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HERTS VALLEYS CLINICAL COMMISSIONING GROUP

WHAT DOES A “PATIENT ENGAGED ORGANISATION” LOOK LIKE AND HOW

DO WE GET THERE: CLINICAL AND STAFF PERSPECTIVES IN SHARED DECISION-

MAKING AND INFORMATION GIVING

FINAL REPORT VERSION 1.005.08.11

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CONTENTS

PageIntroduction and background 3

How best can we build support for shared decision-making and information giving in routine NHS care?

4

How can commissioning maximise patient involvement in their own health and care, considering shared decision-making and information-giving as outcomes, and how might these be reflected in commissioning specifications?

14

How can we build an understanding that shared decision-making is part of the same paradigm as personal health planning, supported self-care and the wider personalisation agenda (no decision about me without me), that is a key priority of government - in order to support spread and implementation across regional systems?

17

Conclusions and Lessons Learned 19

Appendix I: Project planAppendix II: Example material from Manor ViewAppendix III: Draft PPI structures showing links with social care commissioning

Version control

Number Author Date Action1 JT O4.08.11 Sent to Nicolas Small (interim chair)1 JT 05.08.11 Sent to Sarah Walker

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What does a “patient engaged organisation” look like and how do we get there: Clinical and staff perspectives in shared decision-making and information giving

Introduction and background

Herts Valleys Clinical Commissioning Group (HVCCG) put in an application in February 2011 to

the Strategic Health Authority for funding to support clinical and staff perspectives in shared

decision making and information giving.

The brief for the project was framed around three questions:

1. How best can we build support for shared decision-making and information giving in

routine NHS care?

2. How can commissioning maximise patient involvement in their own health and care,

considering shared decision-making and information-giving as outcomes, and how

might these be reflected in commissioning specifications?

3. How can we build an understanding that shared decision-making is part of the same

paradigm as personal health planning, supported self-care and the wider

personalisation agenda (no decision about me without me), that is a key priority of

government - in order to support spread and implementation across regional systems?

The timescale for the project was 12 weeks. In order to explore each question above a number

of activities were initiated. This report provides a picture of the progress that has been made.

The report is organised around the three questions above as these formed the basis of the

project plan (see Appendix I).

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Question 1: How best can we build support for shared decision-making and information giving in routine NHS care?

SCOPE

Our perception of Question 1 was that integrating shared decision-making and information

giving in routine NHS care, requires that clinicians in general practice are involved in shared

decision-making with individual patients and groups of patients, and that a culture of making

sure that patients are enabled to make informed choices should be embedded throughout the

patient experience of primary care.

Three strands of work contributed to answering the first question:

1. The first strand of work was to identify best practice at clinician level so that we could

identify practical steps that clinicians are already taking to increase patients’

involvement in their own health and care.

2. The second strand of work invited GPs to trial work on shared decision-making with

discrete groups of patients so that we could focus work to increase our understanding of

the barriers and facilitators to shared decision-making, which we can then apply across

wider groups of patients.

3. The third strand of work was:

To map existing patient participation groups and provide support for those

practices that do not have a group.

To evaluate the development of patient resource hubs in practices where they

exist, which will be a focal point of information for patients to promote shared

decision-making with a view to rolling this model out to all 65 practices.

To pilot engagement ‘Champions’ in 1-2 practices across each locality (we have

had huge success with Carer’s Champions which this system would be modelled

on), again with the intention of evaluating and rolling this out across the Clinical

Commissioning Group.

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PROCESS

For the first strand of work, practices were asked to provide examples of shared-decision

making to the project manager. A document asking for expressions of interest for strand 2 and

for the engagement champion work (part of strand 3) was prepared and circulated to all

practices within HVCCG.

Four practices were approved by the HVCCG steering group to pilot shared decision-making

(strand 2). Table 1 shows the scope of the pilot.

Table 1

Practice: Davenport House SurgerySummary: Working with residents in a home run by Mencap, and their carers to support

better access to health and health related issuesOutcomes: To enhance access to care for residents by increasing their understanding of

health and health related issues.

Practice: HolywellSummary: Working with people with long term conditions to pilot a patient held record

which would be brought to each consultation. The record will include a current summary (including medication); recent values; management plans agreed with the patient; medication information; a diary e.g. when bloods are due to be taken, reviews; and a healthy living section.

Outcomes: To empower the patient by ensuring that they have information to enable better shared-decision making, to aid compliance, to minimise unnecessary visits and streamline delivery of chronic disease management.

Practice: Maltings SurgerySummary: Working with people with Type 2 diabetes to review their knowledge of their

treatment and perceptions of their involvement in decision making about their care

Outcomes: Better understanding of how people with Type 2 diabetes understand their condition so enabling the practice to identify and provide information and resources to meet actual rather than assume individual needs.

Practice: Schopwick SurgerySummary: Working with patients with Parkinson’s disease, this pilot will first ensure that

an up to date directory of available resources is available to ensure that shared decisions only look at realistic options. Each patient will be invited for review after the directory has been completed.

Outcomes: Complete review of the needs of a discrete group of patients and discussions on an individual basis with the patient to decide together most appropriate courses of action.

In order to share the outcomes of the pilot work, practices involved in the pilot were asked to

submit case study examples and other information that would be helpful to others derived from

their work.

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Seven practices were approved by the HVCCG steering group to pilot ‘engagement champions’.

Table 2 shows a summary of the action plans for the engagement work (strand 3).

Table 2

Practice: Davenport House SurgeryActions: 1. To print a leaflet and posters advertising the Patient Participation

Group. Leaflets will be stapled to repeat prescription requests. Membership forms will also be available.

2. To maintain a collection box at reception for patients who do not have access to email and mail copies of newsletters and membership forms to these patients.

3. To support a large group meeting in July for patients around health reforms and on-going smaller events around patient identified health topics.

4. To promote the Patient Participation Group to younger patients.5. To support the development of an email database through which to aid

communication of events and general discussions of surgery developments.

6. To support the development of self-management information for patients.

Practice: Maltings SurgeryActions: 1. To analyse in detail the demographic profile of the practice population

and attendees at the practice.2. To form a patient representative group ideally reflecting the age, sex

and ethnic profile of the practice. The PRG will be advertised via posters and through the practice website.

3. The intention is to enable the PRG to be part of the design of a programme which is likely to include:- Update of the practice website and explore Twitter feed to share in a

transparent way the pressures that practices face.- Self-care and signposting to make the website the first port of call

for patients seeking information. An audit of urgent appointments and home visits will support tailoring of information. Links to NHS Choices self care pages.

- Information on GP areas of speciality so that patients can make choices about which GP to see.

- Management of long term conditions - to include a written management plan and information about what to do if a condition worsens.

- Identification and individual review by a named GP of frequent attendees.

- Seminars/events/small group networks on specific conditions.

Practice: Highview Medical CentreActions: 1. To develop the practice website with links to outside organisation, self-

help groups, patient choice, NHS Direct. The website will allow direct communication between GP, nurses, practice staff and patients.

2. To provide self-help advice for common minor illnesses and over the counter medication advice through the website.

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3. To develop the Patient Participation Group.4. To support patient education events for the practice population

publicised through the website, mailings and newsletters.5. To develop e-newsletters and support a Practice Twitter.6. To develop a Practice Facebook.7. To promote self-management programmes and exercises to alleviate

common musculo-skeletal problems.

Practice: Schopwick SurgeryActions: 1. To promote the Patient Participation Group through the development of

information and targeted mail-shot.2. To develop material for the practice website to enable communication

with patients and opportunity for patient feedback on our services and other services that patients have accessed.

3. To support the Parkinson’s shared decision making pilot with a view to rolling the model out to other groups of patients.

4. To be a resource for other members of the practice team around patient engagement.

5. To liaise with other practices to identify good practice that can be brought to Schopwick.

Practice: Bennetts EndActions: 1. To reach out to patients, remembering those who use and do not use the

service, by utilising a variety of communication methods and promoting the Patient Participation Group, including reaching out to the wider community with virtual PPGs providing the opportunity for patient feedback on our services.

2. To develop material to enable communication with patients with sensory impairment, and to promote learning to increase the awareness of practice staff for effective communication with this discreet population.

3. To explore and, hopefully, set up and run a clinic, - by one of the managing partner/Management Assistant/Head of Reception/Reception team leader(s) and a member of the Patient Participation Group – where patients can discuss the services, improvements and becoming involved.

4. To be a resource for other team members in Practices within Herts Valley Clinical Commissioning Group.

5. To liaise with other practices and networks, e.g. the National Association for Patient Participation and the Royal College of General Practitioners to identify good practice that can be shared at Bennetts End and with other practices across the HVCC.

Practice: Manor View Actions: 1. To promote the Patient Participation Group through the development of

information.2. To develop material for the practice website to enable communication

with patients3. To develop a practice questionnaire that is useful and meaningful to the

practice and patients equally.4. To be a resource for other members of the practice team around patient

engagement.5. To liaise with other practices to identify good practice that can be

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brought to Manor View.

Practice: HolywellActions: 1. To promote the better use of advance care planning for people with

dementia in care homes.2. To develop a robust process to ensure that documentation around the

wishes and preferences of people with dementia is known about and adhered to, particularly in an emergency situation. This should include DNAR wishes and LPA.

A simple evaluation framework was developed for practices to report on the patient

engagement champion work. The framework (see Table 3 below) asked for progress and

information against each of the actions:

Table 3

Action Progress Information

E.g.To promote the Patient Participation Group through the development of information and targeted mail-shot.

E.g.

Information and promotional material produced. Available on practice website and mailed to x people.

E.g.

Leaflet attached. Website link is *****

Work on mapping existing Patient Participation Groups (PPGs) was undertaken with support

from the Patient Engagement Manager at NHS Hertfordshire.

The development of the resource hubs is being piloted in one of the localities of HVCCG. Hubs

can be actual or virtual. As some of this work is embryonic the evaluation focused on those

practices which had well established patient information hubs, so that good practice could be

shared. Further evaluation will be on-going and shared across HVCCG.

OUTCOMES

Audit of existing shared-decision making best practice

We received only one example of good practice about shared decision-making on an individual

basis, although anecdotally we believe that more good work is taking place. The one example

from Annandale Surgery, is the development of self-management plans for people with Chronic

Obstructive Pulmonary Disease (COPD), which includes an ‘emergency pack’ with steroids and

antibiotics with discussions and written information about when to initiate these, plus a booklet

which discusses breathing exercises, nutrition, general muscle exercises.

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We did receive data about work with groups of patients. For example, one Davenport House

Surgery has held evening events on prostate cancer, depression, foot problems, diet, gastro-

enterological problems, menopause, incontinence and breast cancer. Two GPs from the practice

have given talks at the local children’s centre to encourage self management and awareness of

services. Parkfield Surgery offer similar events and have recently offered talks on Dementia and

reconstructive surgery, with a further event planned in October on hip and knee surgery.

Shared Decision-Making Pilots

The shared decision-making pilots are underway. Progress reported to date is provided below

in Table 4:

Table 4

Practice: Davenport House SurgerySummary: Working with residents in a home run by Mencap, and their carers to support

better access to health and health related issuesProgress: Awaiting report

Practice: HolywellSummary: Working with people with long term conditions to pilot a patient held record

which would be brought to each consultation. The record will include a current summary (including medication); recent values; management plans agreed with the patient; medication information; a diary e.g. when bloods are due to be taken, reviews; and a healthy living section.

Progress: Awaiting report

Practice: Maltings SurgerySummary: Working with people with Type 2 diabetes to review their knowledge of their

treatment and perceptions of their involvement in decision making about their care

Progress: A group of patients with diabetes on drug treatment have been randomly selected and asked to participate in the pilot. A questionnaire has been circulated which asks:

1. Do you feel actively involved in the decisions affecting your diabetes treatment?

2. Do you feel you have a good understanding of diabetes as a condition?3. Do you feel that the doctor or nurse listens to your concerns when you

come to see them about your diabetes?4. How can we make you feel more involved in the decisions taken around

your diabetes care?5. Do you feel you know enough about your repeat medication and why

each item is prescribed?

Results from the survey are still being received by the practice. Data will be analysed when all returns are received with a view to making any changes which might benefit shared decision-making, such as the use of aids, being given links to specific types of information, more continuity or attending educational sessions.

A diabetes review template has been developed which provides information

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about blood sugar control, weight, blood pressure, cholesterol and lipids, aspirin, kidney damage and albumin creatinine ratio, eye checks, flu vaccination. Ideal and acceptable targets are specified and an agreed action plan for each element of the plan is formed.

Practice: Schopwick SurgerySummary: Working with patients with Parkinson’s disease, this pilot will first ensure that

an up to date directory of available resources is available to ensure that shared decisions only look at realistic options. Each patient will be invited for review after the directory has been completed.

Progress: Patient information pack completed including local and national information.Searches of patients completed and all patients have been invited for review.Meeting arranged for patients with speakers including a consultant, nurses and the Parkinson’s team from a nearby specialist centre.

The pilot sites have found the timescales very challenging. However, we anticipate that case

study material will be available over the next few weeks.

Patient Engagement Champions in Practices

The seven practices which applied to pilot engagement champions were asked to report

progress using the template provided. To date we have received reports from five of the pilots.

Practice: Davenport House SurgeryProgress: Awaiting report

Practice: Maltings SurgeryProgress: A practice meeting has been held to discuss frequent attenders, signposting and

the practice website where we did small group work so that all of the team were involved. The practice website should be live imminently and has a lot of patient signposting on it with links, as well as details on who to see when. The practice is actively managing frequent attenders by drawing up a list and reviewing them at regular less frequent intervals. The Patient Participation Group is meeting in September.

Practice: Highview Medical CentreProgress: Website is now in its final stages of design - it should hopefully be live in

September - page and logo for patient participation group, e-newsletter being developed, page linking to other organisations etc; self help pages etc Facebook and Twitter set up with followers. Patient participation group up and running - 3rd meeting scheduled for September 13th. Two patient education evenings booked- November and February - talks by consultants arranged and booked. Patient Meeting arranged for October 4th - all day drop in sessions to discuss

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new premises, patient group representatives will be there and recruiting patients for PRG, qualitative focus groups throughout the day to develop practice survey questions, web site team will be demonstrating on line services and website, Hertfordshire leisure services promoting exercise on prescription scheme, smoking cessation advice information, Chlamydia screening information, blood pressure monitoring, healthy eating stand, and lots more! Six patient focus groups organised during September to discuss what services different groups of patients need and require from the practice - will be used to develop the practice survey questions, influence commissioning in the future and give information to us on the services needed in the future. Target groups including patients with long term conditions (diabetes and COPD - emergency admission avoidance); new patients registered with the practice (lots of immigrant families to the area, how we compare with other practices, expectations from a doctors surgery); parents of children under 10 (out of hours services, A&E, the effect of the lack of the extended family on health related problems in children, health visitors role); The Commuter Belt patients (will the change in boundary rules affect our patient registrations, what do we need to do to retain these patients); patients with mental health issues (the provision or lack of provision of mental health services for patients and their families).

The groups will be facilitated by a professional analyst (member of the patient group) and if successful we will target different groups of patients throughout the year - 8-10 patients in each group.

Practice: Schopwick SurgeryProgress: Patient Participation Group established - named the Schopwick Patient

Community. The group has met twice to date. The ‘champion’ has also worked with the Local Medical Committee to share the work with patient engagement at a local conference.

Practice: Bennetts EndProgress: Completed a review of complaints, comments and compliments and held a

meeting with the Managing Partner and the Head of Reception. Patients have been invited to take part in improvement work and email contacts have been taken so that they can take part in any survey work or improvement work. Mapping of the patient experience has taken place to inform the patient improvement journey.

Workshop held to raise awareness of access for patients with sensory impairment working with the Hertfordshire Hearing Advisory Service and the Hertfordshire Society for the Blind. A ‘help desk’ for those with sensory impairment is planned as a ‘pilot’ and a drop-in clinic (combined with the seasonal flu campaign) is being organised - there will be two clinics (one for those with hearing impairment and one for those with sight impairment).

Work on sharing good practice is planned to include participation in a Practice Manager’s event and promoting the work of the Practice Manager’s Network and N.A.P.P.

Practice: Manor ViewSee Appendix II

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Practice: HolywellProgress: Awaiting report.

Mapping Patient Participation GroupsMapping of existing Patient Participation Groups (PPGs) took place in April 2011 (see Box

below). Of the 65 practices within HVCCG, eleven had a PPG meaning that only 17% of our

practices had a group. Nationally, the figure is around 25%.

Bennetts End (Dacorum)Haverfield (Dacorum)

Parkwood Drive (Dacorum)

Highview (Hertsmere)Parkfield (Hertsmere)

Davenport (St Albans and Harpenden)Redbourn (St Albans and Harpenden)Highfield (St Albans and Harpenden)

Wheathampstead (St Albans and Harpenden)

Attenborough (Watford and Three Rivers)Park End (Watford and Three Rivers)

Since April two of the practices participating in the pilot work have established or are in the

process of establishing groups (Schopwick, which is part of the Hertsmere locality has a group

which has met twice to date; Manor View, which is part of the Watford locality is having its first

meeting in September). We are also aware that a significant number of practices are in the

process of setting up Patient Reference Groups in line with the Direct Enhanced Service,

accessible through the Quality and Outcomes Framework.

Evaluation of Resource Hubs

The practices in the Hertsmere locality have recently received funding to help establish patient

resource hubs. A hub might be a room, a space in the surgery or virtual. As the hubs are still

developing the project manager visited one established hub in Hertsmere which is providing

one model for other practices to follow. The project manager also visited a practice in Dacorum

which has a patient resource area within the waiting room:

Parkfield

Parkfield Medical Centre has set up a patient resource room adjacent to the patient waiting area.

The resource room contains a patient library which has books which patients can read on site,

or they can borrow. The room also contains a range of leaflets, a blood pressure monitoring

machine and a machine for estimating BMI - both purchased by the Patient Participation Group.

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Patients are frequently directed to books in the resource room by clinical staff so that they can

better understand particular illnesses.

Bennetts End

Bennetts End Surgery has allocated an area of the waiting room to the Friends of Bennetts End

Surgery (FOBES). There is a room where members of FOBES make tea and coffee for patients in

the waiting room, and there is a range of books and leaflets for patients.

Evaluation of the remaining Hertsmere hubs will take place over the coming weeks.

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Question 2: How can commissioning maximise patient involvement in their own health and care, considering shared decision-making and information-giving as outcomes, and how might these be reflected in commissioning specifications?

SCOPE

In order to explore how commissioning can maximise patient involvement in their own health

and care we undertook four pieces of work to further our knowledge and understanding of how

we might address Question 2.

1. Develop a commissioning involvement strategy, which would build on existing

structures and best practice, and link to the commissioning cycle, as well as exploring

links with social care.

2. Develop patient champion groups across the localities to work with the commissioning

group to explore how best to engage and involve.

3. Roll out our ‘people bank’, which is a matrix of people with special interest in different

health and care specialities.

4. Develop a web presence which will include a repository of health and care information

for local people, as well as a toolkit of information for practices about involvement and

engagement.

It should be noted that we had involved patients in the development of our pathfinder

application to become a Shadow Clinical Commissioning Group, a patient representative from

each of the existing patient groups in each locality are members of the Commissioning Group’s

steering group - two of these representatives sit on the project management group

PROCESS

The work to develop the commissioning involvement strategy was undertaken by the project

manager. It was informed by four key meetings/events:

1. The patient engagement manager for NHS Hertfordshire and the project manager for the

‘patient engaged organisation’ project hosted a meeting which was attended by

representatives from the four HVCCG localities and the Chair of the Hertfordshire LINk.

The purpose of this meeting was to scope existing work and to plan future collaboration.

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2. The project manager met with a representative from Hertfordshire LINk who had been

nominated to be the liaison with HVCCG but who was unable to attend the meeting

above. This enabled sharing of experiences, proposals and plans.

3. In June 2011 an Accelerated Design Event was held which was attended by a significant

majority of the 65 practices across HVCCG, patient representatives and officers from

NHS Hertfordshire. A specific workshop about patient involvement and engagement was

held - facilitated by the Chair of the Commissioning Group’s steering group and the

project manager.

4. The project manager met with the Brokerage manager from Hertfordshire Health and

Social Care, which commissions Social Care services across HVCCG. This meeting to

enable greater understanding of current work and future plans.

Work to roll out the patient champion model involved sharing information about involvement

activities and patient groups across localities to ensure that each locality commissioning group

has patient involvement with their work.

Work to roll out the People Bank model is being piloted in one locality through practices and

through the locality website, newspaper articles and word of mouth. The People Bank model

has been met with enthusiasm by the other locality groups and after a brief period of evaluation

will be rolled out across the Clinical Commissioning Group. Essentially, the People Bank aims to

engage people who are interested in ‘single’ health issues such as mental health, diabetes,

coronary heart disease, stroke etc. People can identify ‘their’ issues and provide a ready-made

consultation group who can be called upon when the Clinical Commissioning Group is focusing

on a particular clinical issue.

Developing the web-presence is an essential part of the process of sharing information with

patients and the public, as well as clinicians. Part of the project work has involved developing

and searching out information that will help practices to become patient engaged.

OUTCOMES

The Commissioning Involvement Strategy

The Commissioning Involvement Strategy has been developed and will be placed on the HVCCG

website when it has been approved by the HVCCG board. This is unlikely to be before the Health

Bill has made its way through the parliamentary process and we are more certain of

requirements on us.

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Elements of the strategy, for example linking with social care commissioning have been agreed

and we have attached this as an example in Appendix III.

Patient champion groups

Understanding how HVCCG can build on existing group structures in order to support

commissioning from the four localities has been a key piece of work. Many groups exist across

HVCCG - some emerged from previous patient forums and others formed around Practice Based

Commissioning locality groups.

With support from the Patient Engagement Manager at NHS Hertfordshire we have been able to

map how groups interact with each other, and how in each locality, groups will link to locality

commissioning groups and from there to HVCCG.

A second meeting of a small group of representatives from each locality is planned for

September when charts will be finalised and placed on the HVCCG website.

The People Bank

The People Bank will be expanded across HVCCG as soon as the evaluation in Hertsmere is

complete. Leaflets, flyers and press releases - similar to those used to launch the People bank in

Hertsmere have been developed in preparation for the launch.

The HVCCG website

Information about this project and other tools and resources will be placed on the website

which has just been launched after a long delay. The web pages are currently being prepared. As

well as information for patients and the public, our part of the site will include information for

practices with links to, for example, the N.A.P.P. resource on setting up a PPG and the Practice

Managers Network site, which houses information about setting up a virtual Patient Reference

Group.

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Question 3: How can we build an understanding that shared decision-making is part of the same paradigm as personal health planning, supported self-care and the wider personalisation agenda (no decision about me without me), that is a key priority of government - in order to support spread and implementation across regional systems?

SCOPE

Building an understanding of shared decision-making so that we could support spread and

implementation across regional systems is an essential part of the project. We needed to ensure

that we have a comprehensive way of capturing and using data from shared decision-making

activities. We needed to develop robust ways of monitoring and measuring the impact of shared

decision-making so that we could provide an evidence base for clinicians, staff, patients and the

public that shared decision-making is worthwhile and makes a real difference to patients. This

includes developing processes for feedback to patients, the public and other partners and ways

of continually monitoring the need to adapt decision-making activities. In this way we could

develop an evidence base of the effectiveness of shared decision-making that matches the

growing body of evidence around personal health planning, supported self-care and the wider

personalisation agenda.

We undertook to do two pieces of work to support Question 3:

1. To develop a data capture tool - this would be available to practices and others through

the website and which will be incorporated into our patient and Public Involvement in

Commissioning Strategy.

2. To develop an impact framework.

In addition we have undertaken/agreed to undertake three other activities:

3. We have attended regional meetings and met with the SHA project lead, and have

produced monthly progress reports.

4. We have agreed to speak at an SHA event about the work of our project.

5. We are planning an event for Practice Managers, who we see as key to promoting

involvement at practice level, so that we can share progress to date.

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PROCESS

The data capture tool was developed by the project manager, using a ‘Structure, Process,

Outcomes’ model (see Figure 1 below).

Figure 1

The impact framework was developed by the project manager to build on the data capture tool,

and requires further measurement of the outcomes to evaluate the impact of a particular

activity or event.

OUTCOMES

Data capture tool

The data capture tool, based on the structure, process, outcome model shown in Figure 1, has

been developed into a short ‘How to’ guide, which will be placed on the website as part of the

toolkit.

The impact framework

The impact framework, which includes guidance on measuring the impact of involvement has

also been developed into a short ‘How to’ guide, which will be placed on the website as part of

the toolkit.

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Conclusions and Lessons Learned

The project set out an ambitious programme of work and has achieved a great deal in a very

short period of time. There is still much to do and much to achieve. It will, however, provide

HVCCG with an excellent baseline from which it can move forward to become a truly patient

engaged organisation.

There are a number of issues which have challenged us in completing the project on time and

we have highlighted a few of these below:

1. We launched the project at the beginning of April, which in retrospect was a difficult

time because of several public holidays and many staff being on leave. We felt that we

had to impose short deadlines for expressions of interest in the pilot work but we

believe that we ‘missed’ some people who would have been interested if we had

launched the project at a different time.

2. The launch of the project coincided with the end of year QOF work, which is always a

difficult time for practices.

3. The website should have been launched in early May but has only just become live due

to authorisation issues.

4. The ‘listening exercise’ has meant that there is still uncertainty about the final

constitution of the Clinical Commissioning Group. The strategy, which was completed

some time ago needs revisions which we will not be able to do until the HVCCG has

finalised its functions and hence its functional units.

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Appendix I

HERTS VALLEYS CLINICAL COMMISSIONING GROUPWhat does a “patient engaged organisation” look like and how do we get there: Clinical and staff

perspectives in shared decision-making and information giving

PROJECT PLANWeeks

Activity 1 2 3 4 5 6 7 8 9 10 11 12Audit to identify best practice across the localitiesWrite up audit and ratify with steering groupPlace results on web-siteIdentification and set up shared decision-making pilotsCollate information and write up case studiesPlace case studies on web-siteMap Patient Participation groupsPut map on web-siteBring together toolkit of available resourcesMake available on web-siteEvaluation of resource hubs and sharing resultsIdentification of engagement champions (ECs)Developing the evaluation framework for the ECsEvaluating and sharing ECs approachesRolling out the patient champion modelRolling out the People BankDeveloping the web-siteDeveloping the commissioning involvement strategy Develop and share the involvement capture toolDevelop the impact frameworkCollate the final reportProject closurePresent end of project final report

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Appendix II - Engagement Champion Pilot (examples)

Manor View Practice – Patient Participation Group Development Update 30/6/2011

Action Progress Information6. To promote the Patient

Participation Group through the development of information.

Information and promotional material produced. Available on practice website, in the practice, on repeat prescription forms and on practice recall letters.Clinical and admin staff are encouraging patients to apply whilst they are in the practice- they can fill out a form at reception which is identical to the website form

1. The Process went live on 29/62. Leaflet /poster attached. 3. There is an electronic message on our

electronic display screens- this is attached.

4. A message is added to the bottom of repeat re-order slips, to the email response to a repeat prescription request and on the bottom of certain recall letters. The message is “Would you like to have a say about the services provided at Manor View Practice? We are forming a patient participation group – please see our website for more details www.manorviewpractice.co.uk

7. To develop material for the practice website to enable communication with patients

We have begun to receive email requests to join the PPG. The email addresses are stored in a secure database which will be used to email out the questionnaires which are an integral part of our website. Patients will not have to log onto another website to do this. Email addresses received in the practice will have to be added manually.

Website link is www.manorviewpractice.co.ukSee also www.manorviewpractice.co.uk/secure/survey_signup.aspx?p=E82073

8. To develop a practice questionnaire that is useful and meaningful to the practice and patients equally.

Once the PRG has sufficient numbers (we hope a minimum of 100) we will email out a “priority survey”

Draft priority survey attached.

9. To be a resource for other members of the practice team around patient engagement.

10. To liaise with other practices to identify good practice that can be brought to Manor View.

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http://www.manorviewpractice.co.uk/

http://www.manorviewpractice.co.uk/

Screen shot and flyer

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Priorities survey

We are planning a survey and to ensure that we ask the right questions, we would like to know what you think should be our key priorities when it comes to looking at the services we provide to you and others in the practice.

What do you think are the most important issues on which we should consult our patients? For example, which of the following do you think we should focus on:

Please rank the following from 1-9 with 1 being the most important issue and 9 the least important

Clinical care Satisfaction with clinical staff

Satisfaction with reception and admin staff

Communication including telephone access

Ease of getting an appointment and appointment times

Opening times

Accessibility of health centre and parking

Facilities and cleanliness inside the practice

Other please specify below

Please use the space below to add any comments. If there are specific medical conditions that you feel the practice should devote more attention to please specify below.

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HCL PPI GROUPST ALBANS PATIENT GROUP

DACORUM PATIENT GROUP

WATCOM PATIENT GROUP

LOCAL HEALTHWATCH

HERTSMERE VOICEST ALBANS VOICEDACORUM VOICE(PLANNED)

WATFORD VOICE (PLANNED)

LEARNING DISABILITY FORUM

Appendix III

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HEALTH AND WELLBEING BOARD

HERTS VALLEYS CLINICAL COMMISSIONING GROUP

HEALTH AND COMMUNITY SERVICES (COMMISSIONING)

WATCOM DACCOM ST ALBANS HERTSMERE

WATCOM DACCOM ST ALBANS HERTSMERE

PATIENT PARTICIPATION GROUPS/PATIENT REFERENCE GROUPS

GP PRACTICES

JOINT COMMISSIONING TEAM

CRITICAL FRIENDS

TIME BANK AND PEOPLE BANK

INTERESTED INDIVIDUALS

PLANNED

herts valleys clinical commissioning group€¦ · web viewto maintain a collection box at...

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