Good practice in South Worcestershire

Involving the public in the development of a new model for primary care on South Worcestershire

Summary

South Worcestershire Clinical Commissioning Group (CCG) involved local people in coproducing a new model for primary care. This included setting up a primary care patient advisory group, using different types of patient feedback, and engagement events.

Situation

In April 2015, South Worcestershire CCG took on responsibility for commissioning GP services for its population (‘full delegation’). The CCG needed to develop its model of primary care and wanted to involve local people in that process. The vision was to commission primary care in a way that supported more integrated services for local people.

There was also a legal duty to involve the public. Developing a model of primary care involves planning activity in relation to primary care and as a result the NHS Act 2006, 13Q duty applies.  The CCG had delegated responsibilities under NHS England’s 13Q duty.

Overview of public involvement activity

The CCG developed a primary care commissioning committee to make decisions. This committee has mainly lay members and one GP member, and is chaired by the governing body lay member responsible for integration and partnership. The GP on this committee comes from another CCG area, ensuring that the committee had clinical input while avoiding conflict of interest.

A Primary Care Clinical Commissioning Advisory Group was also formed to make clinical proposals to the Primary Care Commissioning Committee described above. This advisory group includes the Head of Primary Care Commissioning for the CCG and local GPs.

A Primary Care Patient Advisory Group works alongside the Clinical Advisory Group and was developed with co-production principles. It has links to the CCG’s engagement structures.

The new model of primary care has been informed by the following activities:

  • The Primary Care Committee met in public and at several workshops held jointly with the clinical advisory group and patient advisory group.
  • The work of the primary care patient advisory group.
  • A co-production event where about 50 members of the public supported the decision for the CCG to apply for full delegation, and discussed what excellent primary care would look like.
  • Qualitative feedback from a variety of sources including; Youth Takeover Day, Learning Disabled group, Long Term Conditions group, Healthwatch Worcestershire reports on young people, BME communities and the deaf community.

Quantitative feedback from local people on primary care from a Local Authority survey.

Who carried out the activity?

The Patient and Public Involvement lay member, Sarah Harvey Speck, advised on developing the approach to involving the public, drawing on learning from an NHS England-organised conflict of interest workshop.

Sarah worked with the South Worcestershire CCG Engagement Team to design an engagement and communications strategy based on the principles of co-production. Public and patient engagement continues to shape and inform this developing area.

Monitor also conducted a workshop with the South Worcestershire CCG Governing Body regarding conflicts of interest which provided assurance that the considerations and processes in place were correct.

What difference has the activity made?

  • Governance arrangements have been put in place to set out how potential conflicts of interest are dealt with. Involvement of trained members of the public plays a key role in open and transparent decision-making processes which connect to local networks.
  • Insight and ideas to improve primary care have been gathered from a diverse range of local people, helping to maintain a patient focus and support innovation in the development of new models.
  • A public appetite to change and improve primary care has encouraged local GP practices to be more open to change.

Patients are helping the CCG to develop its future approach to engagement including assuring the quality of GP services.

What, if anything, would you have done differently?

Booked a larger venue for the first public engagement event, which attracted a high level of public interest.

Who is the contact for more information?

South Worcestershire CCG PPI Lay Member, Sarah Harvey Speck, sarah.harvey-speck@nhs.net

South Worcestershire CCG Engagement Manager, Helen Perry-Smith helen.perry-smith@worcestershire.nhs.uk

How were people told about the difference their participation had made?

The Patient Advisory Group has been involved on an on-going basis including inclusion in the primary care committee workshops. Feedback is provided to the CCG engagement groups (Patient Stakeholder Advisory Group and PPG network) and Healthwatch Worcestershire.

Updates on primary care have also been included in the South Worcestershire-Bulletin which is a newsletter, circulated bi-monthly to a wide variety of stakeholders.