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Table discussion – no health without mental health
Paraphrased notes from a table discussion at Strengthening the Patient Voice, one of a series of events in West Bromwich linking up patients, their carers, their representatives and their communities, and the Sandwell and West Birmingham Clinical Commissioning Group (CCG).
This table discussed one of the CCG plans:
“No health without mental health – treat mental ill health and promote wellbeing.”
GPs not investigating or listening to concerns (imaginary illness).
Exercise and physical activity is not the be all and end all of cures.
GPs are financially constrained to make referrals, so they may not always refer to specialists.
GPs quick to prescribe medication without investigating thoroughly.
GPs stereotype specific groups, including ethnic groups.
GPs need to work with specialists on mental health issues.
Meet needs of frail and elderly – independence and dignity
Paraphrased notes from a table discussion at Strengthening the Patient Voice, one of a series of events in West Bromwich linking up patients, their carers, their representatives and their communities, and the Sandwell and West Birmingham Clinical Commissioning Group (CCG).
This table discussed the needs of frail elderly.
Financial impact – may be two tiers for the haves and have nots.
GPs to listen to their patients – There’s no health without mental health.
Dignity and respect is not just for the elderly – it applies to people of all ages.
One person mentioned how, when visiting GP, you can see message on a board flashing when a 10 minute appointment has taken 10 minutes. It’s undignified, disrespectful.
GPs only allowed to deal with 1 problem at a time.
Some practices have a system where, if you can’t see your usual GP, you can see another GP. Consistency and continuity is important.
How can you get information about the surgery/practice and changes in them, such as GPs hours, rotations or locums? Should not require having to physically going to the surgery – need other ways of communicating changes to patients, such as post.
Internet is concerning for elderly. Example of Birmingham City Council having a dedicated phone line for older people – would this work for a GP surgery?
Easy access to GP – by this, we mean home visits, not being told to get in a taxi and visit the surgery.
Table Discussion around CCG priorites, What services do you think should be developed.
After a day of presentations the tables are now breaking out into groups to discuss CCG priorities and based on their experiences look at a specific way that patients and the CCG can develop services to meet one of those priorites.
The table I am seated at has chosen to focus on meeting the needs of Frail elderly around Independence and Dignity. These are some of the comments and suggestions for action around this:
- Locally you need to find out WHO fits this category, what elderly do we have in the area?
- How do we engage the community?
- Address the costs of carers in the home.
- Look at services like Agewell in Sandwell – a forum for over 50′s
- Look at assets already available, audit their effectiveness and fill gaps in local areas.
- Advertise where people could go for advice.
- Look at social media, introductory classes to make digital engagement easier, – include people who can’t get out of their house online look at health centres and community centres for “hot desking” for Social Media support.
- Improve transport to services – more community transport
- Gadgets for lighting – falls happen at night when people get up to use the bathroom and lights aren’t turned on.
- Bring services closer to patients
- Fix the issues with Ring & Ride
- Fix hospital patient transport issues
- Set up a community buddy system
- Hospital car parking fees – it’s cheaper to take a taxi sometimes
- Advertising availability of hospital parking “season tickets”
- Look at parking passes for people receiving repeated care I.e. dialysis
- Continuity of parking fees and procedures across hospitals
- Campaign for sensible slipper to stop trips and falls.
- Education and information sharing on looking after yourself.
- Signpost to council Independent living services. Help maintain people in their own homes.
- Discharge from hospitals – need to know peoples circumstance
- Issues with Social workers
- Warden alarm services
- Outdoor lighting and street safety – trip hazards
- Address number of recycling bins make it easier
- Gritting in winter - prioritise salt for elderly by default. (Ice melt packs)
Dr Taiwo Soyannwo explains Local Commissioning Groups
Dr Taiwo Soyannwo, a GP based in Great Barr, spoke at the Strengthening the Patient Voice in West Bromwich today.
In this short video, Dr Soyannwo introduces the Pioneers for Health Local Commissioning Group he represented at the event, which serves people across Great Barr, Perry Barr, Soho and Lozells.
He explains how a Local Commissioning Group (one of five) fits in to the overall Sandwell and West Birmingham Clinical Commissioning Group.
What is commissioning and how will Sandwell and West Birmingham Clinical Commissioning Group commission?
Dr Nick Harding is a GP and Chair of Sandwell and West Midlands Clinical Commissioning Group (CCG). In this session, he discussed what and how will will the CCG commission.
The CCG is not simple and works with many partners. including Sandwell and Birmingham City Councils and will be responsible for a wide range of services
Our CCG will be made up of a board with 16 voting member each with equal voting rights.
Commissioning is about who is buying which care – who is buying the appropriate care for the patients. This how the CCG are looking to get patients fully represented to make this happen:
The priorities for the CCG will be safety monitored by population health improving, effectiveness monitored by effectiveness of treatmets and patient experience – that the population is satisfied with their treatments.
They’ll be responsible for the commissioning of Community health Maternity, Elective Hospital Care, urgent and emergency care inc A&E, Older people’s health care, Children’s, mental health, learning disabilities continuing healthcare, Infertility and fertility, Wheel chair home oxygen and treatment of infectious diseases.
More questions from the floor
Some paraphrased questions and answers from the floor at Strengthening the Patient Voice, one of a series of events in West Bromwich linking up patients, their carers, their representatives and their communities, and the Sandwell and West Birmingham Clinical Commissioning Group (CCG).
Q: “I have been involved in health service for a long time. The service is always restructuring. If CCG was a film, it would be a cross between Titanic and Back to the Future. What is different this time?”
A: “When everything is changing you can protest, which is a perfectly legitimate response. Also, you can say, how can we help the population?”
Q: “I’m doing project on BME access to mental health services. How will decisions be made on my behalf?”
A: “Making changes in Sandwell and Birmingham. We are now starting to listen. It’s one of our top priorities. In Sandwell, working much closely between primary and secondary care.”
Q from Chair of Cape Hill Patient Representation Group: “How many hours does a good GP have in a day? Are we already seeing GP burnout and will we see more of it in the future?”
A: “GPs are good at spotting burnout in each other. It’s also great that people see GPs as individuals, as people with their own families.”
Q from a retired nurse: “Devolving finance to GPs leaves me with little confidence that GPs can focus on the wide range of health issues – we live in a diverse culture with very different needs. Where is the time for GPs to concentrate on our health needs?”
A: “Not all GPs will be involved with finance. A select group of GPs in a practice may be involved; an organisation will be in place to help with this. In reality, most GPs will only deal with clinical care. Also, in terms of the pressure of the extra financial responsibilty, it’s something GPs will have to step up and deal with.”
Q: “How would GPs work with social services to provide patients with a truly seamless service?”
A: “GPs have been trying to do something about junction between primary and secondary care. Probably time to attempt to do this more formally – confirming how GPs interact with social care, interacting with health and wellbeing boards. These issues haven’t gone away – it’s our job to resolve this. That’s why we [CCG] are doing what we are doing.”
Questions from the floor:
A summary if some of the issues being raised by attendees at the clinical Commissioning Event at the Hawthorns today.
Q. I have a long term condition so are involved with the NHS , I feel like we are talking about change, but not practising what we are discussing? Are we delivering continuity when we are closing practises? Are we really consulting with patients and taking on their experience as I’ve heard examples where we are failing people?
A. The reason we are changing things is because what you are telling us in our consultation rooms. The white paper was released and the train is running and we have no choice but to jump on board or we will get left behind – or run over.
Q. I have the up most respect for GPs but what concerns me is I have 24hours in a day but how many hours in a day does a GP have? Do they have enough time to do everything we ask of them? Are we already seeing GP burn out?
A. This is a serious issue, we need to make sure GP’s are running around managing the NHS but it’s important that GP’s are involved. There will be a presentation later show structures and how there will be GP boards so not all responisbilty is on one person. GP’s will also look out for each other to make sure this doesn’t happen
Q. Quite often as a community we feel it is a top down approach and we are suppressed receiving information 2nd or 3rd hand. IN our area we are knocking down community facilities to build housing ad bring more people into an area, removing things positive for the health and increasing the pressure on health resources. Where is the supportcoming from to support PPGs in light of this?
A. We as GPs are here today hoping we can do things bottom up, all of our well-being programmes are being linked to community.
Sandwell and Birmingham LINks – Local Involvement Networks
Here are some notes from Strengthening the Patient Voice, one of a series of events in West Bromwich linking up patients, their carers, their representatives and their communities, and the Sandwell and West Birmingham Clinical Commissioning Group (CCG).
Here is Pam Jones, Chair of Sandwell Local Involvement Network:
…and Chris Vaughan of Heart of Birmingham Action Group, Birmingham LINk:
Pam and Chris presented together as the respective areas their LINks (Local Involvement Networks) they serve overlap with the Sandwell and West Birmingham CCG.
Pam: LINk stands for Local Involvement Network. A way for people to monitor and give their views on the health service and social care.
LINk was set up after demise of Patient and Public Involvement Network. LINk is an independent body, which means that people can talk to them and give their views openly.
Mandates for LINks when they were set up:
- Get the views of people about their needs for health and social care services.
- Gather experiences of people using health and social care services, spot trends and hold services to account.
- Enable people to monitor and review the commissioning and provision of health and social care services.
Chris:
“Health is too important to be left to be left to the doctors and the politicians. We need to be involved from the start in building the house that is now being designed, because we have got to live in it.”
There is a patient involvement group attached to every surgery.
The main point of being here at the event today is to establish LINks in the planning and design of the Clinical Commissioning Group for Sandwell and West Birmingham. LINks are here to find out how we can be involved.
LINks work because they involve people.
LINks will be in place until March 2013. Evolving into Healthwatch. Have a collaborative approach to the transition. LINk sit on the Health and Wellbeing Board.
Chris:
Little different from Sandwell in that they’re dealing with a larger city.
Concerns at the moment – working with Birmingham Chest Clinic, GPs and Birmingham City Council to raise level of awareness of TB.
Vitamin D deficiency – often goes unnoticed. This particularly concern children and older people.
Working with Birmingham City Council on transition from LINks to Healthwatch in 2013.
Introducing Locality Commissioning Groups (LCGs)
Representatives of 5 LCGs are introducing themselves and giving a quick overview on the areas they represent and things they have put in place or are planning to implement;
Black Country
An example of innovation is where we’ve moved services into the community, bringing things closer to home, We have cardiology units running “closer to home” and we’re hoping to expand to diagnostic services.
Health Works
High on our agenda is end of life care – we started right at the beginning by asking patients what they wanted, not GP’s/
ICOF
Track record of working together with patients, we’re working on patient experience and perception. We’re hoping to improve that. We’re also looking at heart disease – setting up a diagnostic centre in Aston.
Pioneers for Health
We here basically for you, the services we are trying to provide are much the same across our areas but in our consortium we are looking to see if we can provide specialised gynaecology service “in house”
Sandwell Health Alliance
We are have formed a “United States of Sandwell and West Birmingham”. We have already held 2 patient summits, we realised we need to look at providing care closer to home for out patient appointments where appropriate, We want to improve the health of people in Sandwell
Dr Nick Harding GP and Chair of Sandwell and West Birmingham Clinical Commissioning Group: Healthcare Without Boundaries
Nick opens by introducing himself as a husband, a father, a carer and a GP.
Things are changing and it effects everybody from the Department of Health, the NHS Commissioning boards, PCTs and Strategic Health Authorities. But the changes aren’t all coming in, in one go, There is to be phased approach which started in April this year.
The new clusters started delegating some responsibility to the CCG’s things such as;
- Commissioning and Monitoring services
- Improving quality and safety
- Hitting key performance measure
You can view his full presentation on slideshare
Opening Presentation Richard Nugent, Former Chair and Non Executive Director, Black Country PCT Cluster
The NHS is changing – more now than ever before.
The PCTs no longer exist as we know it PCT’s have been pulled together to form Clusters. The Clusters over riding priority is maintaining high quality , safe, efficient service and secondarry to help manage the change.
Our key issues are
- Reducing health acquired infections
- Reducing avoidable deaths
- Reducing pressure ulcers
- Eliminating “never events“
- Improving the patient experience
Our strategy is based on transformation
- Prevention and early intervention
- Supporting people to manage their own health
- Care closer to home
- Joined up care
- Highest Quality and “right” sized hospital care
- Innovation and market shaped
Managing the Transformation
We will have to manage the transformation within the organisation, the PCT clusters are working closely with the new CCG. The CCG will be responsible for the bulk of the work the PCT were previously responsible , particualrly around commisioning, lead by GP’s.
The change is already happening and the new structure will be up and running by next April. There are more challenges to the come but they are committed to “No decision about me, without me” – patients having a say!
How different will clinical commissioning groups be to primary care trusts?
What do you think? Is this a change for the better? Will patients and their families be better served by these new organisations?
