Health Ambassadors Scheme

Minutes of the Health Ambassadors Scheme Meeting

Doncaster CVS - 16th May 2016

Who attended the meeting:

Name / Representing
Sue Womack / Doncaster CVS (Chair)
Tom McKnight / Doncaster CVS
Dennis Atkin / Health Ambassador (Cancer) - Chair Designate
Violet Cannon / Health Ambassador (Gypsy & Traveller Community)
Joyce Foster / Health Ambassador (Homeless)
Peter Nicholson / Health Ambassador (Deaf Community)
Rob Tame / Health Ambassador (Learning Disability)
Julia Burne / Health Ambassador (Refugees & Asylum Seekers)
Cath Fox / Health Ambassador (LGBT Community)
Kayleigh Wastnage / NHS Doncaster CCG
Adam Tingle / NHS Doncaster CCG
Nick Andrews / BSL Interpreter
1.  Welcome / Sue welcomed everyone to the meeting and introductions were made.
2.  Apologies / Some people could not make it to this meeting:
Mary Ellis - Health Ambassador (Sex Workers)
Mary Jones - Doncaster and District Deaf Society
Paula Nicholson - Gypsy & Traveller Community
3. Minutes from the previous meeting held on the
11th April 2016 / The minutes from the previous meeting were read and accepted as a true record.
4. Matters Arising / There were no matters arising from the previous meetings minutes.
5. Presentation by Kayleigh Wastnage - Transforming Primary Care Agenda / Kayleigh advised the meeting that NHS Doncaster CCG is now a fully delegated CCG from the 1st April 2016. This means the CCG is the decision maker and is responsible for General Practice (GP practice) services. This includes monitoring their contracts and designing and enforcing new services. In 2015 Doncaster CCG had developed the Primary Care Delivery Model. The Delivery Model has four ‘pillars’ of care:
•  Keeping People Well
•  Responsive Primary Care
•  Proactive Coordinated Primary Care
•  Extended Primary Care
In 2016-2017 Doncaster CCG will be focusing on the Proactive Coordinated Primary Care ‘pillar’.
Following the presentation by Kayleigh, a copy of which is attached to these minutes, questions were taken.
Dennis asked if some of the changes were in operation already, in particular, Nurses in GP Surgeries undertaking triage activities to try to lessen the need for patients being seen by GPs. Kayleigh responded by stating that GPs are private businesses and deployed their workforce to the best available advantage of both patients and their surgery depending on skill, qualification and experience levels.
Sue asked if there was any timescales involved in this delivery model and Kayleigh responded by stating that the Proactive Coordinated Primary Care Core Specification would be live in October 2016.
Sue stated that at present, responses from the Sub Groups to questions posed by the CCG are fed back to the Engagement and Experience Committee and how will these responses influence decisions being made by the CCG. Kayleigh responded by stating that all feedback is evaluated and considered when drafting the Service Specifications along with other evaluation and feedback received from other bodies that the CCG consults with.
Cath asked the question regarding GP Practices not conforming with the Service Specifications issued to them. Kayleigh responded by stating that in the first instance this would result in the CCG having a 'conversation' with the GP Practice concerned to ascertain the reason why they were not conforming to the Service Specification. If that did not remedy the situation, the CCG can then issue a Breach Notice which, if not responded to, could lead to non payment by the CCG to that Practice and even a contract being terminated resulting in patients being transferred to other GP Practices in their area. However, this action would only be taken as a last resort and, in practice, the CCG would work strongly with any failing GP Practice to endeavour to remedy the situation before these drastic measures would need to be taken.
Dennis pointed out that Doncaster is made up of varying areas of both affluence and deprivation and asked if it was a 'one size fits all' model?
Kayleigh responded by stating that Service Specifications are written to allow flexibility and take into account the location of the various GP Practices in both areas of affluence and deprivation. GPs are paid by the number of patients registered at their Practice but 'weightings' are applied depending on age ranges and medical conditions of patients at differing Practices.
Peter asked if more money was allocated to Practices if they had patients with disabilities registered and Kayleigh responded by stating that was indeed the case. Each patient has a different sum of money 'attached' to them depending on age, illness or disability.
Joyce asked if the Service Specifications being issued to GP Practices had 'targets' attached and Kayleigh responded by stating yes, targets were part of the Specifications and this would apply to all four of the 'pillars of care' that the CCG would be looking at.
Action: Tom to obtain a copy of the presentation delivered by Kayleigh and forward with the minutes.
6. Sub Group Activities / Sue advised the meeting that some of the recently formed Sub Groups had met and had displayed a degree of creativeness in how they had approached the issue of obtaining the views and opinions of the groups of people that they represented on the question of Access to Primary Care.
Dennis will use existing Cancer Groups who he will approach to obtain views and opinions. This avoided the duplication of setting up a Cancer Sub Group. Violet had obtained views and opinions from members of the Gypsy and Traveller Community whilst attending a coffee morning as this was a tried and tested method used successfully in the past. Sue mentioned that Mary had used their weekly outreach service as a platform to obtain views and opinions from Sex Workers as they attended outreach for a number of reasons including for their health needs. Joyce was obtaining views and opinions from homeless people through their Community Support Team and Peter had set up a dedicated Sub Group made up of members of the Deaf Community representing different Groups.
The first round of CCG questions on Access to primary Care had flagged up some issues. These were:
·  The 'language' used in compiling the questions which some Groups found not to be accessible to their members. Work had been undertaken by some Groups to remedy this issue. Rob had obtained assistance from a highly trained colleague to have the questions rewritten into 'Easy Read' format and Peter requested if he could have access to this material.
·  Julia also encountered problems with the questions with her Group and considered that they would have benefitted from 'examples' of other options available in relation to some of the questions where options were required to be considered but not supplied.
·  Joyce mentioned that for the homeless people that M25 supports, the questions had had to be translated into fourteen different languages.
As a result of this feedback on 'language', future questions will be supplied to Health Ambassadors for comments before they are presented to the Sub Groups.
Joyce asked the question regarding 'sample size' and 'timescales'. Sue responded by stating that she would ask the CCG for a responses to these questions. There was already an eight week timescale between Health Ambassador meetings for responses to questions which will be fed out after future Health Ambassador meetings. However, it is recognised that differing groups have their individual problems to obtaining views and opinions from the people they represent and that 'quality of response' should take priority over 'quantity of response.'
Julia raised the concern that 'consultation' often raises 'expectations' amongst her members and this was a concern amongst most of the Health Ambassadors present where it was considered that consultation must lead to change.
Sue advised the Ambassadors that it was incumbent upon them to be clear with the people that they consulted with that any changes that occurred as a result of consultation was likely to take time as it was part of a much broader piece of work being carried out by the CCG.
Sue advised the meeting that once all the feedback had been received from all the 'Sub Groups' this would be populated into a document showing a 'themes and trends' summary and sent to the CCG Engagement and Experience Committee along with all the notes from the Sub Groups so that all information received from the Sub Groups was sent for reference.
Sue advised the meeting that the CCG had requested that the Health Ambassador pilot be expanded to included representation from a Veterans Health Ambassador. Tom had contacted Lisa Swainston, Stronger Communities Wellbeing Manager, Adults, Health and Wellbeing at DMBC with a view to moving this forward. A meeting had been arranged for Friday 3rd June 2016 to discuss the matter
Action: Sue to ask the CCG about 'sample size' and 'timescales' in response to the questions being asked by them for views and opinions from Health Ambassador Sub Groups.
7. Any other business / Adam mentioned that the CCG were currently running a campaign on Medicines Waste and requested Health Ambassadors take this message to the members they represent. Tom advised those present that cards were available 'Show the red card to medicines waste in Doncaster' and they were welcome to pick some up for their members at the end of the meeting.
Adam mentioned that he would like to thank everyone for getting involved in this project. He said that the CCG Commissioners were excited about the information they were getting back and appreciated the assistance and help given by the Health Ambassadors and the members and communities they represent.
8. Date of next
meeting / 4th July 2016 - 3 pm to 5 pm. (Please note the change of time for this meeting.)
Venue - Doncaster CVS

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