NHS THANET COMMUNICATIONS AND ENGAGEMENT UPDATE 11/09/18


Today I presented the following Communications and Engagement update report to the Governing Body at Thanet CCG.

Communications and engagement progress update.

Our approach to communications and engagement.

We recognise that listening to, and acting on, what matters to local people is important to the delivery of our commissioning intentions and plans. The more actively we engage and communicate with patients and local people in jointly designing and commissioning services, the more active and powerful a resource they will become and this will help us gain a much better return on the money we invest in local services.

1. Patient and Public Engagement

1.1 Thanet Health Reference Group (HRG) is chaired by our Lay Member for Patient and Public Engagement and it continues to provide valuable support and positive challenge (as a critical friend) to NHS Thanet Clinical Commissioning Group (CCG) on local health service provision.

Among many issues, at its last meeting the group had an in depth discussion on prescribing and medicines waste in Thanet with our Medicines Optimisation Pharmacist and his team. The two-way conversation proved valuable to both HRG members and CCG staff.

Thanet HRG members also had an excellent presentation from the Macmillan User Involvement Manager for Kent and Medway and, through further debate and discussion, offered a number of ways for patient participation groups (PPGs) to help promote Macmillan services to their respective practices across Thanet.

The patient participation group chairs from across Thanet's GP practices also shared information and ideas relating to their own PPG projects, spreading 'best practice' across the Thanet CCG area.

1.2 Thanet Health Network consists of patients, the public, and representatives of local voluntary organisations and community groups. Our Lay Member keeps the Health Network updated on the CCG’s work with a monthly e-bulletin. We also communicate and engage with them on questions about services in Thanet.

1.3 Improving discharge

The NHS in east Kent is reviewing how people are discharged from hospital after an inpatient stay, in order to improve patient outcomes, experience and efficiency. It is better for people, particularly people who are frail, to recover at home whenever possible. Ten days of bed rest in hospital for someone over 80 leads to ten years’ worth of muscle wastage, putting them at high risk of a fall, infection and loss of independence.

It is better for patients, better for their friends and families, and better for the NHS for people to recover in the right place, so the aim is for a new approach to discharge, with home as the default option, to be developed. This will assist the hospitals in preparing for winter pressures and to meet stretching national targets.

Three workshops were held in June 2018 - one for clinicians, one for people responsible for the delivery and commissioning of care and one for patients. These were designed to:

  • explore the issues around delayed transfers of care (DTOC) and their impact on patients and services

  • consider how systems and processes could be improved, and aligned with local care initiatives in east Kent, to help patients get home faster, with the right care and support

  • ensure smoother, more effective transitions across services and reduce the significant number of people in hospital beds when they could be at home, if everything was in place for them.

The themes from all three events were similar and covered everything from clinical issues to practicalities and communication. Improvements were identified including:

  • strong clinical leadership: to change culture/behaviours; lead by example, promote use of one assessment/care plan, and respond to patients’ wishes

  • create one shared IT system and strategy, to standardise and share patient information across all services and organisations

  • early intervention, before crisis, to avoid admission where possible

  • clear and timely communication across services: between acute, community, GP and other

decision-makers, particularly those who know the patient best, particularly the GP

  • open, honest communication with patients and families so they have enough information to

make their own choices and decisions

A patient panel is being established on 30 August to help implement the changes and give patients a voice within the plans.

1.4 Wheelchairs

In our last update, we reported on work underway to understand the reasons for long waits for wheelchairs, and that we were working with the provider on communications to service users and stakeholder. Since then, we have discussed these issues with Kent’s Health Overview and Scrutiny Committee, and attended a very positive meeting with representatives of the Kent and Medway wheelchair users’ groups. At that meeting, we invited them to form a service users’ group to oversee the improvement plan that Millbrook Healthcare has submitted, to ensure we are all satisfied it is sufficiently robust, and thereafter to monitor together delivery of the plan.

  • We are very pleased to have received confirmation that the representatives at the meeting have agreed to form a user group. We are meeting again as soon as possible to agree the membership and next steps to put this group into place without delay.

We will look to this user group to help us develop more meaningful key performance indicators, clarify the eligibility criteria, and offer guidance and advice on how best to communicate with the wider group of wheelchair users on the delivery of the plan.

We are returning to Kent’s Health Overview and Scrutiny Committee with an update in September, and will be attending Medway’s Health and Adult Social Care Overview and Scrutiny Committee in October.

1.5 Local care

The new Director of Local Care and Integration is establishing communications and engagement priorities for the work she is leading, including on the development of urgent treatment centres. Extending access to pre-bookable GP appointments is also a priority for communications and engagement.

1.6 East Kent communications and engagement

A communications and engagement working group, chaired by the Director of Communications and Engagement for the Kent and Medway Sustainability and Transformation Partnership, has been established to support the transformation work across east Kent. The group has reviewed the east Kent pre consultation communications and engagement plan and is preparing to:

  • run a series of open meetings across the east Kent clinical commissioning group areas

  • commission research to gather views from groups whose voices are not always heard

  • engage with specific patient groups/representatives of services affected by the proposals

  • run an online public survey

  • run staff engagement events

  • engage with patients and the public, key stakeholders and organisations outside east Kent

potentially affected by the proposals. The timeline for this work is to be confirmed.

1.7 Sustainability and Transformation Partnership (STP)

The Public and Patient Advisory Group (PPAG) continues to meet each month. A recruitment process is underway for new members in five districts where there are vacancies. Applications are particularly encourage from young people, people with disabilities, and people from communities whose voices are seldom heard. Most of the PPAG members are now each involved in at least one of the STP workstreams, ensuring a patient/lay perspective at a more detailed level across the programme.

A working group has been established within PPAG to develop a co-production approach with members of the public and patients to planning, implementing and monitoring the transformation of health and care delivery, as part of an Engagement Strategy for the STP. This aims to embed a wider and more inclusive approach to engagement, with patients and the public fully participating alongside professionals in the work of the workstreams and the wider STP. The recommendations include making sure appropriate training and support is available for participants. The working group’s objectives include undertaking three pilot co-production projects over 12 months within the workstreams to test and refine the support and training needed for both public representatives and the health and care staff working with them.

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

The public consultation on urgent stroke services in Kent and Medway closed on Friday 20 April.

Over the summer, two reports about it have been published. The consultation response report, written by an independent research consultancy, analysed all the feedback received and provides

detail on the themes emerging from the public consultation. The consultation activity report describes the range of activity that took place across Kent and Medway and neighbouring areas. Both are available at www.kentandmedway.nhs.uk/stroke

The Joint Committee of Clinical Commissioning Groups has reviewed the reports and will be looking at the responses in more detail as part of considering whether any viable additional options have been put forward.

The consultation activity report shows that the public consultation activity reached in excess of two million people, and generated over 5,000 responses.

Key themes from the feedback identified by the independent analysts include:

  • the majority of people who took part in the consultation activity agree that hyper acute stoke units should be established in Kent and Medway.

  • people generally think that the two most important questions to ask about the proposals are whether they will improve access to care and whether they will improve the quality of care.

  • the location of hyper acute stroke units, and travel times to the proposed units, are the key

area of concern, with particular concern for people living in Thanet.

  • many feel that the geography of the area means that four units would be better in order to

provide fair and equal access to all residents.

  • many people within the CT postcode area (which covers the largest part of east Kent, but

not Faversham or Ashford) did not feel any option is suitable and expressed a desire for Kent and Canterbury Hospital or Queen Elizabeth the Queen Mother Hospital to be re-considered as part of the short-listed options.

The reports were discussed by the Kent and Medway Stroke Review Joint Health Overview and Scrutiny Committee, which has councillors from Kent, Medway, Bexley and East Sussex, at its meeting on 5 July.

  • Comments from the councillors included:

  • “The best consultation I have seen in a long way, the result is incredible and the amount of work phenomenal...I hope all consultations in the future can be as thorough”

  • “Well done on what you have done. I think you have achieved something terrific in this consultation. I think it has been really well managed and I think the outcome when it comes can demonstrably show it has engaged the public”

  • “A very comprehensive engagement with the public and really useful data has come back and clearly an awful lot more people in the area know this is being talked about than some months ago”

  • “We all agree this is an excellent consultation and you have gone out there widely”

  • “I’m very impressed with this consultation, the way it has been presented, and the way it

has been carried out...I think you have done a very, very good job”

  • Chair of the JHOSC: “Every single councillor has commented on the quality of the

consultation – it has been comprehensive and well managed.”

Link to the webcast of the JHOSC meeting here: https://kent.public- i.tv/core/portal/webcast_interactive/361419

1.9 National consultations

Through the health networks and other groups, and our websites, we are encouraging local people to respond to a consultation by NHS England, in collaboration with the Academy of Medical Royal Colleges, the National Institute of Health and Care Excellence (NICE), NHS Clinical Commissioners and NHS Improvement’s Getting It Right First Time programme, on evidence based interventions.

There is a general consensus, both nationally and locally, that more needs to be done to ensure the least effective interventions are not routinely performed, or only performed in more clearly defined circumstances in order to:

  • reduce avoidable harm to patients,

  • save precious professional time,

  • help clinicians maintain their professional practice in line with the changing evidence base

  • allow for innovation

  • maximise value and avoid waste for patients and taxpayers.

The consultation documents (including accessible formats) can be found on the NHS England website, alongside details of how to respond.

  • 2. Spreading the word through the media and other communications

2.1 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 websites.

We sent out four news releases between mid-June and the end of August. These announced the publication of the stroke consultation reports, a message from Glenn Douglas, as Chief Executive of the Kent and Medway Sustainability and Transformation Partnership on NHS 70 and reminded residents to stay well over the summer holiday season, including bank holiday advice.

2.2 Web articles

  • We published heatwave advice, an article on the NHS England consultation on evidence based interventions, a statement on the hernia policy in Kent and Medway, a statement about the four east Kent CCGs being placed into special measures, promotion of the new breastfeeding apps available from Start4Life, promotion of Kent County Council’s rural transport consultation, and promotion of the summer patient newsletter.

We created new banners to promote the summer newsletter, and the annual report, and made changes to the Governing Body page to reflect the change in chair. We also migrated to a new version of the content management system.

2.3 Social media

Between mid-June and the end of August, we sent out 160 tweets on average from each CCG account. We supported national campaigns such as the World Breastfeeding Week and the new breastfeeding apps, Be Clear on Cancer, Cover up Mate, NHS 70 plus awareness campaigns including diabetes and suicide prevention. We also supported provider messaging such as East Kent Hospitals University NHS Foundation Trust and Kent Community Health NHS Foundation Trust. In addition, we promote stay well messaging such as pharmacy, minor injury units, GP, NHS 111, Health Help Now and also social prescribing such as parkrun and Active10. All four accounts have seen an increase in engagement and new users in this period.

NHS Canterbury and Coastal CCG also has a Facebook page which ran the same messaging to supplement engagement with the public and stakeholders. This led to an increase in likes and shares.

2.4 Newsletter

Our summer newsletter has been printed and distributed to GP practices, our partner trusts, local councils, pharmacies, our patient groups, and other public events/groups.

2.5 Winter communications plan

In conjunction with East Kent Hospitals NHS Foundation Trust we have prepared a communications plan for winter 2018/19, to help people find the most appropriate service for them, and enable A&E staff to focus on those who need the specialist skills of consultant-led emergency teams.

We have already prepared:

  • A back to school pack for the parents of primary school children

  • Tailored information for students aged 18 plus, particularly those in their first year

  • A Healthy Ageing booklet for older people in east Kent, with advice on how to stay well,

planning ahead, and what to do if they become unwell. It also has a directory of local services.

Health Help Now, which gives clinically approved advice by age group for common symptoms, and links to appropriate services, showing whether they are open or closed and travel directions, continues to be a key part of our year-round communications plan. It now links to other useful apps including WaitLess which gives information about time to access minor injury services in east Kent, including travel and waiting times.

As of the end of August 2018, the Kent Health Help Now web app, which launched in December 2013, had been used 362,533 times by people using 305,509 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 in December 2014, had been used 82,890 times by 32,388 visitors. People typically stay on for four minutes and look at 12 screens.

2.6 Working with others

Where required, we offer guidance and advice to local GP practices on responding to media enquiries and communicating issues of note to patients.

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

3. Public affairs

3.1 Health overview and scrutiny

At the Kent Health Overview and Scrutiny Committee (HOSC) meeting on Friday 20 July 2018 briefings were presented on:

  • transforming health and care in east Kent

  • East Kent Hospitals University NHS Foundation Trust

  • Getting It Right First Time (GIRFT) Orthopaedics Pilot: East Kent Hospitals University NHS

Foundation Trust

  • Kent and Medway wheelchairs service

  • east Kent out of hours GP services and NHS 111 (written briefing)

The next HOSC meeting takes place on 21 September. At the meeting, briefings will be presented on:

3.2 NHS preparations for winter 2018/19 Kent and Medway wheelchairs service

east Kent CCGs special measures transforming health and care in east Kent including a timetable update and a report on details relating to the number of patients from other council areas that look to East Kent Hospitals University NHS Foundation Trust to provide acute care.

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