are part of a Kent and Medway wide review of stroke services, which is looking at the care that people receive immediately after having a stroke (the hyper-acute / acute phase). The aim of the review is to deliver clinically sustainable, high quality, hyper-acute / acute stroke services for the next ten to fifteen years, that are accessible to Kent and Medway residents 24 hours a day, seven days a week.

All the clinical commissioning groups in Kent and Medway are part of this review. In October, we and the other CCGs ran a survey for anyone who had experience of local stroke services. In total, 285 people completed it. The full report will be available soon but, in summary, people said that:

The most important things when a stroke or TIA first happens are:

  • Fast ambulance response

  • Getting quick diagnosis and treatment

The most important things relating to the hospital stay are:

  • Specialist care

  • Being treated with respect and dignity

The most important things relating to the staff are:

  • That staff knew my case, treatment and care plan

  • That staff treated me as a person not just a patient

The things of most importance after discharge are:

  • Physical rehabilitation information and exercises

  • Follow up visits from nurses to check on progress

During September and October, 11 focus groups were organised in Kent and Medway by the Stroke Association or independent stroke groups to enable the NHS to listen to the experiences and hear the views of 172 people affected by stroke, their families and volunteers. The review also received views from East Sussex and Bromley.

Full reports will be available soon but, in summary, people in Kent and Medway said:

The most important things when a stroke or TIA first happens are:

  • Fast ambulance response

  • Quick diagnosis and treatment

  • Getting swift access to specialist support is of equal importance with being admitted to a specialist unit.

The most important things relating to the hospital stay are:

  • Being treated with dignity and respect

  • Specialist care

  • Clear information and support to understand my treatment

The most important things relating to the staff are:

  • That staff treated me as a person not just a patient

  • That staff knew my case, treatment and care plan.

  • That staff respond as quickly during the night as during the day.

We are also working with voluntary and community organisations that support people from black and minority ethnic communities, and others whose specific needs will be considered within the overall plan, to ensure their views are heard.

In November and December, the review is holding three “deliberative events” with panels of the public, stroke survivors and carers, and community representatives, including voluntary organisations. They will review the case for change, possible options for the future, and the criteria that should be used in taking decisions on options. The panels have been carefully recruited to ensure they have a representative mix of people from different communities and locations.

The stroke review is overseen by a Stroke Review Programme Board, which has representatives from all the eight clinical commissioning groups in Kent and Medway, the South East Cardiovascular Network, public health, communications and engagement, a stroke survivor, the Stroke Association and Healthwatch Kent.

The Review Programme Board is supported by a Clinical Reference Group (CRG) which is represented at the RPB through its Chair, Dr David Hargroves, lead stroke consultant at East Kent Hospitals University NHS Foundation Trust, in his role as South East Clinical Network stroke lead.

Consultants from the four main hospital trusts in Kent and Medway are on the CRG, along with specialist nurses and senior managers. The ambulance trust is also represented. The role of the CRG is to provide clinical guidance and assurance to the review process.

Recommendations about changes to stroke services will be put forward by the Stroke Review Programme Board to clinical commissioning group Governing Bodies, which will take the final decisions.

The Health Overview and Scrutiny Committee for Kent and Health and Adult Social Care Overview and Scrutiny Committee for Medway have agreed to form a joint committee to review the plans and process used by the stroke review. It is expected to meet for the first time in January.

1.7 Integrated community equipment service

We have worked closely with Kent County Council and the other clinical commissioning groups in Kent on the procurement of a new integrated community equipment service. It will provide health and social care equipment to people of all ages who have been professionally assessed as needing equipment to help them live independently at home.

We are the lead commissioner for the NHS. Contracts for the community equipment service were awarded in September 2015. The new service includes the loan of equipment such as hospital beds, pressure care equipment, walking frames and other daily living equipment to help older and disabled people to live independently in their own homes. It also includes Telehealth services in Kent.

Acute and community staff will be able to order a broad range of community equipment to support patients and carers. The new service also offers patients the convenience of having all their equipment delivered at one time, and extended hours for deliveries which they can arrange at a time to suit them.

We have been working with the new provider, NRS Healthcare; the former lead provider for equipment, Kent Community Health NHS Foundation Trust; with staff who order equipment in hospitals, the community, social care and hospices; and with Kent County Council to ensure people have the information they need for a smooth transition.

The new service started on 30 November 2015.

1.8 Wheelchair services

A Kent and Medway wide review of wheelchair services is looking at existing experience of services as well as gathering feedback on potential changes, ahead of re-procurement of the service in 2017. A survey has been conducted with people who use wheelchair services and their carers to ask about their experience of and views on the service they have received. A total of 129 responses were received and feedback highlights the following themes:

The majority were generally positive about the wheelchair service overall citing repairs, efficient service, quick assessments and good customer care

A third of respondents experienced a delay of more than two months for assessment (32 per cent). Over half indicate ‘no delay’ for service on a wheelchair (54 per cent). Three-fifths of those experiencing a delay were not aware of the reason for it (61 per cent)

“Need more wheelchair assessors.”

The majority of respondents support the orders being prioritised by date and postural/pressure care needs (68 per cent) although a third do not (32 per cent)

“…there need to be guidelines on how long non priority patients should wait.”

The majority of respondents support the possibility of stopping self-referrals for those already with wheelchairs (64 per cent) although more than a third do not (37 per cent). (Numbers were rounded).

“Need to implement a three strike rule. If patients do not turn up three times, they cannot self-refer again.”

The feedback will be taken into account as we consider recommendations for the service in the future. Further engagement is planned as the service is developed.

1.9 Patient Transport Service

We are very grateful to patients who have helped us, working with the other clinical commissioning groups across Kent and Medway, to evaluate tenders for the Kent and Medway patient transport service. Patients helped both to shape the specification, and particularly the Patients’ Charter setting out what people expect from the service, and to evaluate bids.

We expect to announce the outcome of the procurement in December 2015. The current contract expires at the end of June 2016 and will be replaced by three separate contracts covering respectively: renal patients, Darent Valley Hospital patients, and the general Kent and Medway Patient Transport service.

2.0 Spreading the word through the media and other communications

2.1 Thanet’s main media outlets are the Isle of Thanet Gazette and the KM Group Thanet Extra. The CCG’s media profile in these publications is positive, and media coverage is supportive of the CCG’s work.

Over the past two months, news releases have covered many topics, including the east Kent careers fair and encouraging the use of pharmacies for minor illnesses.

The CCG also worked closely with KCHFT for the ‘Big Thanet Health Check’ when more than 200 health checks and health MOTs were carried out at ‘pop-up’ clinics in the community during the first week of November.

Teams from KCHFT set up a temporary health clinic in ASDA in Broadstairs, where Dr Tony Martin was interviewed by ITV Meridian television, advising Thanet people about the importance of self-care.

A precis of the NHS Thanet CCG annual report has been produced, for CCG members and local people, highlighting the CCG’s core strategy and finances. This will be available in print and digital form.

Most recent press releases:

  • Engaging Thanet’s public (covering a patient engagement event in Margate).

  • Antibiotics won't help but simple steps can beat the bug

  • Listening to stroke survivors

  • Use your pharmacist for minor illnesses.

2.2 Urgent care communications

The CCG has a national requirement to produce an operational resilience and capacity plan. This is to help manage seasonal pressures. As part of the plan for 2015/16, the CCG has developed a communications plan to support key messaging around use of A&E. We will work closely with providers of NHS services and Kent County Council communications on delivery of the plan, and are seeking innovative ways to engage with other organisations in Thanet to spread the word.

A key part of this for us is Health Help Now, the mobile optimised website and app for Kent and Medway.

  • As of 22 November, the Health Help Now web app had been used 88,431 times by people using 65,689 devices (such as smartphones, tablets or computers). Users stay on for two and a half minutes on average. Thirty nine per cent of users are aged 18 to 34, 23 per cent are 35 to 44, 17 per cent 45 to 54, 11 per cent 55 to 64, and 10 per cent 65 plus. Two-thirds of usage is by women.

  • The downloadable app, which launched on 9 December 2014, had been used 9,364 times and downloaded 5,906 times. People typically stay on for just over three minutes and look at eight screens.

In the build-up to winter and the festive break, we will work with the media and partner organisations to get out clear messages encouraging people to

use Health Help Now and avoid the QEQM A&E unless it is an emergency.

The CCG always sends out such releases during peak holiday times (such as Christmas) and bank holidays.

2.3 Dementia awareness

NHS Thanet CCG is continuing its work with other CCGs in Kent – and Kent County Council and Kent and Medway NHS and Social Care Partnership Trust (KMPT) – to raise awareness of dementia and increase early diagnosis.

The dementia diagnosis rate in Thanet for October is 57.3 per cent, up from 48.27 per cent in March 2015. The diagnosis rate is lower than other parts of Kent.

The next stage of the publicity campaign will be to focus on the four main benefits of diagnosis:

  • Early planning and assistance

  • Checking concerns

  • Treatment

  • Health management.

The campaign, starting in December, will comprise press releases, social media and the use of visual images to complement the main message.

2.4 Medicines waste

Poster and stickers have now been produced for the CCG and are being distributed. The main message is ‘only order what you need’ to discourage excess ordering with repeat prescriptions.

Part of this phase of the campaign includes an emphasis on getting the message across in the local press, with emphasis on:

• In east Kent approximately £3 million is wasted on medicines which aren’t used. This could fund …

• Once a patient picks medicine up from the pharmacist, that medicine cannot be reissued to another patient.

• Research has shown that some people continue to cash in prescriptions for medicines they don’t need or want to take, sometimes stockpiling medicines.

• We want to encourage patients to talk about their medication, ask questions and let their doctor, pharmacist or nurse know if they are not taking medication.

• Key message – ‘only order what you need’.

2.5 Patient newsletter

The four-page patient newsletter will be distributed at Christmas/New Year time and will feature at least one patient case study.

The newsletter will also feature an article from the Lay Member for Patient and Public Engagement, Clive Hart and a public health message on mental health.

2.6 Digital and social media

The CCG continues to use new technologies to better engage and communicate with patients and stakeholders.

The CCG’s Twitter account @NHSThanetHealth now has 2,130 followers, and the quality and quantity of tweets has increased. This has generated more ‘likes’ and re-tweets. There has also been a greater use of more pictures linked to tweets, generating more interest.

Recent tweets include:

Birchington Medical Centre supports @ThanetHealth at King Ethelbert School Skillsfest. Inspiring Thanet's youth! http://ow.ly/i/eCvp4

What is #self-care? #Thanet people get together to discuss how we can help the #NHS by helping ourselves. http://ow.ly/i/eAmlc

Excellent turnout for @ThanetHealth #NHS patient engagement meeting in Trinity Resource Centre, #Margate. http://ow.ly/i/eAlg9

Want to know why we're reviewing #stroke services in #Kent & #Medway? Read the case for #change: http://ow.ly/UL8nm #yourNHS

Take Care and Self Care this Winter. NHS Thanet CCG is proud to support #Selfcareweek 2015

Thank you. The @NHSKentCHFT team have been really busy! Very well done to all 'Working Towards a Healthier #Thanet'

3.0 Public affairs and stakeholder management

3.1 Health overview and scrutiny

We regularly update KCC’s Health Overview and Scrutiny Committee (HOSC) on progress. The HOSC oversees the planning, provision and operation of health services under Section 244 of the National Health Service Act 2006 and amendments contained in the Health and Social Care Act 2012.

At its meeting on 9 October, we briefed HOSC on the East Kent Strategy Board so that members are aware of the context for many of the changes that need to take place. The committee was also updated on progress with our integrated care organisation (ICO) and the emotional wellbeing strategy for children, young people and adolescents.

East Kent Hospitals University NHS Foundation Trust (EKHUFT) briefed the committee on its clinical strategy, finances and chemotherapy service.

KCC presented an update on the transformation of public health services and NHS England an update on specialist vascular services.

3.2 Stakeholder briefings

There have been no requests for MP briefings since the last meeting.

Clive Hart