Communications, engagement and public affairs update - January 2019


2019 is now underway and I was pleased to present the following Communications and Engagement update report to our NHS Thanet CCG Governing Body this afternoon:

Thanks to David Muir and his team at NEL Commissioning Support Unit for producing the report.

This report highlights activities undertaken since the last governing body meeting.

1. Patient and Public Engagement

1.1 Lay Rep’s Update

Thanet Health Reference Group (HRG) met twice. 0n 13 November they met with Dr Jihad Malasi, our Thanet CCG Chair and on 5 December with our East Kent Director, Caroline Selkirk.

Both meetings lasted two hours and covered a very wide range of patient-raised concerns. Chaired by our Lay Member for Patient and Public Engagement, the group continues to provide valuable support and positive challenge (as a critical friend) to NHS Thanet Clinical Commissioning Group (CCG) on local health service provision.

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. This month’s bulletin provided feedback from recent discussions concerning the Margate Hub project. We also communicate and engage with the network on a broad range of topics concerning NHS service provision in Thanet.

Our lay member (Public Champion) also promotes the work of the CCG in relation to engagement, healthy and active lifestyles and positive causes to 1,100+ followers using social media platforms.

At a meeting of Thanet Adult Strategic Partnership (TASP) on 28th November, our lay member heard concerns from the voluntary sector concerning communication with CCG staff on specific work stream issues. It appeared that some CCG personnel had changed roles and third sector organisations were having difficulty gaining and maintaining contact. A new contact sheet for the East Kent Executive Team, provided by the CCG, was presented to the meeting and went some way to helping this situation.

TASP members also called for a stronger Thanet Health and Wellbeing Board as it is the only public forum at which they could more meaningfully engage with Thanet District Council, Kent County Council, and the NHS.

Our lay member supported the Ageless Thanet 50+ Festival held at St George’s School in Broadstairs on Sunday 4 November and the national annual Ageing Better Conference held at Turner Contemporary on 8/9 November, also hosted by our local Ageless Thanet team. Both events were excellent showcases for examples of best practice taking place locally and nationally in the fight against ageism, social isolation and loneliness.

Our lay member attended both the recent public (pre-consultation) NHS East Kent listening events in Ramsgate on 13 November and in Margate on 20 November. The listening events were part of wider pre-consultation engagement on potential changes to local care and hospital services. Both events were well attended and our lay member would like to thank everyone who supported this latest round of discussions.

East Kent Clinical Commissioning Groups

1.2 Thanet Health Network

Thanet Health Network consists of patients, the public, and representatives of local voluntary organisations and community groups. We also communicate and engage with them on questions about services across Thanet.

A recruitment plan has been developed to increase the number of members on Thanet Health Network. This will be done in various ways such as, face to face with sign up cards by targeting existing groups and seldom heard groups, online through the use of the CCG website and promotion through advertising on social media sites which include Facebook, Instagram and Twitter.

1.3 Margate engagement on development of services for new Bethesda facility

To make sure that the new Margate hub meets the needs of the patients already registered at Bethesda Medical Practice, patients registered at Northdown Surgery, and the local Margate population, the ideas and plans were shared and tested with Margate residents, with four specific questions:

  1. What services should be in the hub and why? Which of these are essential and which desirable? What have we missed? 


  2. Are there any other factors you would like us to consider in terms of the community hub helping to keep the Margate population well? 


  3. What should we consider to make sure the hub is easily accessible and can serve our population? 


  4. This centre and the additional services will be at the Bethesda Medical Practice, but the extended facility is available to patients across Margate, so what should we call it? Suggestions include: community hub, integrated community services, Margate health centre, Margate healthy community hub. What would make sense to people? 


The answers to all of these questions showed consistent concern from people about the possibility of Northdown Surgery merging with Bethesda Medical Practice. There will be separate engagement with local people about this.

Other main themes were:

 Support for social prescribing – working in partnership with voluntary and community organisations to run projects for people who are socially isolated or have mental health issues. 


 A need for good access – this focused mostly on adequate car parking and good access to the building for people who are disabled, but also touched upon the challenges people may face trying to get there on time for an appointment. 


 Transport/travel – this is a real concern for people, especially those living in the Dane Valley and Northdown area of Margate. There will be a need for people to catch two, if not three, buses to get to the building one way and the cost may also become prohibitive for some residents. 


 Concerns about the appointment system – if the number of patients increases, will people be able to get an appointment? This is already a struggle. 


 The need for more appointments – This focused on appointments being available for working adults after 5pm and before 8am on a weekday and more availability at weekends: this fits with the CCG’s recent introduction of more appointments to improve access to GP services. 


East Kent Clinical Commissioning Groups

 Improving information for local people – providing health and wellbeing information and service information more readily available in places people go.

Recommendations

 Engagement and communication to continue throughout this project. 


 Assess the needs of the community to develop a sustainable transport/ travel plan, 
co-designing this with local people. 


 Look at different ways of working within the community to support local people, not necessarily from the Bethesda Medical Centre. 
An engagement report was written to support the full business case which was submitted to NHSE at the end of November.

1.4 East Kent Transformation

Ten public listening events were held between 30 October and 12 December 2018 across east Kent. More than 600 members of the public attended across the ten sessions. The programme for each event included a mixture of presentations (on the case for change and options being developed), whole group question and answers, and facilitated table discussions. Each event ran for three hours. On two occasions (Hythe and Ramsgate) the whole group discussion continued for an extended period so there were no table discussions. Engage Kent attended all sessions as observers and will produce a report on the events.

1.4.1 Key themes from listening events

From the communications and engagement group’s perspective, some key themes from the listening events are listed below. In each case, the comments highlight the need to provide more compelling evidence and to further clarify current challenges and future plans as part of preparing the Pre-consultation Business Case (PCBC) and materials for a public consultation.

 Case for change support – good levels of general support for the objectives of improving care by providing more local services and bringing specialist services together. However, clear expectation of more evidence being made available to support statements about the challenges facing local services. 


 Workforce – concerns were raised about current workforce shortages in primary care, community and hospital services and the impact this will have on the ability to deliver the proposed improvements. A particular focus of comments was on general practice with current workforce constraints already making it difficult to access services and concerns about how general practice could take on more. 


 Travel times – concerns were raised about the potential distance people would need to travel for A&E, maternity and specialist services. Concerns covered both travel in ambulances and by private car or public transport. At several events people questioned the assumptions we are making about travel times from various parts of east Kent. Feedback from areas such as Romney Marsh and Hythe was that existing hospital services were already a long way. 


 Developer’s offer – concerns were raised about the potential risk of the developer’s offer falling through and what impact that would have. Comments about whether the NHS should accept such offers were raised.

East Kent Clinical Commissioning Groups

1.4.2 Public Survey

An online and hardcopy survey ran until 9 December 2018. A total of 774 responses were received. Most responses have been from members of the public with a smaller number coming from NHS staff in east Kent.

The survey asked similar questions to the discussion topics at the listening events e.g. how well people feel the case for change has been made, whether the proposals will improve patient experience and quality of care; and what additional information people would expect to see supporting a public consultation.

An independent report on the results is being produced to support the stakeholder engagement section of the PCBC and preparation for consultation.

1.4.3 Engage Kent undertake Outreach engagement for east Kent transformation

Engage Kent has been commissioned to carry out research with seldom heard groups. They have used a mixture of street surveys and group discussions to gather feedback. and have spoken with over 400 people.

Groups they have attended include:

 Homeless & migrant 


 Mental health 


 Nepalese 


 Slovak & Roma mums 


 Parents with disabled children


Street surveys have focused on geographical areas with multiple indices of deprivation and rural isolation, including: Cliftonville (CT9), Victoria Park (TN23), Shepway (CT20), Northgate (CT1), Minster (CT12), Tenterden (TN30) and Hawkinge (CT18). Surveys were also carried out with students on the Canterbury campus. Further meetings and street surveys continued in December, with additional visits to areas where we were not able to run public listening events including Romney Marsh, Whitstable, and Deal.

1.4.4 Out of area patient and public engagement

The East Kent Hospitals University NHS Foundation Trust (EKHUFT) runs a number of specialist services with a catchment area beyond east Kent. These services include haemophilia outpatients, Primary Percutaneous Coronary Intervention (PpCI) and renal inpatients. The number of patients from outside east Kent using these services (and the percentage of EKHUFTs activity for each service) is relatively low; however a programme of targeted engagement with patients will be taking place in January.

1.4.5 East Kent transformation next steps

A full report from the Oct-Dec 2018 pre-consultation engagement activities will be prepared for the East Kent Transformation Delivery Board and will be used to support the next stage of evaluation of the current options. It will also be included as part of the stakeholder engagement content for the PCBC. The communications and engagement group are currently developing a plan for ongoing stakeholder engagement between now and the public consultation to ensure we continue to gather feedback and provide progress updates to stakeholders and inform the plans for public consultation. An initial discussion with the Patient and Public Advisory Group about consultation planning is being held in January.

1.5. Kent and Medway Patient and Public Advisory Group

The Public and Patient Advisory Group (PPAG) continue to meet each month. We have successfully recruited new members and are currently inducting them and seeing which of

East Kent Clinical Commissioning Groups

the Kent and Medway Sustainability and Transformation Partnership (STP) work streams they would be interested in joining. PPAG members are now each involved in at least one of the STP work streams, making sure a patient/lay perspective at a more detailed level across the programme. We have shared the co-production approach across all work streams and we are encouraged to hear that several are intending to use it: local care and the development of the carer’s app, mental health has identified several opportunities and prevention also wants to use it.

In November we had positive updates on:

 the clinical vision captured on a single page shows the influence of patient’s 
perspectives 


 the prospective medical school has appointed a Foundation Dean, Professor Chris Holland. He has assumed leadership of the school. 100 places were approved in spring 2018 and the two partner universities immediately began the multiple, inter- related pieces of work required to gain the necessary accreditations 


 the changing governance arrangements for local care 


 the Kent and Medway Care Record, having finalised its outline business case, is 
ready to proceed to procurement. 
2. Spreading the word through the media and other communications 
2.1 News releases 
We have sent out five news releases across all four CCGs since the last governing body meeting. These announced the additional east Kent listening events, the third award in a year for the Mind and Body programme, reminded residents to take up their flu vaccination and promoted Self Care Week. 
2.2 Web articles 
We published an update on the Kent and Medway wheelchair service, promoted free suicide prevention training offered by Kent County Council and the east Kent winter patient newsletter. 
Top 5 pages 
1. Prescribing Recommendations 2. About Us
3. Governing Body
4. Contact Us 
5. Who we are 
Web Updates 


 Web banner and news article for Suicide Prevention Training 


 A number of news articles 


 General admin support 


 Adding new categories 


 Adding new Intranet users
The NHS Thanet CCG website has been viewed 4,440 times in the past two months. 


East Kent Clinical Commissioning Groups

2.3 Social media

Since the last governing body meeting, we have sent out an average of 80 tweets from each CCG account. These included promoting the east Kent listening events, details of governing body meetings and all news releases. We supported national campaigns such as Flu, Stoptober, Improved GP access plus awareness campaigns including self-care, alcohol awareness and diabetes. We also supported provider messaging for East Kent Hospitals University NHS Foundation Trust, Kent and Medway NHS and Social Care Partnership Trust and Kent Community Health NHS Foundation Trust. In addition, we promoted stay well in winter messaging (aligned to the national campaign Help Us Help You) including pharmacy, minor injury units, GP, NHS 111 and Health Help Now plus social prescribing such as parkrun and Active10. All four accounts have seen an increase in engagement and new users in this period.

NHS Thanet CCG Twitter account now reaches 14,700 people.

2.4 Urgent care communications

The Kent Health Help Now web app, which launched in December 2013, has now been used 374,269 times by people using 314,910 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 93,400 times by 38,136 visitors. People typically stay on for five minutes and look at 13 screens.

3. Public affairs

3.1 Health overview and scrutiny

At the Health Overview and Scrutiny Committee (HOSC) meeting on 23 November, briefings were presented on:

 Kent and Medway Strategic Commissioner 


 South East Coast Ambulance Service NHS Foundation Trust (SECAmb) 


 CCGs Annual Assessment 2017/18 (Written Update) 


 Kent and Medway Integrated Urgent Care Service Procurement 


 Kent and Medway Non-Emergency Patient Transport Service Performance. 
The next HOSC meeting is on Friday 25 January 2019. The meeting schedule for 2019/20 has been published. 
Following the April 2019 meeting the dates move away from traditionally being held on a Friday. 
The dates are as follows: 


 Friday 25 January 2019 


 Friday 1 March 2019 


 Friday 26 April 2019 


 Thursday 6 June 2019 – newly published from this point onwards 


 Tuesday 23 July 2019 


 Thursday 19 September 2019 


 Tuesday 26 November 2019 


 Wednesday 29 January 2020 


East Kent Clinical Commissioning Groups

 Thursday 5 March 2020 


 Wednesday 29 April 2020. 
3.2 Stakeholder briefings 
A briefing note was prepared for members of the Medway Health and Adult Social Care Committee (HASC) on the Kent and Medway wheelchair service. 
Briefings were prepared in response to a letter to the Secretary of State from Craig MacKinlay MP on the Kent Stroke Services reconfiguration and a letter from Kevin Hollinrake MP on behalf of a constituent who was in need of an A&E whilst visiting east Kent, and who raised some concerns about provision in the area. 
Background: 
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. 
Assessment: 
The CCG has a statutory duty to involve patients and the public in their work in a meaningful way. 
It is important that the CCG involves people in commissioning to improve health and care services and that it meets its legal duties to do so under the National Health Service Act 2006 under sections 14Z2 and 13Q respectively. 
The actions described in this report are part of an ongoing programme of activity to involve patients and the public in commissioning in a meaningful way and one which enables them to make informed decisions about their health care and to give the Governing Body assurance that it is meeting its legal duties. 


Recommendation: 
That the governing body note this report. 


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Clive Hart