NHS Thanet CCG Communications and Engagement progress report June 2018

I was pleased to introduce the latest Communications and Engagement update to NHS Thanet CCG Governing Body today.

Many thanks to Sara Warner and Emma Burns for producing the following report:

Residents 'having their say' at a recent consultation event here in Thanet.

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Introduction

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

Since the last Governing Body meeting in public, Lay Member for Patient and Public Engagement Clive Hart has continued to promote and encourage public participation in local health matters.

Clive regularly attends Thanet Adult Strategic Partnership, Thanet Local Children's Partnership Group, and Thanet Health and Wellbeing Board, and thereby maintains close working relationships with third sector and statutory organisations supporting and caring for residents of all ages across the district.

Thanet Health Reference Group, which Clive chairs, continues to bring together the leaders of GP practice patient participation groups (PPGs) to support Thanet CCG and to help individual PPGs spread good practice through the regular networking opportunity. This two-way engagement process is proving beneficial to all parties concerned and is well attended.

Thanet Health Network is being used increasingly to inform members of the growing number of public engagement opportunities being planned as part of changes to local care and the wider work to transform health and care services in Kent and Medway. Clive also makes sure members are kept right up to date with fast moving changes through a monthly bulletin.

Since the last Governing Body meeting, Clive has attended and supported the latest local Esther Café session in Broadstairs (during May) that focused on social prescribing. The informal Esther Cafes are proving to be a very informative form of engagement at a very practical and local level. Esther Cafés are relaxed and informal events which provide an opportunity to hear first-hand people’s experience of using local services, and a chance for them to contribute their ideas and feedback.

Clive also attended the further Thanet public consultation meetings on the stroke service review, held in St Peters/Broadstairs and Ramsgate. These followed on from earlier events in Margate and Minster and thereby provided Thanet residents with engagement opportunities in each of our three main coastal towns and a more central rural/village location. Throughout the period of the stroke consultation he consistently promoted the associated resident survey through social media channels.

Clive was pleased to see keen involvement in local care issues at a public meeting held in March to discuss plans to provide more joined-up care, closer to home for east Kent. More than 50 members of the public attended the Design by Dialogue event in Canterbury, including representatives of campaign groups, who came together at the cricket ground in Canterbury to share their views on health and care services in the area. A summary report of the event has been published on our NHS Thanet CCG website.

Clive and Ana Nacif (Lay Member for Canterbury and Coastal) share attendance at East Kent Programme Board meetings in relation to engagement matters but the most recent meetings have unfortunately been postponed.

At Kent and Medway level, Clive continues to attend meetings of the Kent and Medway Sustainability and Transformation Partnership’s Patient and Public Advisory Group and also supports the STP’s Communications and Engagement work stream and also attended a workshop on ‘system transformation’.

Clive was also pleased to see closer team working being promoted through an event focused on the ‘Principles of Buurtzorg’, a way of working in small teams used extensively in the Netherlands that KCC hope to ‘pilot’ in other areas of Kent in the near future.

  1. Local care

The integration of health and social care has been acknowledged as the means of delivering better care and improving quality and outcomes for citizens, as well as efficiencies across the system.

On 25 May, there was an ESTHER Café held at Bradstow Court in Broadstairs. Twelve people attended and there was an informal presentation about social prescribing, given by Red Zebra. Social prescribing is a future project which the Local Care team will focus on this year.

We are currently applying, with Bethesda Medical Centre, for planning permission to extend the building and create a state-of-the-art health centre for Margate.

The plans are to create a new “one stop shop” for people in Margate which can cater for up to 32,000 patients, allowing them to get all the medical and nursing services they expect in much more modern and accessible space. The CCG want the building to feel like a community venue and the local community to feel a part of the development. Over the next 12-18 months, there will be opportunities for the local community to become involved in commenting and sharing their thoughts on this.

We have been supporting the Limes to engage with patients about its ability to provide a high quality service at its Garlinge branch surgery and are now supporting the practice to explore options for the future of the branch.

1.3 Thanet Health Reference Group (HRG)

The HRG met on 11 April 2018, when a presentation was given by Oena Windibank, the Chief Officer for Local Care. The presentation focused on the plan for Thanet’s Local Care and the services it could or would provide across Thanet down to locality level. The group members were also asked to comment on the layout and design of the slides to ensure the information is people friendly.

The next Health Reference Group meeting is on Wednesday 06 June, between 10am and 12 noon, at Thanet District Council offices. At this meeting there will be a presentation and a discussion on the new east Kent Rheumatology service.

1.4 General Data Protection Regulation preparing for 25 May

We have been liaising with NEL colleagues to ensure we meet the changes in EU regulations regarding the data we keep and the contact we make with our stakeholders, patients and the public when discharging our duty to involve.

a. Publicly available contact information (eg. GP practice general email address, phone numbers and emails for MPs, councillors, organisation general email addresses) can work on an opt-out basis.

  • When contacting people to opt-out the message needs to be clear what data the CCG holds, how it is used, why, and provide an option for them to no longer receive news updates, and a reminder they can opt-out any time.

  • Store this data/list so there is an audit trail

b. Individual professional email addresses – opt-out

Same as above – where there is already an established communication channel and we have been contacting them before and this information is also available publicly on public facing websites etc.

c. Patients, public, patient groups – opt-in by 25 May.

Be clear what their data will be used for, how long it will be held for, and reminder they can opt-out any time.

Individual CCG staff can continue to contact individuals as part of their day-to-day work – as GDPR is related to general communications emails/marketing, rather than any contact between organisations or individuals.

The virtual health network, which is one of our means of ongoing dialogue with individuals and organisations, has been contacted to request people give their consent to renew their membership.

1.5 Transforming health and social care in Kent and Medway

On Wednesday 18 April, Kent and Medway health and care staff and partners attended a 'Heart of Local Care' conference to look at how different professionals can best work in multi-disciplinary teams (MDTs) to improve care for patients.

The conference attracted frontline colleagues from across the health and social care sector, as well as partner organisations, including Kent Fire and Rescue Service and the Heart of Kent Hospice. Speakers, like trainee advanced clinical practitioner in frailty, Carrie Mandeville, told of the advantages of integrating teams.

Highlights of the conference, which saw the audience chuckling, were two films. ‘What is an MDT?‘ stars local colleagues and helped to articulate the vision and challenges of working this way. ‘Patiently confused‘, shows just how much we’ve confused the public with our use of acronyms, you can watch it here.

1.6 Co-production approach for the STP

The Kent and Medway Patient and Public Advisory Group (PPAG)’s recommendation to the STP Programme Board that they champion a co-production approach (working in equal partnership with the public on developing and implementing plans) has been enthusiastically adopted.

At its most basic, co-production of public services is about ‘action’, for example, people (including professionals and people who use services) coming together and producing a service or an outcome.

Voice-based initiatives, where we ask people to tell us what they want, may be able to design better services than those that don’t engage with people but, ultimately, they are not aimed at unlocking the practical skills and capacities of people who receive services.

Six principles of co-production:

1. Assets: transforming the perception of people from passive recipients of services and burdens on the system into one where they are equal partners in designing and delivering services.

2. Capacity: altering the delivery model of public services from a deficit approach to one that recognises and grows people’s capabilities and actively supports them to put them to use at an individual and community level.

3. Mutuality: offering people a range of incentives to engage with, enabling them to work in reciprocal relationships with professionals and with each other, where there are mutual responsibilities and expectations.

4. Networks: engaging peer and personal networks alongside professionals as the best way of transferring knowledge.

5. Blur roles: removing tightly defined boundaries between professionals and recipients, and between producers and consumers of services, by reconfiguring the ways in which services are developed and delivered.

6. Catalysts: enabling public service agencies to become facilitators rather than central providers themselves.

Some of these principles, such as asset-based approaches, are distinct practices in their own right, with robust emerging evidence bases, especially for improving health and wellbeing.

A working group of project leads and PPAG members is being formed to create a business case for co-production, including the development of a number of pilots in Kent and Medway. Each STP workstream is currently identifying a suitable project for a co-production pilot.

1.7 Stroke consultation across Kent and Medway, and parts of south London and East Sussex.

The consultation closed on Friday 20 April and all feedback is now being independently analysed. The analysts will produce a report for the stroke review team and the joint committee of ten clinical commissioning groups to consider.

Patricia Davies, senior responsible officer for the stroke review, said: “During the consultation we’ve heard a range of views from people across Kent, Medway and the surrounding areas. There have been some important points made covering: travel times, links to rehabilitation services, recruitment and many other topics.

“Alternatives suggested during the consultation will be evaluated and viable options included in the report to identify a preferred option. We expect to be ready for the CCGs to make a final decision at a public meeting towards the end of this year.”

The consultation feedback includes:

• 2,240 responses to the online questionnaire

• 299 hard copy questionnaires

• Notes from 28 public listening events attended by 850 people

• Notes from meetings hosted by others where we discussed the proposals

• Notes from consultation events with staff in NHS trusts

• 701 telephone interviews

• 442 face-to-face discussions through focus groups, street surveys and and outreach engagement

• 500+ email / postal / phone comments and questions

• 500+ comments and questions through social media

• 1,521 postcard responses and a petition with ~3,500 signatures received from a group in Thanet

The feedback report will identify all the main themes from the consultation responses. Notes from engagement events during the consultation and responses from organisations/groups will be published in due course as part of the feedback report. Individual comments will not be published as they may contain personal identifiable information which respondents did not wish to be made public.

The CCG website has been updated to reflect this, as has the central Kent and Medway website.

http://www.thanetccg.nhs.uk/health-network/stroke-services-review/what-people-have-said-so-far

A summary of the process to identify the final preferred option is available at:

https://kentandmedway.nhs.uk/stroke/decision-making-process

1.8 Plans for east Kent

In east Kent, we are looking at how local health and care services can be delivered in a more joined-up way. These will help people get care that looks after them as a whole person, rather than treating their different conditions separately. It will also mean people can get more care and support in their local community, with more services provided at some GP surgeries, community hospitals or other bases.

We are also looking at how to make sure our hospitals provide high-quality sustainable care that meets national standards.

Working with specialist communications and engagement colleagues from a number of organisations, we have developed a pre-consultation communications and engagement plan. It outlines the strategy and activities for undertaking the final phase of the pre-consultation engagement, up to and including the formal evaluation of the proposed medium-list of options, and the formal agreement to prepare and undertake consultation on any option shortlisted following this process.

In a nutshell, there will be:

  • Local Design by Dialogue sessions (where the ‘system players’ can tell their story together)

  • Targeted sessions with, for example, people with protected characteristics and users of specific services such as maternity, inpatient surgery, and primary angioplasty from other parts of Kent

  • Sessions on the evaluation of the potential options that include patients and public. A citizen jury type approach may be useful here

  • Broader stakeholder engagement with for example local authorities, MPs, partner agencies Healthwatch PPAG other NHS organisations, GP practices and primary care teams including demonstrable clinical engagement across the system

  • A whole system stress test simulation-type event (presenting the proposed whole system model, creating scenarios that will enable people to see how it might work and stress test it to extract learning and refine the model where required) We will need whole system representation in the room.

We will enact the plan in coming months, once the activity modelling work is complete, enabling us to answer the question “What does this mean for me?” for different communities, demographics, and health needs or conditions.

It builds on the intensive programme of earlier engagement which has taken place since the East Kent Strategy Board, now East Kent Delivery Board was set up in autumn 2015. This included engaging widely with staff, stakeholders, patients, carers and the public on the case for change in east Kent, the development of best practice models of care for urgent care, acute medicine and orthopaedic services, the design and development of evaluation criteria, and early thinking for potential option one of the two potential options for urgent, emergency and acute medical care.

1.9 National consultations

The engagement team will be promoting these through bulletins to those registering an interest in the Thanet health network, and to the Thanet Public Health Reference Group, to encourage people to respond.

Consultation on extending access to personal health budgets

The Department of Health and Social Care is holding an open consultation on personal health budgets and integrated personal budgets. The consultation includes extending the right to have a personal health budget to people who have been kept in hospital for mental health care and are eligible for funding for aftercare, and to people with ongoing mental health needs, or people with a learning disability, autism or both, who are eligible for ongoing NHS care. The consultation closes on 8 June. More information and the consultation can be found at the following link:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/697825/personal-health-budgets-and-integrated-personal-health-budgets-consultation.pdf

Alternative ways to have an ‘online’ consultation with your GP

NHS England is supporting GP practices to offer their patients alternative ways to have a consultation with a GP or other practice-based health professional online via the internet, rather than waiting for the next available appointment to attend in person – we are referring to this as ‘online consultations’.

Online consultations are a way for patients to use a smartphone, tablet or computer, to contact their practice about a new problem or an ongoing issue, to ask questions or tell their GP about their symptoms. The practice will ensure their contact is dealt with by the right person in the team, helping ensure they are served as quickly and appropriately as possible. Sometimes this will mean a patient will need a phone call with the GP or nurse, or an appointment at the practice, and this will be arranged as usual.

Places that are using online consultations already have found a number of benefits:

• Patients were able to get a quicker response, rather than waiting for an appointment in person

• It is more convenient as patients do not have to travel to their GP practice or wait for the next available appointment.

• GPs were able to provide more appointments for patients, offering the same level of consultation, diagnosis and necessary actions (such as referral or a prescription) as patients would get in a face-to-face appointment.

NHS England is seeking views through an online survey by Friday 15 June 2018. The survey should take less than 10 minutes to complete. The next steps are to continue these open discussions and to work through the recommendations made by the RCPCH.

https://www.engage.england.nhs.uk/survey/online-consultations-public-engagement/

  1. Spreading the word through the media and other communications

  2. Media relations

We keep the local media updated on plans and progress and regularly receive good coverage for news stories. We also provide responses to requests for further information and post updates on the CCG website.

Recent press releases have included Dementia Action Week, encouraging use of pharmacists for common ailment prevention, and updates on the stroke review.

We have also supported local practices in their public communications and media relations, notably Bethesda Medical Centre and The Limes.

Media releases and other communications continue to be shared with partner organisations as we move towards greater integration of care.

The promotion of the Health Help Now website and app continues in both traditional media and social media.

  1. Change of Chair

We have recently shared the news about our change of Chair, sending information to patients, the media, and putting it on our website.

  1. Wheelchairs

As the lead commissioner for wheelchair services for Kent and Medway, we have been working with the provider on communications for patients and stakeholders about the service, which has been experiencing longer waiting times for non-urgent referrals than we would wish. An audit to understand the reasons for the pressures so we can resolve the challenges is underway.

  1. Healthy Ageing in east Kent

Our booklet, Healthy Ageing in east Kent – your local guide, is now being printed, ahead of distribution to frail and older people.

It gives advice and tips on staying healthy and looking after yourself, and lists ways to spot signs of common illnesses at an early stage, before they become more serious.

It also has details of local services in east Kent that provide help and support on a range of issues including hearing problems, living with dementia, avoiding falls, and meeting new people.

It was prepared with our health, social care, public health and district council partners, and has been clinically approved. It was funded by NHS England.

  1. Over the counter medicines

NHS England has published guidance on a number of short-term minor conditions where, instead of issuing a prescription, patients should be directed to purchase medication in a shop or pharmacy.

This follows a national consultation, and one in east Kent where there was strong support (86 per cent) for the proposal to restrict prescriptions for common health issues.

We are supporting GP practices to help patients understand this change, by preparing posters to encourage patients to self-care where appropriate and make use of their local pharmacy.

  1. Urgent care communications

We are reviewing the system resilience communications plan with a view to increase its reach and impact, including the creation of patient films.

As of 17 May 2018, the Kent Health Help Now web app had been used 346,525 times by people using 290,858 devices (such as smartphones, tablets or computers).

Users stay on for just over one minute on average. Forty per cent of users are aged 18 to 34, 24 per cent are 35 to 44, 17 per cent 45 to 54, 11 per cent 55 to 64, and eight per cent 65 plus. Just over 70 per cent of usage is by women.

The downloadable app, which launched on 9 December 2014, had been used 74,856 times by 27,233 visitors. People typically stay on for almost three and half minutes and look at 12 screens.

  1. Digital and social media

The CCG continues to use new technologies to better engage and communicate with patients and stakeholders. Our digital, media and engagement services work closely to ensure all priorities are promoted and communicated via the website and social media channels.

1 April – 14 May 2018

Web statistics

  • Organic Search – 1,077

  • Direct search – 477

  • Referral – 75

  • Social – 20

  • Page Views – 8,659

  • Unique Page Views – 6,240

  • Site Visits/Entrances – 2,343

Top five pages

  1. http://www.thanetccg.nhs.uk/about-us/

  2. http://www.thanetccg.nhs.uk/about-us/governing-body/

  3. http://www.thanetccg.nhs.uk/contact-us/

  4. http://www.thanetccg.nhs.uk/services/

  5. http://www.thanetccg.nhs.uk/health-network/

Web Activity

  • Bethesda Medical Practice - New section and web banner regarding the new development of Bethesda Medical Practice

  • Capital Funding Boost – News article and web banner

  • Diabetes Awareness Week – News article and web banner

  • Mental Health and Wellbeing – Restructured page

  • Applied NHS 70 logos to website

  • GDPR - Ensuring the website is GDPR compliant. Updated cookie banner and privacy policies. Instructed clients how to delete contact form data.

Twitter

April

  • 14,900 – Impressions

  • 324 – Profile Visits

  • 80 – Mentions

  • 35 – New Followers

May

  • 9,722 – Impressions

  • 123 – Profile Visits

  • 42 – Mentions

  • 27 – New Followers

Recent tweets include:

NHS Thanet CCG @ThanetHealth May 30 Two days left of #nationalwalkingmonth. Still time to take part - why not take a brisk 10 minute walk at lunch time and take in your local views. #walkthismay #selfcare #active10 #mentalhealth

NHS Thanet CCG @ThanetHealth 30 May Today is World No Tobacco Day. If you need help to quit smoking, contact @Kent_cc Smokefree Kent team to find out what is available. http://ow.ly/1k0C30ke0NN #oneyou #selfcare #smokefree

NHS Thanet CCG @ThanetHealth May 29 Life can get really tough sometimes, but talking can help. @Kent_cc Release the Pressure helpline has a highly trained and experienced team available 24/7 to provide you with confidential support to get you back on track. Call them on 0800 107 0160.

NHS Thanet CCG @ThanetHealth May 28 There are seven minor injury units in east Kent which can treat a number of conditions. Patients are often seen much quicker at an MIU than an A&E department. Use @NHSHealthHelp to find your nearest one. http://ow.ly/Q3mE30jPFvk #staywell

NHS Thanet CCG @ThanetHealth May 28 Pharmacists can help you with a range of minor illnesses and injuries. Find out where you can get help this bank holiday #Monday. #selfcare #staywellpharmacy http://ow.ly/GXAX30kd4Ig

NHS Thanet CCG @ThanetHealth May 23 Saturday 9 June is officially NHS70 parkrun day. Over 160 parkruns are hosting special NHS-themed events to mark the NHS’s 70th birthday and celebrate its contribution to the nation. Why not get involved? http://www.nhs70.nhs.uk/parkrun #NHS70 #loveparkrun

NHS Thanet CCG @ThanetHealth May 25 The earlier you seek help, the sooner you can get advice and support. Find out how to get help in east Kent #DAW2018 http://www.thanetccg.nhs.uk/news/blog/?blogpost=10683 …

NHS Thanet CCG @ThanetHealth May 23 Caring for someone with dementia? Have you tried your local dementia cafe, or support group? Find out where your nearest one is in east Kent. #DAW2018 http://ow.ly/k6PY30k7BKq

NHS Thanet CCG @ThanetHealth May 21 Helping people to live well with dementia. Find out where you can get help in east Kent. #DAW2018 http://www.thanetccg.nhs.uk/news/blog/

NHS Thanet CCG @ThanetHealth May 18 Dying matters – what can you do? #DAW2018 http://ow.ly/5Coi30k3UPK

NHS Thanet CCG @ThanetHealth May 15 The NHS in east Kent has produced a new booklet to help older people stay well. 'Healthy ageing in east Kent - your local guide' gives advice and tips on staying healthy and looking after yourself. Download it now. #stayingwell http://ow.ly/lw1W30k0rGc

  1. Public affairs and stakeholder management

  2. Health Overview and Scrutiny

Due to bad weather, the 2 March HOSC meeting was cancelled with all items to be carried forward to future meetings.

At the meeting on Friday 27 April 2018 we presented briefings on:

• Kent and Medway strategic commissioner

• Financial recovery in east and north Kent

• Transforming health and care in east Kent

• Patient transport services

• Kent and Medway integrated urgent care service procurement

• East Kent OOH and NHS 111 service.

The next HOSC meeting will take place on Friday 8 June 2018.

  1. Stakeholder Briefings

There have been no requests from the Department of Health for briefings since the last governing body report.

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Clive Hart