Table of Contents Document Page 7 8 - 170622 PPP ... · (10) Item 11 12. Any Other Business --...

Table of Contents

Document Page

1 1.0 PPP Agenda final 32 3 -May Draft PPP minutes Final 53 3.1 - PPP Action Log July 2017 114 3.2 Extract Islington CCG Risk Register Complete_v60 135 6 - PPP Committee Urgent Care Report 2017-06-28 156 7 - 20170623 CYP Parents Involvement PPPC Report Revised 197 8 - 170622 PPP Communications Report FV 298 9 - PPP Strategy update July 17 339 10 - PPP Committee ToR DRAFT_kt_final 4710 11 - Agenda Planner PPP Committee 2017-18 51

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Agenda

Please look over the agenda and think about which of these topics might present an area of conflict for you.

This means an item where a decision or recommendation made may advantage you, your family, and your workplace or business interests. These advantages might be financial or in another form, perhaps the ability to exert unseen influence.

Where anything on the agenda has the potential to put you in such a position, or is raised during the meeting, you should tell us all about it. This means we can ensure that our decisions, recommendations or actions can be protected from the impact of any possible conflict you or others could have.

If you are unsure it is always best to raise the possibility with the Chair before the meeting, or at any point during the meeting. This openness is important as we can all discuss how to manage decision making in a complex environment that involves public money.

Item Lead Timings Papers

1. Welcome and Apologies Chair 10:00-10:05 (5)

--

2. Declarations of Interest Chair 10:05-10:10 (5)

--

3. Minutes of the last meeting 3.1 Action Log 3.2 Risk Register

Chair 10:10-10:20 (10)

Item 3.1 and 3.2

4. Matters Arising Chair

10:20-10:35 (15)

--

5. Sustainability and Transformation Plan Update

Jo Sauvage 10:35-10:45 (10)

Verbal

6. Urgent Care Update Report Dan Windross 10:45-11:00 (15)

Item 6

7. Childrens' Commissioning Update Report

Sheron Hoskins 11:00-11:15 (15)

Item 7

8. Communications Update Report John Pritchard 11:15-11:25 (10)

Item 8

9. PPP Strategy and action plan update

Elizabeth Stimson 11:25-11:35 (10)

Item 9

10. Committee Terms of Reference annual review

Chair 11:35-11:45 (10)

Item 10

11. Committee Workplan Chair 11:45-11:55 (10)

Item 11

12. Any Other Business -- 11:55-12:00

(5)

13. Date of next meeting: Thursday 7th September 2017 at 10.00-12.00 (TBC) Deadline for submission of reports: 21st August 2017

Patient and Public Participation Committee Seminar Room, Second Floor Laycock Professional Development Centre Laycock Street, London, N1 1TH Thursday 6th July 2017

10.00-12.00

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Item: 3

Minutes

Patient and Public Participation Committee Thursday 4th May 2017

Seminar Room, 338-346 Goswell Road, London EC1V 7LQ Members Present: Sorrel Brookes SB Lay Member Kay Dixon KD Community Member Pamela Moffatt PM Community Member Deborah Snook DS Joint Practice Manager Representative Jo Sauvage JS CCG Chair (via phone) Dr Katie Coleman KC CCG Vice-Chair, PPP Committee Chair Nicola Maskrey NS Collaborative Commissioning, Islington Council In attendance: Emma Whitby EW Chief Executive, Healthwatch Islington Elizabeth Stimson ES Engagement Lead Rebecca Muncey RM Engagement Officer Apologies: Jennie Hurley JH Practice Nurse Representative Minutes: Muna Ahmed MA Interim Corporate Support

1. Apologies for Absence: Apologies were received from Jennie Hurley 2. Declaration of interests DS declared her attendance at the South West CHINS meetings.

KC declared her attendance at the CHINS meetings.

3. Minutes and Action Log & Risk Register The following amendments are required before the minutes from the March meeting can

be approved. Item 5. First paragraph should read “This is an agenda item…” Item 5. Last paragraph – “Who’s health is at risk” Item 5. Paragraph “RL updated…” It was queried who will be the delegated authority. It was agreed to delete the last line in the paragraph. Item 5. Paragraph “JH is keen to…” a space is required between “…support the…” Item 7. Typo “Highlighted the” is typed twice Item 9. Paragraph after bullets to be reworded to reflect that NHS England capture data at a high level and are therefore unable to break it down by CCG. Date of next meeting is incorrect – it should read 4th May. Action log 16.02-04 Planned care on agenda – close. 16.02-05 Personal Health Budgets paper not received. KC updated all that PHB will mainly be targeted at those with Multiple Sclerosis, continuing healthcare needs and children in transition to adult services. KC suggested an update paper on PHBs given the time lapsed and progress. The update to include any learning and impact on services.

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Item: 3

Action 17.05-01: Personal Health Budgets update report to be added to forward planner (Clare Henderson to identify who will present this). 07.04-10 Close 05.01-03 The action was unclear, as social isolation is covered by the work of PPP Committee. It could possibly relate to Jess McGregor looking at social isolation in the Prevention Strategy. ES to look at January minutes to clarify action on social inclusion and close. Additional action not picked up from March minutes – EW to update on Haringey’s involvement of people in the Wellbeing Partnership. Haringey is setting up a reference group for users of mental health services across NCL (the 5 CCGs), to feed into service design and commissioning. All boroughs are represented by the reference group. Each workstream needs to be clear on how it will involve patients and the public. Healthwatch would like to have oversight of the involvement of patients and public in the Wellbeing Partnership. Islington CCG (ICCG) will be meeting with Haringey in June and will seek to assure itself that PPP is embedded across ICCG and Haringey. Action 17.05-02: KC to provide feedback from meeting between ICCG and Haringey (in June) at PPP Committee meeting in July. As of June, ICCG will look to formalise how it supports PPP and will also be raised with Tony Hoolaghan (incoming Chief Operating Officer for Haringey and Islington CCGs). Risk Register It was suggested that the risk of PPP not being carried out properly, should be added to the risk register, as well as transition and working in more of a partnership. It was queried whether Jennie Williams, or someone from the quality team needs to attend the Committee in future. Action 17.05-03: ES to raise with Frazer Tams the risks to be included in the risk register, regarding PPP not being carried out properly, transition and working in more of a partnership. Action 17.05-04: ES to raise Director of Quality attendance at PPP Committee at meeting with Haringey in June.

4 Matters Arising None 5. Sustainability and Transformation Plan (STP) update Overview of commissioning structure

Helen Pettersen – NCL Accountable Officer, started 1st April 2017, is the lead for STP, Accountable Officer for the 5 CCGs and will be working with an existing team. Helen’s senior team will be the following 3 people, who will take up their positions from 1st June. They will be based at Haringey CCG in Wood Green but will travel between the 5 boroughs. Simon Goodwin – Director of Finance Will Huxter - Director of Strategy Paul Sinden – Director of Acute Care and Performance Tony Hoolaghan – Chief Operating Officer for Haringey and Islington CCGs, will also start on 1st June.

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Item: 3

JS has met with Tony and discussed the need to align and co-produce what the future looks like for ICCG with Haringey. Branding for ICCG also needs to be considered. A consultation process has been taken forward by Paul Sinden and Head of Corporate Governance at Camden, to design the function and structure of the Joint Committee for the 5 CCGs for commissioning services, primarily for acute services, integrated, urgent and emergency care and transforming care. There will be an away day on how the Joint Committee will work together. STP – a letter was received from NHS England and NHS Improvement on 3rd April, sent to Chief Executives and Accountable Officers within NCL, highlighting the requirement to produce a cap on expenditure programme (CEP) in STP areas where efficiency savings can be made. A meeting was held between system leaders to look at services which are not providing cost effective services, nor providing high quality care. Main areas identified are:

- mental health, - lack of availability of step down resulting in long delays in transfer of care

(DTOCs), - specialist commissioning, - medicines management in Primary Care to improve quality and savings, - collaborative working across the 2 mental health Trusts.

Work on CEP is currently on hold until after the election. JS went through the NCL STP slides developed by Gen Ileris (NCL STP communications and engagement lead) and highlighted: Rewrite of the draft plan and a public summary in plain English – to review whether the plan is achievable, look at how we develop CHINS, how we deliver integrated, urgent and emergency care and look at elective/planned care pathways and standardise services. The plan will be updated to include King’s Fund and Nuffield reports, phase 2 of five year forward view, spring budget social care funding and Brexit. The public summary will include financial transparency of STP. Communications and engagement plan – a draft was sent out for feedback, which is currently being collated. It was generally felt that the plan was focussed on communication and telling people about the STP, rather than engagement. ES is working closely with Gen and identified a lack of resource, as Gen is the lone communications and engagement lead for NCL STP. It was highlighted workstream leads do not always attend the monthly communications and engagement working group. Gen and ES are working on engaging workstream leads. Development of the website – branding has now been designed. It was discussed if this needed to be co-produced. However, it was highlighted that this was actually not as important for local community engagement and co-production as service and plan development. It was highlighted there needed to be commitment to engagement running through the STP. NM highlighted that support engagement guides had already been created – and shared with workstream leads but these should be actively used along with sharing the Council’s informing, involving, engaging, consulting and co-production. KC highlighted that ICCG has developed such strong engagement through its leadership recognising and actively supporting the importance of PPP and a layered approach which sees local residents are embedded in decision making. It was suggested that we advertise for local residents to attend the Board and then use the same approach for all Boards / working groups. This approach follows:

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Item: 3

Residents sat (approx. 2 per group) on every working group and Committee (all residents have a short interview and application process – acknowledging certain skills are needed to participate)

Some formal regular groups set up – such as islington wide patient groups for engaged members of community

Targeted engagement and co-design on specific services – with us going out to local communities rather than them coming to us

Working with voluntary sector – often commissioning small pieces of community insight through them

And, working with local patient groups already set up to gather community insight Strategic engagement pieces looking at how we shape our services – again

seeking that we go out to the local community rather than asking us to come to them, and asking questions in a way they can understand – facilitating their voice so they can co-design even if they have limited time to give

And, a community development and self-care approach – which looks at individual engagement

It was highlighted there is limited resource for STP engagement team – there is a lead who covers comms and engagement who works with each engagement team across the 5 CCGs. However, there is no formalised process in place and varies between the CCGs. A proposal was put forward to hold a PPP Summit to look at how we engage across North London Health and Care Partners – and explore ways the engagement support for the STP could be developed. It was suggested we invite Tony Hoolaghan to the next Committee. It was agreed we would share this section of the minutes with JS, to then share with the STP strategic team to highlight the concerns and discussions we are having around engagement. STP will be a standing item on the agenda going forward. Action 17.05-05: Proposal for a PPP Summit across STP Action 17.05-06: Tony Hoolaghan to be invited to a PPP Committee. Action 17.05-07: Discussion on engagement to be sent to JS to share with the STP strategic team.

6. Planned Care and VBC update RK provided a summary of the Planned Care workplan, which is linked to STP and

includes local priorities. The workplan continues to evolve. RK highlighted:

- Development of CHINS – which will be a vehicle for how Planned Care can be provided

- STP requires a reduction in all Planned Care activity, except 1st outpatient appointments.

- Respond to analysis of data provided by NHS England via RightCare programme, looking at and comparing variations and reduce those variations.

Workstream plan

- Musculoskeletal services transformation (MSK) Objectives are: To articulate a clear model of care across all MSK services. Improve experience of booking and receive the correct appointment. Improve communication, increased education and support with self-care.

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Item: 3

RK will ensure that patient and carer feedback is central to the model. Engagement has already taken place which has developed the business case. There are 2 engagement meetings planned for June, to discuss with patients any complex issues identified in the business case, before it is taken to the Wellbeing Partnership Board. PM noted that wheelchair service and cost are not mentioned in the paper. . KC clarified that the local authority provides wheelchair services which was recently re-procured. RK is working with the council which links in with social care and will ensure access to wheelchairs is included as part of planning. There was a discussion about how we prepare MSK patients before their physiotherapy appointments. Development of patient information sheets was suggested. There was consensus that a clinician/consultant should go through the physiotherapy exercises with the patient first, before referring them to videos/self-care. It was acknowledged that some people will need more assistance than others and that the public needs to be consulted. KC suggested Whittington Health carry out some research on shared decision making. Additional planned care projects:

- Dermatology – it was found that the community dermatology service had low activity and wasn’t fulfilling the aims of the service. Following feedback from an online survey, it was agreed to close the community service and re-commission the activity in secondary care and look to further developing the service i.e. more advice and guidance for GPs, an urgent clinic and triage of referrals. Dermatology will be a focus of STP and will therefore need to ensure there is a coherent model across NCL and that the engagement activities are aligned.

- Ophthalmology – there was a procurement exercise with City & Hackney CCG

(last year), to introduce a minor eye condition service. Healthwatch was commissioned to deliver patient engagement to inform the service specification. The procurement was unsuccessful. The 2 CCGs are currently negotiating service provision with existing providers.

Concern was raised about “Repatriation of work from non NHS services”, as it was felt this would not address the long waiting lists and that this is not a long term solution. It was clarified that the provider will commission the non NHS services and will need to meet the targets set by CCG. RK will relay the feedback to STP programme manager and the need to give clear explanations for patients and public on plans. Action 17.05-08: Template with strategic goals to be shared with commissioning managers when requesting reports.

7. Care closer to home integrated networks (CHINS) engagement

The CHINS design brief shows a clear, strong commitment to working with local residents around community research and holistic community projects. The CCG engagement team will work with CHINS and Quality Improvement Support Team (QISTs) (each CHIN has a QIST), to develop a community engagement and development plan, looking at:

- what research is available, - public health population data, - any gaps identified.

To engage the CHINS populations by:

- using existing projects, - commission local organisations to work with their client groups, - additional outreach, - survey through practices and focus groups, - ensuring there is community representation on any working groups and

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Item: 3

- providing feedback on any findings and research and how they will be used in the development, to the specific CHIN populations.

Looking to recruit 2 more community members to each CHIN. CHINS have assigned £50K for community development/innovation for each area. The proposal is to look at current effective projects and build upon them. North and South West CHINS are already looking at engagement that has already taken place with South West looking to also hold an introductory event for residents. ES and EW will be meeting with North CHINS to discuss engagement.

8. Committee work plan Work plan to be reviewed outside the meeting. 9. Any other business 1. Concern was raised about the 360 feedback survey, as it was felt it had not been

distributed widely enough. Action 17.05-09: ES to ensure the distribution list for 360 feedback survey is correct and up to date.

10. Date of next meeting Thursday 6th July, 10:00 – 12:00, Seminar room, 2nd floor, Laycock Professional

Development, Laycock Street, London, N1 1TH

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Appendix 3.2

Meeting

Date

Minutes

Reference

Action Description Responsibility Target Date Progress Details

05.01.17 05.01-03 ES to look at how social isolation can be incorporated in to the work of the committee going forward.

Elizabeth Stimson Mar-17 04.05.17 ES to look at January minutes to understand action, before closing.

04.05.17 17.05-01Personal Health Budgets update report to be added to forward planner (Clare Henderson to identify who will present this).

Muna Ahmed Jul-17

04.05.18 17.05-02KC to provide feedback from meeting between ICCG and Haringey (inJune) at PPP Committee meeting in July.

Katie Coleman Jul-17

04.05.19 17.05-03 ES to raise with Frazer Tams the risks to be included in the risk register,regarding risk of PPP not being carried out properly, transition andworking in more of a partnership.

Elizabeth Stimson Jul-17

04.05.20 17.05-04ES to raise Director of Quality attendance at PPP Committee at meetingwith Haringey in June.


04.05.21 17.05-05Proposal for a PPP Summit to be considered with Tony Hoolaghan duringco-production discussions.

Katie Coleman Jul-17

04.05.22 17.05-06Tony Hoolaghan to be invited to a PPP Committee.

Muna Ahmed Jul-17

04.05.23 17.05-07Recommendations from the STP communications and engagementdiscussion to be collated for JS to share with the STP strategic team.


04.05.24 17.05-08Template with strategic goals to be shared with commissioning managerswhen requesting reports.

Muna Ahmed Jul-17

04.05.25 17.05-09ES to ensure the distribution list for 360 feedback survey is correct and upto date.


ACTION LOG: Patient & Public Participation Committee

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Version: 55 Islington CCG risk register

3 27/04/2017 11:39

ID, C

ategory

Heading

Objective

Programm

e affected

Principal riskWhat could prevent this objective being achieved?

Describe in terms of cause, event, effect.

Risk A

pproach

Proximity D

ate

Initial Consequence

initial Likelihood

Initial Rating

MitigationExisting mitigating controlsPlanned mitigating controls

Gaps in mitigation, and action plan

AssuranceExisting assurancePlanned assurance

Gaps in assurance, and action plan

UpdateMost recent on top

Current C

onsequence

Current Likelihood

Current R

ating

Date last review

ed

date of next review

Risk lead ( risk ow

ner where blank)

Risk ow

ner

Status

Com

mittee

320 R

Involvement w

ith patients and public

Statutory Obligations and C

ore B

usiness

Core B

usiness: Quality and Integrated

Governance

Involvement with patients and publicIf the CCG fails to engage effectively at a time of change the CCG may not meet its individual or collective* duties to involve patients, service users, carers and residents. This could damage the CCG’s reputation lead to legal action and impede the CCG’s effectiveness in planning and delivering high quality healthcare services to our residents.*Duties relate to• Individual: commissioning Self-care for individual patients• Collective: commissioning of programmes of work e.g. peer support, behaviour change and support for self-management

Mitigate

Ongoing

3 3 9

Current ControlsPatient and public participation (PPP) strategyPPP Committee Regular reports from programmes of the CCG on progress against the PPP StrategyParticipation & dialogue with groups• Twice-yearly Islington patient participation group• Voluntary sector forum• Last years of life patient group• We have patient and community representatives on CCG working committeesYearly programme of community research to support commissioning intentionsTargeted community research to support particular programmes and projects

Current assuranceThe reporting of progress against the strategy to the Governing BodyAnnual review of PPP committee terms of reference.Minutes and reports of the PPP Committee are presented to the Governing BodyReporting of qualitative and quantitative progress against PPP action plan.Assurance review by NHS England of the CCG's collective and individual dutiesAnnual Engagement report.

No change from previous meeting

3 2 6

01/03/17

01/06/17

PP

I & E

ngagement M

anager

Director of Q

uality and Integrated G

overnance

Open

Patient and P

ublic Participation

Com

mittee

321 R

Statutory duties around equality and diversity

Statutory Obligations and C

ore Business

Core B

usiness: Quality and Integrated G

overnance

Statutory Duty on Equality and DiversityThere is a risk that the CCG will not meet its statutory requirements on equality and diversity if it does not actively respond to inequalities existing within the health and care economy.This could lead to legal action, damage the CCG’s reputation and hinder the CCG’s ability to plan and deliver high quality health care services to our residents

Mitigate

16/11/2015

3 3 9

Current controlsEquality and diversity are part of mandatory training.Regular planned discussions on equality with PPP (Patient & Public Participation) Committee, Governing Body, patient groups, and staff groupsThe PPP Strategy has an explicit equality statement which has been shared with stakeholders and staff Staff equality objective has been setEquality and diversity objectives are part of the PPP strategy. Strategy).Use of workforce equality and race standard toolDelivery of unconscious bias training

Current AssurancesThe CCG has verified and reported on the achievement of equality objectives and is actively monitoring progress for 2016/17Equality Objectives report publishedThe staff organisational development group and has reviewed the equality actions that address concerns raised through the staff surveyOver 80% of staff throughout the last 12 months have been up to date with equality and diversity training.Equality Objectives of CCG meet the Equality Delivery standard.Progress on meeting equality Objectives is reported to Executive Management Team and PPP committeesPositive internal audit report Jan 16

No change from previous meeting

2 2 4

Patient and P

ublic Participation C

omm

ittee

Open

Director of Q

uality and Integrated Governance

PP

I & E

ngagement M

anager

01/06/17

01/03/17

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MEETING: Patient and Public Participation Committee DATE: 12th July 2017 TITLE: Urgent Care Update LEAD COMMITTEE MEMBER:

Clare Henderson, Director of Commissioning, Primary Care and Integrated Services

AUTHOR: Dan Windross, Primary and Urgent Care Manager CONTACT DETAILS: [email protected]

Purpose This report is for ASSURANCE This report provides assurance and identifies any consequent risks to the Committee on the Urgent care work streams.

Overview: This report provides an overview of the Urgent Care work. It seeks to highlight the patient and public participation activities that have taken place. Within Islington CCG, Urgent Care sits across two key teams; Primary Care and Integrated Care. The key areas of work described by this report are;

1. The procurement and ongoing contract management of Integrated Urgent Care (the combined 111/OOH service)

2. The procurement and ongoing contract management of the IHUB service (procured as the Extended Access service)

3. The developing Urgent and Emergency Care work streams under the Sustainability and Transformation plan

Issues to be considered Patient and Public engagement in work streams to date and relevant planned work streams Key risks (including those on the Corporate Risk Register) Inadequate patient and public engagement. We recognise that the Urgent Care offer across North Central London can appear fragmented and confusing to patients. We are seeking to standardise this offer by, where possible, developing shared specifications and contracts. This report details the development of two such shared contracts; Integrated Urgent Care and Extended Access.

1. Integrated Urgent Care (IUC)

Integrated Urgent Care is the name given to the service which replaced (and brought together into one service) two previous services, 111 and Out of Hours (OOH) General Practice. The intention is to simplify the offer and reduce duplication. 111 is the free number to call for urgent healthcare needs. It is described as the right number to call when patients need medical help fast, but it’s not a 999 emergency.

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mailto:[email protected]

2

Out of Hours services refer to provision of General Practice services outside of the ‘core hours’ of 8am-6.30pm. GP’s can choose either to provide a 24/7 service or to ask the CCG to commission a service to deliver this for them. All practices in Islington have chosen to ‘opt-out’ of providing this service themselves and are therefore covered by the integrated urgent care offer. Islington, alongside all five NCL CCG’s, commissioned an Integrated Urgent Care service which started in October 2016. This service is provided by LCW (London and Central West Unscheduled Care Collaborative), a GP led not-for-profit organisation. The service receives about 4,000 calls a month from Islington patients. 1.1 Patient Engagement in Procurement

The procurement of IUC involved considerable public engagement as follows; Establishing a Patient and Public Reference Group (PPRG). This Group had

representatives from all CCG’s and Healthwatch organisations across NCL. The group had the opportunity to comment on the specification and make detailed comments and recommendations

The proposed service specification was published on all 5 CCG websites across July and August 2015. Over 800 comments were received.

The feedback from engagement was summarised and incorporated into the service specification as an appendix

Members of the PPRG were closely involved in assessing and awarding the contract, including assessing formal presentations from bidders

1.2 Patient Engagement in Contract Management

The CCG’s key contract management function is through monthly meetings with LCW. These meetings review delivery of the service against the contract. They are chaired by the Clinical Lead for Urgent and Emergency Care in NCL and are attended by the Chief Executive and Medical Director of LCW. Each CCG benefits from a patient representative. These representatives receive all paperwork shared at the meetings, including Key Performance Indicator reports and analysis of serious incidents. 1.3 Next Steps; Improving Patient Experience within IUC

Islington CCG is working with Islington Practices to commence direct booking to GP practices from 111. This means patients will phone IUC, and, where appropriate, be directly booked into an appointment in their own practice instead of being asked to ring their practice to book an appointment

IUC is trialling online applications to allow patients access to health advice via the internet We are reviewing the current range of Key Performance Indicators. The patient

representatives will be involved in this process

1.4 Media Incident

On 2nd April 2017, the Sun newspaper published an article from an undercover reporter in the IUC offices which provide services to Islington residents. This report made a number of allegations about the service, including finding traces of cocaine in the toilets and call handlers placing suicidal callers on hold. This incident has been fully reported to the Contract Management meetings and remains under investigation. It has been treated as a serious untoward incident by LCW. Reports of the findings will be taken to the CCG’s Quality and Performance Committee.

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3

2. IHUB (Extended Access)

IHUB allows patients to book a Primary Care appointment outside of core hours. The service runs from 6:30pm-8:00pm on Monday to Friday, and 8:00am-8:00pm Saturday and Sunday. The service provides GP and Nurse appointments at three ‘hubs’ across Islington – Ritchie Street, Islington Central and Andover practices. Up to April 2017, the service was a pilot site funded directly by NHS England. From April 2017, the service was procured directly by Islington CCG, working alongside the four other CCG’s in North Central London. Islington CCG awarded the contract to Islington GP Federation. 1.5 Patient Engagement in Procurement

Islington CCG appointed a patient representative to sit on the group overseeing the procurement process. This role included developing the specification, attending market engagement events to meet potential providers before moderating tenders and awarding the contract. 1.6 Patient Engagement in Contract Management

Islington CCG is currently exploring with the provider how best to involve patient representation in the contract management process. We currently have no involvement. We are considering replicating the ‘reference group’ that was developed during the NHSE pilot phase. This group had membership from Healthwatch Islington and provided local support and context to the pilot. Some of the functions of the group have now moved to contract management by Islington CCG, so the structures have had to be reviewed. In response to recommendations from Auditors, and in recognition of the different status and associated risks relating to contracts awarded to the Islington GP Federation (as a provider organisation made up of general practice), Islington CCG has set up a group to provide oversight of this relationship (between Islington CCG and the Islington GP Federation). This group is chaired by a CCG Governing Body Lay Member. 1.7 Next Steps; improving patient experience within IHUB

We are working on cross border opportunities; we want to develop reciprocal agreements to allow patients to book appointments with extended access hubs across NCL.

The service will allow unregistered patients to access General Practice in Islington. We are working with the provider to develop a rapid registration process to enable patients to access appointments in evenings and weekends while registration is processed.

We are working with the provider to explore new appointment types, including group appointments, travel clinics and so on.

3. Sustainability and Transformation Plan (STP) and Future Developments

This section provides an overview of the Urgent and Emergency Care (UEC) work stream, as one of the key areas within the NCL STP. Much of this work is at early stages, apart from Integrated Urgent Care, consequently this section of the report is included for information. Equality Impact Assessments have been completed and communication / engagement plans are being developed. The UEC work has five key areas as follows

Enhanced Community Based Admission Avoidance – joining up of all community based admission avoidance services to support patients to receive care at home, supported by a

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4

single point of access, developing services in acute trusts to support same day emergency care and developing admission avoidance / ambulatory care models.

Acute Frailty Pathway – enabling rapid, early, risk based assessments of elderly people by senior geriatricians and the provision of diagnostic support, therapy, mental health teams, access to care in the community 7 days a week and access to rehabilitation teams through a single point of access,

Last Phase of Life – improving the quality of care for patients in the last 12 months of life by focussing on care homes, linking palliative care services to provide 7 day advice and single points of access, exploring telemedicine opportunities in palliative care

Integrated Urgent Care – as set out above Simplified Discharge – establishing trusted assessor models to drive single assessments,

and 7 day community services to support 7 day discharges, improving patient flow through the hospital, specific focus on stroke admissions and discharge processes

In addition, the UEC board will be overseeing responses to designation criteria – these are new standards being developed by NHS England against which urgent care services will be measured. The UEC workstream is overseen by a UEC Board. This group has membership from Healthwatch and from the Voluntary Sector. Our intention is to bring further updates on the STP work as this develops. 4. Conclusion

Urgent Care is a key area of work for Islington CCG. As an area of critical importance to patients and the health care system, we recognise that the current offer is fragmented and confusing. We are using the opportunities brought by the STP and closer working across CCG’s to provide a more consistent offer. We have demonstrated how we have done this with two key areas; Integrated Urgent Care and Extended Access. This report sets out the areas for future development under the STP UEC plan.

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of 9

MEETING: Patient and Public Participation Committee DATE: 6th July 2017 TITLE: Involvement of children and young people and their parents in the design

and delivery of health services. LEAD COMMITTEE MEMBER:

Dr Katie Coleman

AUTHOR: Sheron Hosking Head of Children’s Health Commissioning

CONTACT DETAILS: [email protected] 0207 527 1772 Purpose This report is for ASSURANCE This report provides assurance and identifies any consequent risks to the Committee in relation to the involvement of children and young people and their parents/carers in the design and delivery of health services. Overview: The work of the Children’s Health Commissioning Team (CHCT) is underpinned by the Children and Young People’s Health Strategy 2015 - 2020 which reflects the key principles of the ICCG Patient and Public Participation Strategy. The strategy has meaningful engagement with children, young people and their parents and carers at the heart of its delivery. This report sets out the key areas of work delivered over the last year by CHCT and its partners in line with the objectives set out in the CCGS Patient Public Participation Strategy and also sets out some key issues for further discussion by the committee to inform future working. Over the 2016/17 period the Children’s Health Commissioning Team have directly engaged with 104 young people (aged 13 to 25) and 41 parents / carers throughout a range of stages of commissioning, including development, design, procurement, delivery and monitoring of services. Context: This report provides an overview of the involvement work that has been carried out in relation to the Patient and Public Participation Strategy and the Children and Young People’s Health Strategy Action Plan. This work was led by the teams Participation Officer (in the first part of the year), supported by the Children’s Health Commissioning Team (CHCT) and in some cases directly delivered by commissioned services. The team’s participation officer resigned from post in August 2016 and it has taken 2 rounds of recruitment to fill the post. Children and young people played a key role in this recruitment process. The new post-holder will take up post in August 2017. This report frames activity under the four key objectives set out in ICCG Patient and Public Participation Strategy. Issues to be considered:

1. How can we further utilise Youth Health Platform to inform the development of broader CCG initiatives and in particular the development of primary care services in Islington?

2. How do we further develop the delivery of the ‘You’re Welcome’ programme across local health services in Islington? Do we want to consider how we utilise the programme in

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Primary Care? 3. What can we learn from the delivery of self-management programmes in Adults to inform the

development of self-management initiatives with children and young people? Key risks (including those on the Corporate Risk Register)

1. It may be difficult to re establish Youth Health Platform following a long gap without a participation officer in post.

2. The CCG may not have the funding to do the things that children and young people say they want

Outline the impact and outcomes of public and patient involvement The Children’s Health Commissioning Team has engaged with young people, parents and carers throughout the teams’ programmes and through specific projects. This has led to specific outcomes which are identified across the engagement activity within the report. Impact Assessments: This report does not include any reference to de-commissioning so Impact Assessments have not been carried out

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Involvement of children and young people and their parents in the design and delivery of children and young people’s health services.

Children’s Health Commissioning Team.

1. Introduction 1.1 The work of the Children’s Health Commissioning Team is guided by the Children and

Young People’s Health Strategy 2015 - 2020 which also incorporates the CAMHS Transformation Plan. Meaningful engagement and participation is at the heart of the delivery of this strategy in line with the key objectives of the ICCG Patient Public Participation Strategy.

1.2 Over the 2016/17 period, the Children’s Health Commissioning Team have directly engaged

with 104 young people (aged 13 to 25) and 41 parents / carers throughout a range of stages of commissioning, including development, design, procurement, delivery and monitoring of services. There has been additional engagement with children, young people and parents/carers by commissioned service providers that we have supported. This is more difficult to quantify but is in the region of 135 young people.

1.3 This report provides an overview of work that has been delivered by both the Children’s

Health Commissioning Team and its partners. 2. Objective 1 - To support people to look after their own health and build the number of

people who self-care in Islington 2.1 During the consultation period of the ‘Children and young People’s Health strategy’ children

and young people told us:

I need good quality information and support so I know how to look after my physical and emotional wellbeing

I need as much support as possible to stay healthy in the places I spend most of my time

2.2 It is with this in mind that a key action from the ‘Children’s and Young People’s Health Strategy’ is to empower children and young people to self-manage their long term conditions. The CCG has made a number of investments to empower children and young people to self-manage in primary care, secondary care, community services and schools, but much work remains to be done.

2.3 Under the Health and Wellbeing priority for Islington Youth Council (2016-18) the Youth Councillors aim to promote health and wellbeing services to young people using their social media platforms and signposting to the range of health information in izzy.info. The Participation Officer shares information about health and wellbeing services and health care changes with the Youth Council.

2.4 The CCG continues to make a number of investments in nurse specialist roles located in secondary care, the community and primary care. These roles include clinical nurse specialist roles in allergy, epilepsy, eczema, asthma. These nurses have been added to an already present team including diabetes, oncology and sickle cell clinical nurse specialists. All nurse specialists’ roles develop care plans with the family and empower children and young people to self-manage their long term conditions.

2.5 The Asthma Friendly School Nurse project continues to be rolled out across Islington Schools and 73% of all schools have now been awarded asthma friendly status, which

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includes policy, procedure, care planning, training and access to emergency medication. The asthma friendly school nurse also runs coffee mornings with the parents/carers of children and young people with asthma to create peer networks and shared learning opportunities around self-management. The coffee mornings are proving to be a success with parents/carers as they learn about how to improve the management of their child’s asthma and share experiences with other parents/carers. In 16/17 74 parents had attended a coffee morning.

2.6 Just before the end of 16/17 a contract was agreed with Whittington Health to pilot an asthma self-management course for young people aged 13-17yr. There are very few examples of self-management courses for young people nationally so it is an exciting innovative project and will be similar to the expert patient programmes currently being provided for adults. The pilot will be developed through co-production with young people and delivered by a youth worker ideally alongside a young person with lived experience.

2.7 The Children’s Nurses in Primary Care were implemented in August 2014 to help build capacity, paediatric capability and improve self-management for children and young people with asthma, viral induced wheeze, eczema, constipation and reflux. Every child and young person seen by the nurses has been given a care plan and in depth education around self-management for the referring condition. The service is undergoing a review and 21 parents have responded to a questionnaire. The responses have been overwhelmingly positive about the service they have received for their child. The majority of parents reported they felt more able to manage their child’s condition, their child’s condition improved and the amount of times the child had to see their GP or visit hospital had reduced.

3. Objective 2 - To involve and engage patients in all levels of decision making from

commissioning decisions to service design to the delivery of community wellbeing projects 3.1 The Children’s Services Improvement Group is the main forum for discussing strategy

and commissioning in relation to children’s health, before going to the CCG Exec Team, Strategy and Finance and Governing Body. We have increased representation this year to two parent representatives on this group. The Participation Officer / Children’s Commissioning Manager, maintains contact with the parents between meetings and supports them to facilitate meaningful engagement and contribution to meetings. This year the agenda has been amended to include a dedicated section at the beginning of the meeting for parents to raise any concerns or issues that they want to bring to the table. This has proved to be very enlightening and has resulted in actions being taken by local service providers.

3.2 The Disability Strategy and Commissioning Group is a multi-agency group led by the

Council to which the CCG contributes. The group has two parent members that attend and participate regularly supported by Centre 404.

3.3 Following the departure of the previous participation officer in August 16, the post was advertised and a number of applicants were interviewed in November 16. The Participation Officer Interview panel consisted of 4 young people and 2 interviewers, 2 of the young people were from the Youth Council and 2 were from Youth Health Platform. The young people made an invaluable contribution to the interview process; asking questions, scoring the answers and giving feedback on each of the candidates, including whether they felt engaged. This helped to inform our decision around each of the candidates and following a unanimous decision it was decided that none of the candidates were appointable. The second round of interviews took place in May 17 following an extension of the Participation Officer’s hours. Once again 4 young people were invited to sit on the interview panel and due to exams only 3 young people could attend, 2 young people were from Youth Health Platform and 1 young person was from the Youth Council sat on the panel. Once again the young people made a vital contribution to the process and provided insightful observations

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from a young person’s perspective. We anticipate the new officer will be in post by August 2017.

Young people’s engagement 3.4 Islington Youth Council’s (YCllrs) activity over the past year in relation to health and well-

being has included:

YCllrs attended a consultation event around Patient Held Records for Young People and gave their views as young people (Jan 16)

Patient Held Records Session for Young People Consultation Event at Lift (Feb 16) YCllrs attended this event in order to review the Patient Held Records site and provide comments and feedback.

YCllrs have worked with the Participation Officer – Children and Young People’s Health Services and young people from CAIS and the Youth Health Platform to develop the Youth Mental Health Charter (May 16)

YCllrs contributed to Islington CCG and Islington Council 5-year plan outlining the priorities and intentions to improve the health and wellbeing of children and young people in Islington.

YCllrs attended the Youth Health Forum at Lift (June 16) which has a focus on Young people’s emotional health and wellbeing

Young Mayor Darey and Deputy Young Mayor Diana attended this meeting and introduced participants to the Youth Council priority relating to Health and Wellbeing.

YCllrs attended the Mental Health Awareness Training at Whittington Hospital event (July 16)

YCllrs attended the Whittington Health Forum and Children and young person's board at Whittington Health with Steve Hitchins & Colette Datt (Aug and Nov 16).

YCllrs contributed to a Web design Workshop: Anna Freud National Centre for Children and Families (Aug 16)

YCllrs attended the Young People’s Sexual Health Services Consultation (Arsenal Hub) supported by the participation worker (Aug 16)

Participation Officer Interview recruitment panel: YCllrs formed part of the recruitment panel. (Oct 16 and May 17)

Whittington Health Event (Nov 16), YCllrs introduced the Youth Council and their work around Health and Wellbeing to young people who attended.

Accessing GP services Fran White -Project Manager, Healthy London Partnership – Transforming London’s health and care together, Children and Young People’s Programme (March 17)

3.5 The previous Participation Officer continued to hold the young person engagement group Youth Health Platform, until she left in August 2016. The group was developed in partnership with a core group of young people who developed their own Terms of Reference and chose the name for the group. There were between 8-12 regular members and they met every 2 weeks.

3.6 Whilst Youth Health Platform were meeting regularly they were engaged and involved in a range of opportunities:

Development of the Children and Young People’s Mental Health Charter Engaged and fed back on the Islington Smoke Free Strategy Attended level 1 smoke free training sessions Attended mental health and positive psychology training sessions Involved in a young people’s sexual health consultation Attendance at a Health Watch public meeting They met with the leader of the Council and executives Attended NHS Youth Voices (London wide youth forum)

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3.7 This group is currently on hold until the new Participation Officer starts. Despite the meetings being on hold the Children’s Health Commissioning Team have continued to contact the members when engagement opportunities have arisen and 2 of the members were on the interview panel for the new Participation Officer.

3.8 The Children’s Health Commissioning Team has previously led on the ‘You’re Welcome’

accreditation programme that was first devised by the Department of Health. The accreditation process involves young people mystery shopping services, feeding back to services how ‘young people friendly’ they are and making recommendations about improvements. The service then has to demonstrate that they’ve made changes. In Islington 3 children’s centres and the Archway Sexual Health Service achieved ‘You’re Welcome’ status.

3.9 You’re Welcome is currently under review by the National Children’s Bureau and British Youth Council with guidance on the next phase of the accreditation programme expected soon. The Children’s Health Commissioning Team will need to consider whether to continue with You’re Welcome, once the next phase is released.

3.10 Islington’s an early adopter site for integrated personal commissioning (IPC), which for children is being rolled out to some cohorts of looked after children with mental health support needs. IPC takes an asset-based approach to helping people build their knowledge, skills and confidence, viewing patients as active co-producers of health and wellbeing, rather than passive recipients of services. An important part of the programme therefore is to ensure that we engage with young people with lived experience and co-produce elements of the programme with young people with lived experience. To start the programme a workshop was held with 8 looked after young people and care leavers to understand what they felt was working well for them and what was not working well for them, which has informed decisions around which cohorts the budgets could be offered to and what sort of areas the budgets could be spent on. 4 Islington young people with lived experience have also attended a national engagement event which has influenced the national looked after children national program.

3.11 In November 2016 Whittington Health organised a large event at the Emirates stadium for

young people aged 11-17 years. The aim of the event was to engage young people and create a new health forum that would help to improve health services for young people across Islington and Haringey. The event was attended by 60 young people and 40 young people put forward their names to join the forum. The forum is now in place and is used to engage young people about the health services being provided by Whittington Health.

3.12 SEND Parent Consultants - The Parent Champions have renamed themselves to become Islington Parent Consultants. During 2016/17 they carried out an extensive piece of consultation work around the ASD review. This was to gather information on parent/carers experience of our current assessment and diagnostic pathways for children with ASD. They were involved in an initial meeting with the researcher and worked with her to design a survey and a poster advertising 2 focus groups which they facilitated. This information was put into the final review. The second piece of work was to run 2 focus groups looking at gaining information on the local area’s effectiveness in identifying and meeting the needs of children and young people who have SEND. They are currently involved in gathering views of parent’s experience of using the Bladder and Bowel service which will form part of a review. The Islington Parent Consultants will be presenting their involvement in this project at The Disability Board in July 2017. We are currently undertaking a review of the parent consultants and hope to be able to extend the project for 17/18 to a broader cohort of parents.

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3.13 Involvement in the procurement of Key working and Mentoring Services – Additional funding was made available from the local authority around preventing youth violence. 2 focus groups were held in August 2016 – 1 with Youth Council and 1 with CAIS (Children’s Active Involvement Service) looking at young people’s views on safety, youth violence and gangs. The input from these sessions fed into the commissioning of key working and mentoring services. These services were put out to tender and young people formed part of the evaluation panel for the presentations from potential providers.

3.14 In addition a youth deliberative event was held in July 2016 in which 61 young people attended. Young People were aged between 13 and 20, with a spread of gender, social class, schools attended, users and non- users of youth services. Their ideas and input fed into the next stage of commissioning priorities for youth provision as well as feeding into the above commissioning of key working and mentoring services. Tender for Islington and Camden Young Carers Service – Young Carers have always been actively involved in all aspects of service development and delivery. Their views were incorporated within the revised service specification and three young people (one of whom was a young carer) formed the evaluation panel for the presentations given by the 3 shortlisted organisations. Their involvement constituted 5% of the overall marks.

3.15 CAMHS Co Commissioning Proposal for T4. In preparation for the development of a local co commissioning proposal for T4 services, as well as local plans to develop crisis care services, Camden and Islington Commissioners needed to understand young people’s experiences of crisis and T4 inpatient services. Public Voice, a community interest company undertook a piece of research which involved interviewing YP aged 11 - 18 with experience of crisis and T4 inpatient services to identify existing good practice and to identify opportunities for service changes that would improve the experience of young people across the two boroughs. The findings, used to inform our local commissioning plans, covered the following themes:

Access through primary care Accessing school support and counselling Accessing community support and experience of stigma Waiting times for specialist services Experiences of A&E and urgent care Placement in age in appropriate wards Preparation for an in-patient stay Staff attitudes and behaviours Involvement in decision making

3.16 ASD Review – As part of the ASD review undertaken by The National Autistic Society we

were keen to capture the views of CYP, as well as parents/carers, who had experience of assessment and diagnostic pathways. In order to capture these views we worked closely with Ambitious about Autism whose young people’s champions were able to work alongside us with Islington YP in order to capture their views and experiences to feed into the report.

4. Objective 3 - To ensure the local community are always informed and fed back to about the CCG's commissioning direction, and community and engagement work in Islington

4.1 The Participation Officer provided regular updates to Youth Health Platform on the

engagement activity, outcomes and opportunities to the following groups; Islington Youth Council, Children’s Active Involvement Service, CAMHS Youth Board, Young Mums Together, Ambitious About Autism, Camden and Islington Sexual Health Network, Family Action, Eritrean Youth Club, Youth Offending Service and Pupil Services.

4.2 The minutes of the meetings of the Youth Health Platform were shared with the members via

email or post and a formal update is sent every six months to members.

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4.3 The Islington Youth Council is regularly fed back to on the engagement activity and

outcomes. The Youth Council is proactive in feeding this information into young people across Islington which it does through presentations in schools and youth hubs, such as Lift and Platform.

4.4 Young People’s Involvement in evaluation panels – All young people involved in

evaluation panels are contacted and informed of the outcome in line with the procurement rules. Islington Parent Consultants – The ASD review and the SEND report was circulated to the Parent Consultants and to those parents attending the focus group who expressed an interest.

5. Objective 4 - To listen to, involve and consult individuals and groups that find it hard to have

their say because they are socially excluded, vulnerable or experience the worst health. To ensure that they are all treated fairly and equally and that Islington CCG is meeting its responsibilities under the Equalities Act 2010

5.1 Engagement of the VCFS (Voluntary, Community and Faith Sector) in the CAMHS

Transformation Plan – Following an information event held in February 2016 a small grants programme was developed to support programmes of work to increase the emotional health and well-being of CYP. Six voluntary sector organisations were successful. These ranged from 2 counselling services to 4 organisations who adopted some innovative early help type services. These services began in Sept/Oct 2016 with funding agreed for the following year. This information event also provided the catalyst to evolve the Youth Health Forum into what is currently called the Children and Young People Emotional Wellbeing Network. This will be a provider led initiative and a service specification was drawn up by Children’s Health and Young People’s Services who will jointly fund the project. This has been widely circulated with a closing date of July 2017. The Refugee Therapy Centre has been linked into the Refugee Resettlement programme and can offer psychological treatment together with their in house interpreter who speaks the necessary language.

5.2 Youth Health Platform - This overarching mechanism for youth engagement is proactive in supporting engagement from young people that may find it hard to have their say. Youth Health Platform involved young people that had learning difficulties and/or autism, young carers, young people in care and young people from diverse communities. The CHCT works closely with the Children’s Active Involvement Service (CAIS) and In Care Council (ICC), Family Action, Ambitious about Autism, Whittington Health and the Eritrean Youth Club to ensure young people are well supported to access the opportunities for participation offered through the forum.

5.3 Through the IPC programme looked after children and care leavers will also be regularly consulted and given an opportunity to have their say and influence the development of the programme.

Young people with disabilities 5.4 The Whittington Health Additional Needs and Disability Service (IANDS) is the main

service the CCG commissions to work with disabled children and their families. It includes paediatric therapies to children who may or may not have complex needs. The service is in the process of transferring to Meridian, which is an electronic data collection tool used with CYP and their parent/carers, to gain feedback about the service and evaluate training delivered and group work. The service also uses a patient specified functional scale (PSFS) as a tool in RIO to measure outcomes, which CYP and carers evaluate how well the clinical goals have been achieved. Whittington Health are also working with Ambitious for Autism young people to improve CYP experience in the Whittington Hospital including the development of social stories in the emergency department and ambulatory care.

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6. Conclusion

The CCHT have continued to ensure that children and young people, and their parents and carers, are central to commissioning / service developments and that they are key to understanding how effective services are at meeting needs. It has been a difficult year to maintain this focus, without a dedicated participation worker, particularly when trying to engage hard to reach groups, where our experience tells us, this type of work takes dedicated committed time that enables a relationship and trust to develop over time. However the team have demonstrated a commitment to keeping this work going in the absence of a dedicated worker, as have many of our local service providers, as reflected in this report.

6.1 Issues to be considered:

1. How can we further utilise Youth Health Platform to inform the development of broader

CCG initiatives and in particular the development of primary care services in Islington? 2. How do we further develop the delivery of the ‘You’re Welcome’ programme across local

health services in Islington? Do we want to consider how we utilise the programme in Primary Care?

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MEETING: Patient and Public Participation Committee DATE: Thursday 22 June 2017 TITLE: Communications Update Report LEAD COMMITTEE MEMBER: Dr Katie Coleman AUTHOR: John Pritchard, Communications and Media Manager CONTACT DETAILS: 020 3688 2983 Purpose This report is for assurance This report provides assurance and identifies any consequent risks to the committee on communications activity and media. Overview: This report provides an overview of: Objectives:

Provide assurance and identify any consequent risks to the committee on communications activity and media

Issues to be considered: None

Key risks (including those on the Corporate Risk Register):

No risks identified Outline the impact and outcomes of public and patient involvement Our short term communication activities are often made in response to public concerns, questions and feedback. The longer term challenge is to maintain this dialogue. When reporting to the Committee please order your response under the following objectives. These objectives are the Patient and Public Participation, Equality and Diversity objectives and are how the Committee measure if effective engagement has taken place:

1. To support people to look after their own health and build the number of people who self-care in Islington.

2. To involve and engage patients in all levels of decision making from commissioning decisions to service design to the delivery of community wellbeing projects.

3. To ensure the local community are always informed and fed back to about the CCG's commissioning direction, and community and engagement work in Islington.

4. To listen to, involve and consult individuals and groups that find it hard to have their say because they are socially excluded, vulnerable or experience the worst health. To ensure that they are all treated fairly and equally and that Islington CCG is meeting its responsibilities under the Equalities Act 2010.

Item: 8

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Below is an update of current communications activity and media highlights.

Public affairs / MPs – Correspondence of note Since the previous report to the committee in March this year, the CCG has received no further MP questions. This is in part due to the period of purdah prior to the General Election when local MPs focussed efforts on campaigning. Upcoming priorities The CCG has a number of work streams and programmes that require communications support in the coming months. Whilst continuing to deliver the general communications (internal communications, media relations, stakeholder communications and website) the communications team will be working more closely on planned activity with:

The North Central London Sustainability and Transformation Plan Commissioning arrangements in north central London Campaign - GP Online

Campaigns/projects North Central London Sustainability and Transformation Plan The team continues to support internal and external communications and work with the plan’s communications lead and colleagues at Barnet, Camden, Enfield and Haringey CCGs. North Central London Commissioning arrangements The team continues to support internal and external communications work following changes to the senior leadership teams of North Central London CCGs, as well as Haringey and Islington CCGs’ closer working relationship. Annual report and accounts The final annual report and accounts were submitted to NHS England on 31 May. As part of the publication process the report and accounts will be made publically available on the CCG’s website. The Haringey and Islington Wellbeing Partnership The team continues to participate in the Partnership’s communications and engagement group. A communications plan, messaging and materials for staff, stakeholders and the public has also been developed. Public-facing communication is expected to take place at a later date when relevant news is available. Primary care hubs and GP Online Following the end of purdah, the CCG has resumed the promotion of GP Online and primary care hub services. Aimed at primary care staff and Islington residents, the campaign aims to increase the number of patients booking and managing appointments and repeat prescriptions online. Media Lennox House Care Home On 17 May Lennox House Care Home received a CQC rating of “inadequate”. Following an enquiry from the Islington Tribune, the team liaised with Islington Council colleagues to draft and supply a media statement. The supplied statement commented on the referral freeze (imposed in December 2016), the Provider Concerns Process instigated by Islington Council and how the CCG had liaised with Council colleagues throughout the process. A subsequent CCG statement responded to an additional query focussing on the current number of residents, waiting times for individuals to be moved to a different home and weekly costs.

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North Central London Sustainability and Transformation Plan In recent months there has been minimal coverage with the North Central London plan briefly mentioned by local residents in letters to the local media, specifically in reference to an organised demonstration. Moorfields Eye Hospital NHS Foundation Trust Following local coverage of the Moorfields’ relocation project, the team continues to liaise with communications colleagues at the Trust and provide advice where required. In May this year the Islington Tribune published an article titled "Secret talks on move by eye hospital" which focussed on the three options considered at a meeting of the hospital’s board. Website The team is in the process of reviewing the CCG’s public website content to ensure it is up to date and correct. Following completion of the review the team will begin a refresh of the website’s design. Office move The team supported the CCG’s move to the new offices at Laycock Street, ensuring staff, stakeholders and the public were kept informed as appropriate. Resourcing With the team’s interim Communications and Member Relations Officer leaving the CCG in the coming weeks, the team expects to recruit a replacement interim in the coming weeks. Twitter update To date we have 6,674 followers on our @islingtonccg account. This is an increase of over 120 followers from the beginning of the year, an average increase of approximately 10 followers a week. During the period of purdah the CCG’s promotion of local and national campaigns was placed on hold. Following the end of purdah we have been raising awareness of and promoting:

Diabetes Week Bank Holiday pharmacy opening hours GP Online services

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MEETING: Patient and Public Participation Committee DATE: 3rd July 17 TITLE: Update of the Patient and Public Participation and Equality and Diversity

Strategy LEAD COMMITTEE MEMBER:

Dr Katie Coleman

AUTHOR: Elizabeth Stimson CONTACT DETAILS: [email protected] Purpose This report is for ASSURANCE This report provides assurance and identifies any consequent risks to the Committee on the delivery of the Patient and Public Participation Strategy. Context: The below report provides an update on the Patient and Public Participation, and Equality and Diversity Strategy. This report provides information on the delivery of the Patient and Public Participation Strategy. objectives across Islington Clinical Commissioning Group (Islington CCG):

o To support people to look after their own health and build the number of people who self-care in Islington.

o To involve and engage patients in all levels of decision making from commissioning decisions to service design to the delivery of community wellbeing projects.

o To ensure the local community are always informed and fed back to about the CCG's commissioning direction, and community and engagement work in Islington.

o To listen to, involve and consult individuals and groups that find it hard to have their say because they are socially excluded, vulnerable or experience the worst health. To ensure that they are all treated fairly and equally and that Islington CCG is meeting its responsibilities under the Equalities Act 2010.

The report provides information on significant recent activity and the progress of the Strategy. As CCG work programmes report to the PPP Committee they will also provide further updates on the work of the strategy within these programmes. Issues to be considered Progress of the strategy Key risks (including those on the Corporate Risk Register) Risks outlined on the Corporate Risk Register. Outline the impact and outcomes of public and patient involvement The CCG has engaged with patients and local people throughout the organisation’s programmes and through specific projects. This has led to:

Development or design of healthcare services in Islington Two community wellbeing projects to meet the needs of some of the most disadvantaged communities in Islington

A range of initiatives to support people to self care in Islington

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A focus on improving the way in which local people can access and are offered interpreting services.

Impact Assessments: Equality impact assessments have been carried out on some of the projects referenced in this report additionally the Community Wellbeing Projects have been influenced by Joint Strategic Needs Assessment. Supporting papers to this summary Patient and Public Participation and Equality and Diversity Strategy Update

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Patient and Public Participation and Equality and Diversity Strategy Update Introduction The delivery of the strategy is making positive progress and the CCG is building on the strong foundations of the previous year to broaden engagement across the organisation and the local community (particularly across the protected characteristics). Engagement is now a strong part of all commissioning managers’ roles, and is a key part of programme planning and service development as will be or has been evidenced at this Committee. The CCG now delivers engagement training yearly to Commissioners, highlighting good engagement both collective and individual, as well as encouraging managers to consider community development methods where appropriate with support materials for staff whether they have received training or not. These materials have now been adapted to support engagement across North Central London’s (NCL) Sustainability and Transformation Plan (STP). The local community play an active partnership role in all stages of commissioning including development, design, procurement and delivery of services, as well as monitoring the quality of care. They give us insight about how best to engage with our local community and help providers to improve services. The information below is a broad overview of the various pieces of work which make up delivery of the strategy – some of them also form part of the engagement work for the four main programmes of the CCG (planned, primary care, urgent care and integrated care). It reflects the way in which engagement is a key part of CCG’s commissioning intentions and commissioning project planning. This year, we have begun to work more closely across North Central London as part of North London Partners in Health and Care formally called the Sustainability and Transformation Plan, and as part of this with Haringey, as part of the Wellbeing Programme. We are taking the approach we have developed within Islington and utilising this to guide engagement more widely across NCL. Objectives 1

o To support people to look after their own health and build the number of people who self-care in Islington.

Community Wellbeing Project: New River Green Estate Since March 2014, Help on Your Doorstep has been delivering the Community Wellbeing Project in the New River Green Estate. The project, delivered by two local estate residents, has engaged with the community to gather insights on local needs, assets and priorities and created activities to meet these needs with the local community.

Over the last year the below outcomes have been put in place:

To use the community wellbeing project as a launching platform to engage members of the community in regular free or subsidised healthier lifestyle activities such as physical activity, healthy eating and weight loss. Through the dissemination of information, planning local activities delivered by local people or outside specialists, and providing support to residents to encourage continued involvement

To support the development of local opportunities for local groups with shared interests or circumstances to meet regularly to share, provide mutual support and to socialise: The community centres on the estate now have a weekly activities schedule that includes a community coffee morning, over 55 monthly film club night, exercise classes for all ages and community events, gardening and an Expert Patient Programme.

To align with the Good Neighbour Scheme objectives of tackling isolation through identifying and linking people who are isolated with one to one community contacts or group participation opportunities: Through the activities and events on the Estate the project has

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been able to link in with local people and recruit additional volunteers to be part of the Good Neighbours Scheme – the foundation which enabled the project to develop.

To continue to engage young people through a variety of means including supporting the Essex Road Giants football club

Work with local services including NHS services, Council departments such as employment and community police to communicate and address community issues such as access to services, community safety, the built environment and green spaces

To assess the impact of the work, this includes gathering data on the project, surveying with the local residents the impact, along with a collection of case studies.

Health and Wellbeing Groups 2016 Attendances:

Group Name No of Groups run in 2016

Average No of Attendees per group

Football 5-9 36 12 Arts and Crafts 41 8 Luncheon Club 10 15 ADHD Parents Support Group 11 12 Gardening Group 31 6 Mindfulness/Meditation 29 7 Yoga 31 8 Zumba 10 6

Group Participants 2016

This is just to give an overview of attendances at the groups and does not include the volunteers who take part nor the community events which are held twice a year. Help on your doorstep have demonstrated that they attract residents across age groups and ethnicities which are representative of the make up the tenants on the New River Green estate. It is also interesting to note the high level of people with long term health conditions. They are working with a number of unemployed people, and through our projects we build confidence, enable individuals to volunteer and link people in with our Connect services and provide pathways back to employment. Two of our volunteers went on to find employment this year and one built confidence to return to study.

This year we focused on developing the way in which we evaluate the project – we have begun to measure the wellbeing impact of the project on the local community. This is difficult to do in a short time frame – however, we have captured this in a controlled way focusing on those residents participating in the project –and monitoring the yearly uptake of activities alongside this. Below are captured some of the key measures:

More than half of the respondents said that they were much more physically active than before attending the Good Neighbour Scheme.

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83% of participating residents either agreed or strongly agreed that their health had improved as a result of being involved in the Good Neighbour’s Scheme activities. Most people’s additional comments focussed around the social benefits alongside the activities.

Development of Community Wellbeing Projects: Due to the success of the project we have gone onto pilot a further two projects with Islington Council on the:

Andover Estate (Funded by Council and CCG) Bemerton Estate (Funded by Cripplegate and Council, with CCG staff involvement)

Alongside this Peabody Housing Association have funded two further projects in the Caledonian road and Archway area. We are working with Help On Your Doorstep to deliver all projects. Like the New River Green project, the two pilots focus on a small geographical community and aim to make improvements which directly improve this community’s quality of life and wellbeing, working with the local community to assess what their needs are and also what assets and skills they have, finally working with them to design what they feel they need to improve their wellbeing and support the community to take action on this. The pilots have employed local people from the estate to lead their delivery and are currently working with local residents to gather insights. These pilots, combined with evaluation of the New River Green project, will help us to gain valuable learning around how we can use resources to develop projects with community groups – used in a way which they choose – to improve health and wellbeing outcomes which are not only sustainable but also in the longer term provide potential savings and impact upon prevention. A further paper will come to this Committee that will look in depth at the wellbeing outcome measures of both NHS funded projects and the learning of all four sites. Integrated personal commissioning: Integrated Personal Commissioning is a five step process which will support people to care plan and manage personal health budgets. The aim is that they have more control of their health and feel better supported to manage their condition in a way which is appropriate for their life, so that they and their carers can have a better quality of life and can achieve the outcomes that are important to them and their families. To support the development of this approach we are working with local people to know if and how they would like their care and support planning to change so that it is more personalised for them, offering them more choice and control, and ultimately control of some of the money that is spent on their care.

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The CCG are meeting with key Long Term Condition peer support groups across Islington. This includes:

Expert Patient Programme Self Management Programme DESMOND (diabetes) Pulmonary Rehab patient group Breathe Easy (COPD peer group) Diabetes Islington

Alongside this we are commissioning the voluntary sector to speak with 60 to 70 clients who face barriers to accessing services with a particular focus on English not as a first language and deprived communities. We are currently in the insight gathering phase of the project, however, the insight will feed directly into the design of Integrated Personal Commissioning. The next steps of the project will include a co-design piece which will take place post September. We will build upon the paid peer support work we have done within mental health, involving people with lived experience in coproducing the development of the Integrated Personal Commissioning process. On top of this, they will take a paid role to support their peers to develop care plans which are meaningful to them and manage personal health budgets. When this work is complete we will report back to this Committee. Social Prescribing in Islington: We have begun work with the Cripplegate Foundation and the Council to better coordinate social prescribing resources in Islington. In July 2017 we will hold an event with local stakeholders to share information about what has been achieved so far and to plan collectively for a more co-ordinated approach which aligns resources and builds stronger links between health and social care and voluntary sector and community organisations. This event also helps supports the aims of the North Central London Health and Care Partners. Islington is a pilot site for North Central London (working with Building Health Partnerships), to develop the Care Closer to Home Integrated Networks to better engage Voluntary, Community and Social Enterprise (VCSE) support (particularly through social prescribing) to deliver on local self-care priorities. This directly supports the way we envisage the networks developing and operating in Islington and we will be able to share this learning across North Central London and scale up across the footprint. The intention is that this will be the starting point for generating ideas and implementing a collaborative and realistic ambition for Social Prescribing in the borough. Projects we will be focusing on include:

Health Navigators Age UK Help on Your Doorstep connect service and navigators in GP practice SHINE service Claremont Project And many others

We will continue to report back to this Committee as the work progresses. Integrated Care and Primary Care Programme: These programmes have previously provided an update to the Committee however it is worth noting that they are successfully delivering a number of initiatives which will help patients to self-care and manage their conditions including:

Multi Disciplinary Team working Health Navigators

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Help On Your Doorstep navigators in GP practices Objectives 2

o To involve and engage patients in all levels of decision making from commissioning decisions to service design to the delivery of community wellbeing projects.

Community members and patients on Clinical Quality Review Groups: In the last year we have one or more community member attendees at all of our Committees and working groups. Such meetings usually take place every two months. We continually promote these roles to find new applicants. To support our community members we hold network meetings for all members to attend, meet each other and share what is happening in their respective groups. These community member network meetings focus on the strategic overview of CCG (and now Sustainability and Transformation Plans) and give members a chance to talk about what they are focusing on in their different CCG committees / working groups. Patients also provide feedback to local providers through formal quality and contract review meetings. This is in place with all providers the CCG leads on: Moorfields, Whittington Hospital and Camden and Islington Foundation Trust. Patient Participation Groups: To ensure there are several routes through which the local community can provide feedback to the CCG on health issues, the CCG holds two Islington-wide Patient Participation Groups (PPGs) per year. These are open groups, attended by patients and GPs and chaired by a pay person. People from across the borough are welcome to attend and a range of topics are discussed, such as commissioning plans, quality of healthcare services and any current service developments or projects. The groups are managed and organised by HealthWatch Islington, who have an excellent track record of engagement work and working with people who do not always have their voices heard within service design and assessment. Involvement from a more diverse patient group is achieved by Healthwatch sending out invitations to PPG meetings to their own members (600 local residents and organisations) and to people who use their services and take part in research (around 500 – 1,000 a year), as well as those who are already on the PPG members list. Healthwatch also work hard to maintain and increase attendance by allowing for more flexible involvement by working with local organisations, Manor Gardens and Everyvoice who have excellent ties to local communities, particularly Black, Asian, Minority, Ethnic, Refugee and Migrant communities (BAMER). The additional outreach with local residents takes place at:

A local community venue in Islington, usually a housing estate community centre At Manor Garden’s women’s refugee and migrant forum (with translators in attendance)

June 2016, 58 attendees at the meeting and 40 people attended focus groups or one-to-one surveys November 2016 meeting, 44 attendees at the meeting and 41 in focus groups. Some key issues have been raised by patients at these meetings, and the CCG works hard to respond to any comments or questions raised. In the last year patients have identified the importance of pharmacy services and have voiced that clearer information is needed about what services pharmacies offer. We are now working with the Medicines Management team to implement a promotional campaign for pharmacies, including promotion through social media and local community organisations. The CCG has put an application in for additional funding for this campaign.

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People wanted to know what is being done to find people with long term conditions in the community so they can benefit from early intervention and self-management. The CCG highlighted work by Public Health who deliver free health checks in GP practices, some pharmacies and in the community, aimed at identifying undiagnosed conditions in patients aged 35-74 without undiagnosed cardiovascular disease and who have not had a NHS health check during the last 5 years. Care My Way Since July 2015 Islington CCG has had five community meeting, engaging over 100 local residents. Local people have been invited to meetings and workshops through local community and voluntary sector organisations the CCG works with. A broad range of local people were represented at the meetings, including those with learning disabilities, long-term conditions, young people, older people, people with long term conditions and those whose first language is not English.

Accessibility and ease of use were two of the main concerns raised by the community during the engagement process. These will be two key issues people will be asked to report on during the pilot testing phase, to ensure the system is accessible to a broad range of people and easy to use. Local people highlighted during the engagement that they wanted a care plan on their shared record that both they and the healthcare professionals involved in their care could contribute to. Care My Way will thus incorporate a care plan that is co-created by clinicians and patients. People said that they would like clinicians to know what is important to them, and as such Care My Way will include a home page where people can write information about themselves, which will be the first thing healthcare professionals see when they access the system. The next step will be pilot testing of Care My Way Personal (the part of the system patients will see and use). This is to test that the system works properly, highlight any difficulties people may face in using the system, hear feedback from local people about their experience of using the system and to make sure the system meets people’s needs. Pilot testing will begin in September 2017 with an expected cohort of 40-60 people. We will recruit a representative sample of local people to the cohort, including those with long term conditions or complex needs, who will likely benefit the most from using the system. The pilot group will be recruited through local practices. We currently have 81 members on the community reference group for the Care My Way project. Programme engagement: There has also been significant engagement throughout the programmes which have previously provided reports to this Committee. Highlights include:

Primary Care Patient Participation Groups and Care Closer to Home Networks development Joint Commissioning and Mental health including the commissioning of Last Years of Life

service user group Voice for Change and Islington Borough User Group (IBUG) Integrated care and the engagement for the Integrated Digital Care Record and Patient Held

Record All follow a similar method working with services, HealthWatch and voluntary sector to reach out to and speak with local residents. They carry out their engagement in a targeted way and/or speaking to those groups who may face the most significant barriers when accessing services, along with actioning the feedback they gather and providing a response back to the local community. Care Closer to Home Integrated Networks: This Committee has already received a paper laying out our approach for supporting engagement across the Care Closer to Home Integrated Networks. However, it is important to highlight this work within the Strategy update as it will be key to our engagement for the coming year. We have so far:

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Developed an engagement approach based on the CCG’s current approach. It lays out how the engagement lead and primary care team will support engagement and community development within each Network.

Collated research across Islington on key areas the Networks will be working with their patient populations on (Long Term Conditions, Frailty, GP and health services patient experience with areas for improvement and prevention)

Begun initial conversations with voluntary sector and community organisations on working within Networks to support the local populations.

Assisted with shaping the North Network business case Within the next year we will continue to report to the Committee on the Networks’ progress utilising engagement already gathered, additional engagement with the local community, engagement with voluntary sector and community development. Community Research and Commissioning Intentions Engagement: This year we re-commissioned a consortia group led by HealthWatch and made up of nine other organisations who represented communities from Black, Asian, Minority, Ethnic, Refugee and Migrant communities (BAMER), and Help On Your Doorstep who work with deprived communities. The group were given a series of questions covering four topics which feed directly into our commissioning intentions, as well as undertaking HealthVoice Islington with some of their clients. Overall we have spoken with 342 people through this project. The aim of the piece of work is to strengthen the way in which we hear from communities who face barriers to accessing services, gather research in a more organised way on our commissioning, strengthen our relationships with grassroots organisations and support them to develop their evaluation and research skills so they can better represent the views of their local community, and finally to feed the information we gather into commissioning plans ensuring we are meeting the needs of the local population. The reports and recommendations are being shared with the Commissioning Teams and the actions being taken forward through a number of routes. The actions will be reported back to this Committee, as well as shared more widely across Wellbeing Partnership. Key recommendations were:

Health settings could be more customer/patient focused in communicating to user of their services about delays in accessing services whether this is in relation to appointments or waiting times. Proactively informing people in advance of expected timescales and providing alternative solutions around how patients can get the help they need would go a long way in improving patient experience

As hospital interpreting is currently being re-commissioned the CCG should ask hospitals what patient involvement there has been in the procurement, and how patient feedback on existing interpreting services has informed the specification.

For thorough Equality and Diversity training to be undertaken by all reception staff so that they are better able to empathise with the needs of the diverse population in the borough.

The CCG should continue to explore creative and more efficient ways of delivering health

promotion and self-management services in the community to take the pressure off GP and hospital services. The CCG should also explore how partnerships with community organisations can be used to communicate to the local population how and when services should be accessed and provide service information about alternative settings where non urgent care and advice can be accessed.

In parallel with community facing messaging it is important that healthcare providers understand and are supported to respond to the fact the patient priorities extend beyond just

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receiving medical treatment. Patients expect and need person centred service delivery , where they feel listened to and respected

The CCG Should seek to further build on the high approval ratings and levels of trust that pharmacies enjoy from the community to develop new pathways for health services to be delivered from these settings.

Most of the Islington communities that the HOYD respondents live in have seen a significant increase in people who are experiencing mental health conditions. There is significant scope for community based and run wellbeing activities to be partnered with or referred as a response alongside the medication and referrals to talking therapies. The CCG should explore how partnerships can bring services into practices and how practices can link patients into community services. The emerging CHINS model is an opportunity to scale up this type of partnership as is the existing work of the Age UK Navigators and HOYDs GP surgeries.

Free and subsidised health and fitness activities should be more widely funded and

promoted for residents on low incomes Where possible activities should be located in the community venues so that they are more

accessible to those who may have difficulties travelling to mainstream fitness centres

CCG should work with practices to host more social welfare service within practices where practical or in nearby community venues where practices do not have the space. More work need to be done to build referral links between practices/ pharmacies and providers of non-medical support services,

For future engagement work, the CCG should provide the organisations delivering the

engagement activity with publicity materials for some of the key services in the borough to increase uptake (examples could include extended hours GP services and self-referral for physiotherapy and podiatry).

An additional outcome we commissioned for this year from this piece of work was that not only have we captured the views but that signposting and additional more intensive support to statutory and community services was offered to all who took part, with the intensive support for patients with complex needs. Through the project we have been able to share information on accessing services with some of the community who find it the most difficult to access services alongside this we have also been able to identify vulnerable members of the Islington community (who we would not otherwise have been able to reach) who had more complex needs and needed additional support to access health services. Through this work the community groups have become more informed so they can signpost those who took part in the research and they but have been able to offer more intensive support to those in their communities that needed it (support such as attending first appointment with a client). This year 266 people were signposted and given extra information. 116 were given more intensive support into other services. Objectives 3

o To ensure the local community are always informed and fed back to about the CCG's commissioning direction, and community and engagement work in Islington.

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Development of website: This year we have worked with the communications team to improve the community engagement and self care sections of our website. Although previously, there were some dedicated pages on our website, this did not cover the range or wealth of engagement work we undertake in Islington. This meant that our local population and voluntary sector did not have a clear place where they could find out information on ways in which we are engaging with the local community, how services and commissioning have been designed with the local population and what projects they could get involved with. We have now developed the website so that all engagement and community development projects and the accompanying insight across the CCG are available, along with current opportunities. This will be an engagement library. Although, this has primarily been done for the local community and community organisations, we also hope this site will act as a useful resource for staff both in the CCG and our partners to see what our local community have already fedback on services and wellbeing. Feeding back on commissioning programmes: As part of all engagement work we undertake we feedback to the local community on how their insight has helped shape services. Different projects undertake different approaches. This year we have shared information with our local community through a number of routes, including:

Care My Way New River Green Estate and Andover - both through how we’ve utilised research and

service information Commissioning Support and Research – both through how we’ve utilised research and

service information PPGs Third sector forum Communicating on STP and Wellbeing programme Development of NHS fact sheet

Objective 4

o To listen to, involve and consult individuals and groups that find it hard to have their say because they are socially excluded, vulnerable or experience the worst health. To ensure that they are all treated fairly and equally and that Islington CCG is meeting its responsibilities under the Equalities Act 2010.

Community Research: A key part of the CCG’s engagement is focusing on those communities who face barriers to accessing services. The Community Research focused particularly on refugee and migrant communities, and communities who face health inequalities. The CCG are continuing to build relationships with the Third Sector this includes through the work carried out via the equalities research and community research. Alongside this, the third sector forum continues to meet two times a year with between 30 to 40 attendees per meeting. The CCG is also a member of the Black, Asian, Minority, Ethnic and Refugee Women’s Network which meets quarterly. While making links with local voluntary groups is not an outcome in itself, it is through these relationships we are able to successfully engage with such a wide range of our community, gathering feedback from across communities and addressing concerns which can affect the most vulnerable patients.

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This year these relationships have positively impacted the NHS 111 and Out of Hours engagement, gathering of Health Voice Islington data and development of Equality Objectives and the Commissioning Intentions. Equality Objectives: The CCG and HealthWatch are working with GP practices to raise awareness of the Language Line service through engagement with the Local Medical Committee and at the GP Forum, as well as online communication. Use of Language Line is now being monitored to determine effectiveness of the increased communication. Along with GP communications, a brief has also been shared with local community organisations outlining what their clients should expect from interpreting support. Alongside this we are working with Haringey as part of the Wellbeing Programme to improve learning disability service users’ experience of services and support them to become more independent. Engagement across North Central London As part of the Sustainability and Transformation Plan, boroughs across North Central London (NCL) are coming to work together under the banner of North Central London Health and Care Partners. The plans for developing services across NCL are tied into the things we have already heard from local people. However, further community research and co-design work must take place as the work programmes develop. Engagement is key to the way in which we work in Islington and we are keen to ensure our approach can be reflected, wherever possible, in the way the STP carries out engagement. To that end we have so far:

Developed engagement guidance for STP (consisting of a laid out approach and supporting materials)

Offered to meet with all STP workstream leads to support engagement development Regular catch ups with STP communications and engagement lead Attend monthly communication and engagement meeting for STP (which includes

workstream leads) Wellbeing Partnership The Wellbeing Programme is a part of the STP and focuses on joint working between Haringey and Islington. This Committee will receive a full report on the engagement taking place across the partnership workstreams in September, However, it is important to raise the partnership within this update, as this is becoming a key part of the community work which Islington CCG undertakes. The work undertaken to date:

Islington CCG engagement lead is now also engagement lead for the Wellbeing Partnership An engagement approach, with guide has been developed and signed off by the Partnership

Summary reports for each workstream area – on all the engagement which has already

taken place across Haringey and Islington to inform the development of Business Cases.

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Meeting with all workstream leads to develop engagement plans for each of the workstreams (full details will be included in the September update report). These plans are focusing on linking engagement work taking place across the STP with the partnership and connecting with local engagement work which is already in place i.e. the frailty workstream will engage through the Care Closer to Home Integrated Networks, and ensuring a broad range of the population particularly those communities who face barriers to accessing services.

Conclusion: Islington CCG is working across a range of mediums to fulfil each of the four objectives. The projects that sit under these objectives both stand alone and link together to provide a picture of how the local community experiences health services, health commissioning and looking after their own health and wellbeing. There are some core principles which the CCG undertakes to incorporate in all of their engagement work. These focus on speaking to and sharing information with as many people in the community as possible, working with a range of people, working with groups that experience significant disadvantages when accessing services and supporting people to look after their own wellbeing. The staff engagement training and guide has helped to both solidify and develop this approach throughout the organisation. Engagement is now a part of the majority of commissioner’s everyday work – with pockets of creative thinking as engagement becomes more established in people’s roles. Across the organisation, each work programme now has an engagement commitment and approach that reflects the four Patient and Public Participation and Equality and Diversity Strategy goals. We are also working with the Council and voluntary sector to share our experiences and learning delivering community development which has this year brought us national recognition through the New Economics Foundation Alongside this we are developing effective community development and engagement work across our partners. North Central London Health and Care Partners and Wellbeing Partnership, although brings challenges as we work with a wide variety of partners also brings opportunities for further sharing our engagement approach across our providers and commissioning partners, engaging with a wider population across NCL and offering system leadership around engagement approaches. .

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NHS ISLINGTON CLINICAL COMMISSIONING GROUP PATIENT & PUBLIC PARTICIPATION COMMITTEE

TERMS OF REFERENCE 1. Introduction

The Patient & Public Participation Committee (the Committee) is established, and powers are delegated to it, by the Governing Body of Islington Clinical Commissioning Group (the CCG), in accordance with the CCG’s Constitution. The Committee’s overarching purpose is to ensure that the CCG fulfils its commitment to develop and maintain relationships with our patients and the public through reviewing the processes of, and the decisions and actions taken by, the organisation. The Committee has no power to establish sub-committees. These terms of reference set out the membership, remit, responsibilities and reporting arrangements of the Committee and shall have effect as if incorporated into the CCG’s Constitution.

2. Membership The Committee shall be appointed by the Governing Body as set out in the CCG’s Constitution and may include individuals who are not members of the Governing Body. The membership shall comprise:

Vice-Chair (Clinical) Two Governing Body Elected Members The Governing Body Lay Member with responsibility for Patient and Public

Participation Director of Quality and Integrated Governance Governing Body Chair (ex-officio) Chief Officer (ex-officio)

3. Chair

The Chair of the committee will be an elected Governing Body member or Lay Member.

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When the Chair is unavailable, an elected Governing Body member or Lay Member will Chair the meeting.

4. Frequency of meetings The Committee will normally meet a minimum of 4 times a year.

5. Quorum A quorum shall be three members. If a meeting of the Committee is not, or ceases to be, quorate the procedures set out in the CCG’s Constitution shall be followed.

6. Non-voting members Meetings shall be attended by the following non-voting members:

One Local Authority representative One HealthWatch representative Two community members

The Chair of the Committee shall invite other individuals to attend meetings on an ad hoc basis to enable the Committee to discharge its responsibilities.

7. Secretariat support The Head of Corporate Affairs will be responsible for providing secretariat support to the Committee.

8. Conduct of business

The Committee shall apply best practice in its deliberations and in the decision-making processes. It will conduct its business in accordance with national guidance and relevant codes of conduct, the Constitution of the CCG, and good governance practice.

9. Remit and responsibilities of the Committee

The Committee shall:

Promote engagement with patient groups in order to involve interested patients in commissioning.

Oversee the development and implementation of the Patient and Public Participation, Equality and Diversity Strategy 2015/16 to 2020/21.

Ensure that strategies relating to equality and diversity are embedded in the CCG’s structures and processes, including advising the Governing Body of their responsibilities under the Equality Act 2010.

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Promote engagement and partnership working with voluntary and community groups to develop new or existing services.

Ensure that new or developing services commissioned by the CCG consider the patient experience.

Monitor the effectiveness of participation. Receive assurance around the work of the CCG with other committees and groups

to ensure that Patient and Public Involvement is embedded in their structure and processes.

Acknowledge that the Quality and Performance Committee has the responsibility of understanding and using patient experience as part of its fuller understanding of quality.

Receive updates on any areas of concern regarding complaints managed by the CCG

Risk Management

The Committee shall review those risks on the corporate risk register which have been assigned to it and ensure that appropriate and effective mitigating actions are in place. Policy Approval The Committee may approve any CCG policies falling within its remit.

10. Reporting arrangements The Committee shall report regularly to the Governing Body. The report will set out the main matters discussed and any decisions taken. It will also draw the attention of the Governing Body to any matters requiring disclosure to them, or requiring Governing Body approval. In addition, the Committee will report to the Governing Body every six months on progress in implementing the Patient and Public Participation, Equality and Diversity Action Plan. The Committee will receive reports relevant to its remit from any group or working group as appropriate.

11. Review of terms of reference

The membership and terms of reference shall be reviewed annually. Any proposals to change the terms of reference or membership must be approved by the Governing Body.

Adopted: March 2014 Reviewed: September 2016

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Meeting: Patient and Public Participation CommitteeChair: Dr Katie ColemanSupport: Frazer Tams, interim Corporate Affairs ManagerVenue:

04-May-17 06-Jul-17 07-Sep-17 02-Nov-17 04-Jan-18 01-Mar-18 01-May-18

Ap

olo

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s Jennie Hurley

Committee Work Plan (Frazer Tams)







Risk Register Risk Register Risk Register Risk Register Risk Register Risk Register Risk Register

Five Year Plan / STP update (Jo Sauvage)







Planned Care and VBC (Becky Kingsnorth)

Urgent Care Update Report (Jenni Frost)

Equality and Diversity Report(Elizabeth Stimson)

Primary Care Update Report (Clare Henderson)

Integrated Care Report, Maria

Complaints(Rebecca Muncey)

Integrated Care Report, Maria

Urgent Care Update Report (tbc) Deferred to next meeting

Joint Commissioning update report (Jess McGregor)

Joint Commissioning update report (Jess McGregor)

Joint Commissioning - Mental Health Update Report (Jennifer Speller)

Commissioning intentions

Care closer to home integrated networks (CHINS) engagement (Lizzie Stimson)

Childrens' Commissioning Update Report (Sheron Hoskins)

Accessibility Standards, Emma Whitby

Communications Update Report (John Pritchard)

Prevention(Lizzy Stimson)



Healthwatch Report(Emma Whitby)



Performance against the PPP Strategy - to include data (Elizabeth Stimson) Deferred to next meeting

Performance against the PPP Strategy - to include data (Elizabeth Stimson)

Wellbeing partnershjp (Lizzy Stimson)

Wellbeing partnershjp (Lizzy Stimson)

Committee Terms of Reference

Personal Health Budgets update(Clare Henderson)

Communications Plan 2015/16 (TBC)

Annual Report on Complaints (Becca Muncey)

Annual Report on Complaints (Becca Muncey)

PPP Strategy 2015/16 - 2020/21 (Director Q&G)

Seminar Room, Laycock Street

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Monthly report

Quarterly report

Six monthly report

Annual report

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