€¦ · Web viewOne single commissioning voice theory ... old structural slide ... can't all be done in paper and must dome also in public great lose locally if no opportunity

North West London Collaboration of Clinical Commissioning Groups

Integrated Lay Partners’ Group Minutes 10 to 12pm

Room 2:1 Marylebone Road

Attendees Apologies

1. Stephen Otter (SO) Tania Kernal

2. Trish Longdon (TL), Chair Angelica Silversides

3. John Norton (JN) Sola Afuape

4. Julian Maw (JM) Michael Morton

5. Carmel Cahill (CC) Munira Thoban

6. Sonia Richardson (SR) Tim Spilsbury

7. Jane Wilmot (JW) Sanjay Dighe

8. Varsha Dodhia (VD)

9. Peter Cleary (PC)

10. Christine Vigars (CV)

11. Olivia Freeman (OF)

12. Jaime Walsh (JW)

13. Gabriela Francis (GF)

14. Christian Cubitt (CC)

15. Alasdair Ramage (AR)

16. Ray Johannsen-Chapman (RJC)

17.

ILPG Minutes

2 sets Action log:

Remuneration policy on agenda : TL written to Clare : JJ in her absence - will come next time to talk about STP : Point of clarification abacus who receives it - monthly report joint social care : action: everyone to the abacus - briefing JJ

CC is coming Papers in advanced for the Sub-task

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Email circulation JAne and Christine

TRish and Stephen JJ Update on the QUIPP NW London CCG QUipps Local and across NW London May need Kieth the month after Seniority for some one attending

MM: Bottom up creates diverse approaches from the TOP CAr: framework from the bottom to shape the framework

Ben the focus of the discussion

CV: forward plan out of the Choosing wisely this isn't the first time TL: support the question MM: the role has to be of influencing - the views on how this should be shaped JN: it is politically and consistunial notCAr: the organisation going into darkened room without the input

AP: large running policy paper - lookimg forward to your comments requesting any feedback : Put your feedback in writing JW: suggestion right diction expert advice role 2 forms :: Must be consistent across NW London CCGs Which meeting qualifies for expert and volunteer :Requests for types of meeting and activities onsidered for reimbursement : how can we make sure that the 8 are consistent : Once they agree the policy apply it consistently : adopted by all GBs : reported to us : MM role of the Lay member of the GB have small renumeration AP clarified : tight on money is an issue : JM cant force the CCGs to agree to this : TL cant be patient focussed without offering money : GH without cost implications otherwise won't look at it : AP under 5k for each CCG : GH alight to the cost of the DTP: lay memeber to present to GBs: JN one point definition cat C coproduction of materials : £10 hour is half of what it should be : London wage maybe : make is more general : CV page 7 up to max of £26 per hour - should say up to the London living wage : CV will not spend £60 to get £26 back : JM not understanding of the cats : AP to delete : JM dissppojted to pay and not honorium - social care payments : SA policy to send to AP : GH on the cats no childcare payments : AP to make carers related to child care : AP ore people use cars in Brent Harrow and Hillingdon : JW can't be too prescriptive : TL no recepits for TFL - not exceptions circumstances take out the word

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: TL not paying people more than £100 per week : JM more frightened if no limit : public volunteer - change to patient rep or lay rep

BenTL: Collaboration bodies with GBsBW: not to talk through the paper but to provide an overviewBW: group of CCGs in NWL more than ever before - shared clinical stratOne single commissioning voice theory better staff Mixiture of offers to providers in NWLThe features of this Collaboration Board Jojnt committee that ensures clarity : two accountable officers one accountable officer at stage of designing of what this should look like : at the GB accountability came up - who. Are we accountable to GP, public NHSE demonstrate in different cases what does good look like - what is the things about accountability to the public and patients? Question on the table : JM informed respinse until governance is clarified to give balanced response to do until then - fear of lose of local input difficult to define difficult. They affect different thjngs in different ways - Harrow doesn't define NWL as local - this must be resolved in an acceptable way - the big sticking point is financial control who is the boss. BW We can make changes with existing constitutional JM: they have say in spending their money locally TL: local voice to be heard in commissioning SA: old structural slide first STP structure Lay rep issue of local reps something about the decision making bout being layered across the structures how those lay members are brought together JW: the rationale is clear what are the cons on the committee for one HW Rep can reflect the views of 8 boroughs : considering what resources are available - reasons for the different structures local health related issues are apparent - u can't do the same across all the boroughs MM: what are the differences? Are they different to the extent TL: how do we can the local voice involved in the collaborative structure? MM: constructing a difficult beast - this is not workable JN: if this is going to be workable HW together to generate the Collaboration TL: no answers as yet CV: one rep isn't sufficient - no one understand the current structure page 11 problem - more user friendly- to feed in locally TL: reinforce CV the quality of our services way of feeding concerns in must not loose the ability to feed in and public reassurance back GH: STP Withint the NHS team behind it being paid - some of money to hire 50k professional feedback Car: Goveramce design group money orientated - should have two directors, two GPSFeel uncomfortable with money heads and more clinical and patient focussed BW: prefer your comments on the design group SA: at the very beginning it is a requirement any co-design recommendation BW: group meets weekly Hearing what people's concerns are and responding TL: that is not what we do CAr: two audits chairs particularly focus on public focus - missing trick in the development of codesign JW: unrealistic one or two people to know what people want at each level or what local think or want 1: GP The only way to get buy in from local, people to look at what is workimg and what isn't Workshop of all 8 boroughs to inform the GB We don't really understand the transport system what works on the ground and what doesn't

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JW: very disappointed if the top level don't learn from the intelligence gained from the bottom JW share the learning much more widely SA: is there a timeline - meeting in latter part of December TL: can't all be done in paper and must dome also in public great lose locally if no opportunity to discus and aired in publicBW: joint committee draft ideas about the structure look at mearging ideas of GB JM: one clarification commissioning will be done BW: now next steps steering group meeting Friday 1st meeting of design group BW: to attend the next meeting we are responding - BW to send outcomes of the meeting BW: where does the new group fit in.

CC: Senior management - BW commitments not aware of the group concerns raised AR Promised support which hasn't happened made a commitment which hasn't happened- support for Ray - some support for Ray more additional support for this group. CC: forward timetable JJ to attend the next meeting not always had paper work long enough in advance main 3 points Main point who attends a.ways aligned - that would not have happened - it is an important commitment Jo Olsen from NHSE -day to day STP JJ, Sarah, Julia and Alasdair gone Pause before lookimg at like for like replacement What kind of person - not a permanent replacement JW: don't loose sight of what the STP Delivers SA: reps rotating constant live thought in the different delivery areas provide different. Perspective TL: strategic continuity someone - JJ: make sense STP the right person at the moment MM: good idea each month one of the areas come and talk to us

EQIA: plan MG needs to feed in go through the mitigation purposes Around the confidence of if person can't afford MJ Look at overcome that area - Have such disorders lives TL: what should that protection be - people may say yes when they mean noTL: timetable report tomorrow go to lawyers for final sign off SA: equality work around the TMay input

PPwT: Timetable in flux - moving more quickly benign skin lesions more to do with providers than patients - move from acute to community settings

GH: number of GP performs that in the practice but GPS still send patients to acute

2nd things : bareactrics generates a lot of interest

TL: rumours about IVF, knees and hips CC: gone into the long grass save the money is small CAtercis message no progress Marked under the cat of too difficult JW: performance of GPS GH: GPS are being identified are being assessed car: feedback from urgent care centres - there is new contract TL: report on EQIA and Beatrics report to be sent out TL: will there be feedback CC: publish in the site the outcomes com,nets - up and live online GH: what is the governance structure to ensure GPS act in the right way CC: letters from CO and ongoing updates with GPS ensure rules are updated TL: Clare and Rob

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AOB: SA leaving new position got the job. A friend but an advocate appreciated what I have learnt

CW feedback Update from BenJJ STP update SA Workforce group provide guidance CAr: presemtatex st NHSE eye opener frimely and East Sussex further down the long Bitter NEDS and lay memebers not involved within the STPs Why change impetus for financial issues The pure number of organisations we have to bring together

1. Welcome and apologies

TL opened the meeting welcomed all and highlighted the apologises

2. Minutes

Minutes from the previous meeting on 8 August were approved

Hillingdon progress does this need to be followed up...yes it needs to be

The appetite to see the alliance mis Match between - hold the flag and do the right1) Lead on ACP at Hillingdon action RJC do understand direction of travel ask Trish Shared folder on the agenda Looked at the outstanding actions with Framon Update on CW lack of evidence based Outline timelines Is there a plan - undertaking confidentiality Simple reporting in place Put the STP on ice to update some resourceTL: would it be reasonable to invite Keith Edmonds driver2) Action: RJC to invite for September Keith Edmonds How many QUIPP projects do we have 451 projects tracking and monitoring those Operational teams to see this through Behind on how the STP is delivering - need to be sharing with public of NWLJM: what this group can follow - can't follow over 450 projects Group needs to concentrate on NWL wide -TL: the common bits and not the individual but

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AR: C

Integrated lay partner meetingAgenda6 to 8pm, 12 September 2017Marylebone Road, Room 5.4Time Item Action required Lead Papers

Business as usual1) 18:00 Welcome and

apologiesInform members of any apologies

Stephen Otter

Verbal

2) 18:05 Notes of previous meeting

Review minutes from previous meeting

All Minutes

3) 18:10 Action log Review of previous actions All Paper

Future Direction4) 18:15 STP

Communication

Simple guide to STPs Stephen Webb

Paper

5) 18:30 Choosing wisely

a. The learningb. Next steps

Christian Cubbit

Paper

6) 19:00 File sharing IT Solution Alasdair Ramage

Verbal

7) 19:15 QIPP update QIPP Projects Keith Edmonds

Verbal

8) 19:30 Engaging in Ealing

Older people’s survey update

RayJC Paper

9) 19:45 Remuneration policy

Updated version Andrew Pike/RJC

Paper

Future meeting onversation across the STPS to share to stream line Transformational are not transformational but streamlined The test we need is to be honest about what we needTL: strategic agenda over this then report back on what that might look likeJM: SOC 1 and SOC 2 to be added - should be strong cover on this3) Action: AR to organise meeting with Trish and Stephen

Two task and finish groups on the agenda

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Anymore actions

TL: papers beforehand or at least bullet pointsCC: CW next steps feedbackCC: CW pull into the EQIA gone 7 of the 8 governing bodies - only when they content with the EQIA EQIA Validation session in Harrow what the impacts of mitigation could be The key point not 2 session and just tick box.Forms for mitigation to complete to cover over the 5 weeks Report back to the governing bodies responding to the quality of the EQIA For final sign off and then move to implementation will not start until content with the EQIS after the 22 sept to sign off governing bodies Any comments to CCSO: one governing bodies reject what happens? If it doesn't line up what do we doAR: govern fault line the transformation programme need to be smoother to swallow Collapse on governing - or far better on our data taking incremental decisionsCC: work through the governing bodies the EQIA validation session hopefully answering all the GB questions all behind this - issues need to be addressed Only report back if comfortableJM: CCG make their own decision and could loose the NWL approachTL: primary care is prime example, of thatCC: we need general collaboration approach - yes JM ur right but we have to get to that positionCArmel: this is easy to decisions in the future - this effects the GPS more than the others Lessons to learn from CWAction: could we look at paper from the learning from CW the engagement is done at break neck speed - the learning before we moveCC: 12 sept caveat learning and moving forward I was expecting consultation All of the consultation has now moved8 Areas we were looking at 4 taken off - there is not a timetable In reality the timetable is not there yet - aim to plan togetherVD: leaflet the receptionist does not always understand - to do the GP Comms betterCC: differences in activity in terms of understandingCC: next steps - 5 weeks discussion on the EQIA Did it successfully identify the issues?Moving forward with draft materials for moving forward value ur input in that process We don't to hit the go button and nothing happensJW: we have to be assured that the GP and the patients understandCarmel: there needs to be consistency with GP what is the patient likely to ask the GP And will it be answered - there have to be given the tools - if u give them the tools most of them respondJM: guidance to GPS there needs to be scriptJN: PPGsCV: wider than the GPS information out into the communityCC: to change behaviour to make lives easier the engagement across - wider community commsTL: what do expect to have available and when4) action: CC information to RJC learning, report to come to lay partner before GB Material Around implementation and the planJN: prescription area of pharmacists

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AR: file sharing not sorted nearly cracked the system - lets do Dropbox, security not good1) IT estate is not very modern -2) Microsoft platform similar to Dropbox - pilot site in NWL expecting plan in place before the end of the month File sharing site available to all of u - it will be cloud based - whatever u want to put there It is just a space - two people who have access - one running A library - what is the purpose of the space 35GB Should allow to hold the library at some stage there will be some rules - then the confidentiality acccessJW: basic training to uploadCarmel: being aware working on closing services maybe subject to FOI code of conduct - nothing to stop some information doesn't get shared -AR: there needs to be an official viewSonia : IT has been the bane of my life - all sort of events that I've not even be notified about - basic training - starting from position of way back and this horrifies meTL: basic understanding of what that can or can't do support to access and trainingJN: digitalisation is greater issue a general problem had this will be increasingly usedCV: some people use a mac and that the two are compatibleAR: may not be perfect to start with - segmentation5) action before next meeting live service with guidance ARVD: happy to provide peer supportPC: how easy to use in their homesCV: possible demonstrationAR: apologises for the length of time Microsoft file- shareAR: Collaboration board low risk, mid high risk as a starter need to business plan differently what are the transformation programs we need to start we 3 CCG people to challenge the 5 to drive the programmes differentlyTL: we would support common standards and consistency across NWL as long as we know early enoughAR: if braver put altogether ppwhat is the patient experience today and what is that like in history - the language of that is best owned

Remuneration policyJW: not happy with it based on NHSE guidance asked Andrew to make shorter document 8 pagers with appendices extremely difficulty to get agreementJW: like minded have a different way of operating hope that this policy will evolve Typos correct them - claim form on what remuneration will cover Comments and questionsTL: two levels of suggestion push for mandatory scope at the outset Should this be NWL wide? No one disagreesAction: Claire and ROb to collabaratiin board for their supportJM: supportive of expenses concerned about being paid for meeting- problem about independent something about Jurdical ReviewTL: are we all in agreement with travel expenses - expect people to use public transport only taxis and cars unless circumstancesCarmel: late evening meetings agreement in advanceJW: there are ways of getting receiptsJWHW: summary of Oyster card to produceTL: public transport If the user comes with advocate we must cover both expenses - needs clarification

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CArmel: fair amount should be paid - if someone chooses something that isCV: not the mini wage London living wageTL: greater clarity on the 3 pyramidsTL: headings difficult to Understand could we describe in terms of principlesJN: I was unclear who we referring to - very unclear on who this refers toSonia: not unclearTL: it assumes u know what an expert advisor isJM: what are we talking about CCG may reject due to costTL: phrased implementationGAb: I want to agree on the important of meaning of words - payment more volunteers may provide more time - add value - independent gets blurredTL: some people, wouldn't be able to attend because they couldn't afford to take part. TL: maybe called rewardsJN: some people may only attend because they are paidJW: all professionals are paid it is not like attending a public meeting coproduction at the highest level means paymentTL: how long do we do this for and something about accountability

Update on the involvement Lay paperDescription of the role when they meet and how often Clarify the two headings like minded - VD to make sure Action froM RJCAction: Andrew to bring back an updateProvider Board trusts in London get togetherGAb: 5 May digital citizen appealed to participation - it is a cross cutting piece of work Governance table cross cuttingAction: all to send to RJC -STPS guide one pagerUnderstand easy language detail against content1) over view of STP the 4 projects2) why is it better for the system3) get the information over the next 2 weeks4) short message - simply explain comment on its content5) would this mean anything to people on the street6) a number of individuals GAb, John, VD Carmel

Two Task and Finsh groups1) DiversityTL, SO2) FeedbackOF! CV! VD

SO: National audit office review on STP - feedback to SO Imperial college: interested to work with the academicsTL: apologies

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Action: future actions in bold and larger font

3. Actions from the last meeting

Outstanding actions:1) ACTION: Drop-Box update for next meeting in August (AR to

provide update about IT issues)

2) ACTION: Engagement plan for next steps of Choosing wisely (CC to provide engagement plan prior to next meeting

3) ACTION RJC: Number the items on the agenda

4) ACTION RJC: Pick up the outstanding LPAG actions with Framon and provide update at the next meeting

Future Direction

Item 1: Participation Indicators – presented by Paul Butler NHS England, London region

Paul took the group through the CCG Improvement and Assessment Framework and how it is being developed, going through key actions for each CCG and the domains that ratings will be based on.

Initial ratings are expected to be out in the autumn 2017 and discussed with CCGs.

The initial review shows the NW London assessments are green across the board.

SA: asked why peer reviews were taking place after the assessment is published? Could there be peer assessment approach alongside patients and carers panel?

PB: there was underestimation of the amount of work and the panel will be convened after publication.

TL: not sure that the assessment has anything to do with how we involve the public, this should be a learning exercise, not a tick box. We should spend more on what we could do better.

PB: I will feed feedback back into regional and national team.

PB invited members to a conference on 11 September at Guys hospital, for involvement of lay members in STPs. Can one member be part of the planning for the national steering group?

SO: not sure a seminar is right when we are already doing this in NW London, we are ahead of the game, but could offer guidance of what we have achieved over the last few years. We can offer support to help develop.

Overall, the group felt given the green rating in NWL and that this assessment process is less challenging and developmental then the previous pr

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Item 2: Choosing wisely

SO: there are concerns about the equality impact assessment. Feels like a tick box, rather than bringing out actions that need to be done, before the EIA is signed off. What are the next steps?

There was not sufficient time for this round of engagement. There needs to be more time allocated for the next range of proposals, which are likely to be more controversial, where services already vary across NWL. We need a forward plan for engagement, consultation and EQIAs.

TL: was concerned about the legality of the proposals being challenged by some of the health professionals. The group need assurance that the proposals are legal. As a result of the report will there be any changes, and if so what are these?

SO: we were constrained and didn't have enough time to input properly and the next plans on IVF, surgery etc. We have variation across the boroughs already.

Question: What is the process now if a local CCG is unhappy with the answers provided by the engagement team? We have a report that covers some answers, but what will happen, if there are disagreements?

TL: it feels like ‘you said’, ‘we ignored’.

Group: our advice is that there is a real risk if carry on without addressing concerns

5) ACTION: CC to provide an update to the group responding to the concerns highlighted in section 3 of the engagement report, what are the mitigating actions?

6) ACTION: CC to provide outline plan for the next two programmes and timeline to allow time to input.

EQIA

JN: the survey was appalling, in terms of some of the questions, who would know what to take for each condition?

TL: there is no evidence. The EQIA should provide insight on the impact of different groups. We have not effectively taught our population to self-care or self-manage. This needs to be thought through and evidence-based.

SA: on a fundamental level the EQIA was not done properly.

TL: looks like the EQIA was based on five responses of 105 people the survey was sent to. Would the EQIA stand up legally if challenged?

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SO: inadequate to meet the standards, and other questions weaved into support the next programmes, this is not acceptable, if being used to go further.

SA: did PHAST CIC have the right expertise to do this? Feels like the time pressure has caused failure in the EQIA

SO: each CCG has been written to, by health watch and lay members about the programme and the EQIA is not supported and the issues raised.

7) ACTION: we need legal assurance that the EQIA is adequate and there is not a reputational risk. We are not convinced that the EQIA is adequate. The need assurance before endorsement.

Item 3: Older peoples care in Ealing - engagement

KG presented a paper on the future engagement in Ealing around older peoples’ care. She asked the group for their thoughts on groups to engage with and the type of information that should be collected.

SO: what was the leaning from Ealing maternity work, not comprehensive in terms of not all groups were engaged with. To ensure that you capture all groups input.

SA: collate and map as you go along, create further sustainable relationships.

VD: aim to speak to approximately 15 to 20 housebound patients in each locality.

TL: questions to consider: what are you trying to achieve? What is the best outcome you can get? What is good for you?

Is it….’I want to hold my grandchild’, in other words, focus on the outcomes that people want.

VD: be careful how engagement questions are phrased, what do we want to know about? ‘End of life’, ‘last year’, ‘last days or re-ablement’, these all have different views and outcomes.

SA: there are also mental health considerations on housebound patients

TL: the learning in the paper and the language used should be used across other projects

KG: explained that there will be further engagement with the public on the language used for out of hospital hubs

8. ACTION: add out of hospital hub engagement to a future agenda

Item 4: Closing the involvement gaps

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The group acknowledged that they could not cover all groups.

KG suggested adding a column of the current groups that are working on projects, as not all live. She also suggested that the group use the table to inform future agendas, where there isn’t a lay member present, the group could invite speakers to share their plans so they can input and support.

This idea was agreed and supported.

9. ACTION: KG update the table with a column showing which groups are currently up and a time indication of when new groups will come online

10. ACTION group: Email missing groups attended to KG or RJC for addition to the table

New table to be provided for the next meeting

Future meetings

SO and TL: to talk to Alasdair to develop future agendas, based on priorities

MM: the group needs to be more strategic

AOB

JN: information governance board needs reps from all eight boroughs, two additional members have put themselves forward

TL: how do we feedback what we are learning from the groups we attend and how do we feed this back?

11. ACTION: add to a future agenda, recruitment, young people on the group and how updates are provided to the group to share learning from each other

Date, time and venue for the next meeting

8 August 2017, 10 to 12pm, Room 2.1 MBR

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Documents

€¦ · Web viewOne single commissioning voice theory ... old structural slide ... can't all be done in paper and must dome also in public great lose locally if no opportunity