Patient and Community Engagement

Annual Summary 2018/19

Patient and Community Engagement Annual Summary 2018/19

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For further information about how to get involved or about any of the projects in this report please

contact the CCGs' engagement team on 01274 237546 or email: engage@bradford.nhs.uk

ContentsIntroduction 3

Engagement in the CCGs' Annual Reports 3

Why do we engage with the public? 4

How do we listen to people's experiences and views? 4

Grassroots 5

People’s Board 7

Involvement in GP practices 9

Engaging People - working with voluntary and community sector partners 10

Highlights from 2018/19 13

Talk Cancer 13

Carers 14

Care Navigation 15

Community Partnerships development 16

Healthy Minds 17

Assurance on patient and community engagement 18

NHS England ratings 18

Lay members of the governing bodies 19

Involve Group and Involve Tracker 19

West Yorkshire and Harrogate Health and Care Partnership 19

Priorities for 2019/20 20

IntroductionThis report sets out highlights of how the Clinical Commissioning Groups (CCGs) across Bradford district

and Craven engaged with people and involved patients, carers and the public during 2018/19.

We produce this report alongside our full annual report and accounts for each CCG, to help people

understand how their views, experience and involvement influence the commissioning of health

services.

The CCGs' engagement team work across the whole of Bradford district and Craven; this report tells

you about how we've engaged with people and communities in all three CCG areas.

Thank you

Engagement in the CCGs'

Annual ReportsEach CCG produces its own annual report, published

in June each year which includes detailed information

about how we meet our legal duties to engage and

involve our local communities, along with information

about our performance, decision-making and finance.

You can find the annual reports on the websites for

each CCG:

Airedale, Wharfedale and Craven CCG

www.airedalewharfedalecravenccg.nhs.uk/about-us-

/documents/annual-report-/

Bradford City CCG

www.bradfordcityccg.nhs.uk/about-us/our-

publications/annual-report/

Bradford district CCG

www.bradforddistrictsccg.nhs.uk/about-us/our-

publications/annual-report/

Yourviewscount

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Patient and Community Engagement Annual Summary 2018/19

Why do we engage with the public?Our aim is to make sure that all our work is informed by people who use services, care for others or live

or work in the district. We listen directly to people about their health and wellbeing needs, wishes and

aspirations, their experiences of current health and care services and their ideas for improvement.

The CCGs take our statutory duties* to involve the public in our decision-making and governance

seriously. We aim to ensure our engagement with the public goes beyond 'ticking the box' and creates

meaningful opportunities for influence.

The views and experiences of people from across Bradford district and Craven make a real difference to

our decision-making and planning.

How do we listen to people's experiences and views?We want as many people as possible in Bradford district and Craven to get involved in what we do.

People can choose how much or how little you want to get involved and how much of their experience

they want to share – from giving feedback about a service or responding to a survey, to attending a

focus group or taking part in training workshops or becoming a member of the People's Board.

As well as setting up our own ways for people to get involved, we take an asset based approach –

working with the groups and organisations that are already well connected in the community and

hearing from local people.

This report gives you a snapshot of some of our engagement activities; full information about all the

different ways to get involved is available on our websites.

The CCGs' Communications and Engagement Strategy sets out more detail about how we work, in line

with our guiding principles:

Patient and Community Engagement Annual Summary 2018/19

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We are open, transparent and honest. We are clear about what

we are doing and why we are doing it.

We do things at the right time, in the right place, and with the right people.

We learn from what we already know and share information across organisations.

We value what's strong in communities, and work with partners

to build on trusted relationships.

We report back to people and communities about what they tell us

and the actions we take.

We communicate as simply as possible and try to make our

information accessible to all communities.

*Under the National Health Service Act 2006 (as amended by the Health and Social Care Act 2012),

CCGs have duties to involve the public in commissioning, (under section 14Z2).

GrassrootsWe pull together information from external and internal sources into a database which we call

'Grassroots'. Bringing all this rich insight together means that whether you've shared your story with

Healthwatch, Care Opinion or on NHS Choices, taken part in a survey or made a complaint to the CCG;

your views are being heard.

Our new system for storing and analysing Grass Roots data went live in April 2018, enabling deeper

analysis of themes and improved reporting.

Between April 2018 – March 2019, we analysed 1764 individual pieces of feedback about the wide

range of services we commission.

As well as looking at the types of services people are talking about, we try to understand how people

feel about their experience, to identify areas for improvement.

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Emotions expressed in feedback

Delight

Excitement

Happiness

Love

Surprise

Wants and Needs

Anger

Frustration

Sadness

Shock

Patient and Community Engagement Annual Summary 2018/19

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We were given feedback which showed that D/deaf people have difficulties

when visiting their GP practice. As a result of this feedback, the CCGs worked

with local partner Bradford Talking Media on a toolkit for GP practices to

help them support these people. This toolkit includes videos that help GP

practice staff understand how D/deaf people can be better supported.

We heard from carers that people were having to wait too long for

equipment at home once they had been discharged from hospices. This was

because the equipment could only be ordered by an occupational therapist.

The CCGs worked with local care providers to change this process. Now

equipment can be ordered directly by the hospice before a person goes home.

We were told about variation in people's experience of mental health crisis

services.

This variation was taken to the Bradford district and Craven Mental Health

Partnership Board for discussion. There is now an active project, through

voluntary and community sector organisations, to better understand people's

experiences.

This work will help identify specific changes to be made to mental health

crisis services.

Below are three recent examples of how feedback

collated in Grassroots has been used to improve

services in Bradford district and Craven.

1

2

3

You said,we said

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People’s Board

Members of the People’s Board, Left to Right: Mike Frazer, Mohammed Mahboob, Stella Hall,

Sam Samociuk, Emma Stafford, Adam Taylor

Emma Stafford, chair of the People's Board:

“Our board is here to represent the people of Bradford district and Craven and make sure

their voices are heard when commissioners design our local health and care services.

“We're a really proactive and diverse group of people from across Bradford district and

Craven who are all keen to make sure the public voice is heard.”

Having been established in Bradford City and Bradford Districts in 2016, this year the People's Board

opened up its membership across Airedale, Wharfedale and Craven to reflect the joined-up working

between the three CCGs.

In August 2018, we welcomed new members who can bring different perspectives and connections to

communities and local places.

The People's Board has been supported by the CCG engagement team to develop clear objectives and

ways of working, through facilitated development sessions.

The People's Board offers a great opportunity for commissioners to talk through our plans in order to

gather ideas and insights at an early stage, when there is a real opportunity for influence.

An example of this can be found in the Carers section of this report on page 14.

The People's Board has also influenced our strategy development for End of Life Care, giving insight

about their own experiences but more importantly reflecting the needs of different communities and

diverse groups of people. People's Board views were captured for the strategy development and their

ideas helped shape an engagement project which will launch in May 2019.

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Read more about the People's Board on their own blog page: https://thepeoplesboard.blog

Patient and Community Engagement Annual Summary 2018/19

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Involvement in GP practicesAt the heart of our approach to involving patients and the public are the 76 member GP practices

across the three CCG areas, and their Patient Participation Groups (PPGs). There are so many volunteers

working in practices and making a difference through a range of activities from setting up walking

groups or self-care events, supporting clinics or helping gather patient feedback.

Participation Training

To support people who get involved, we have offered a series of training workshops facilitated by

Community Action Bradford and District. The training has been co-produced with the Patient Network

and identified five topics.

1. PPGs – what they're all about?

2. Understanding your local NHS

3. Engagement – what do we really mean?

4. Knowing your community

5. Social media

This training programme will carry on throughout 2019, with more topics being added based on the

needs of PPG members and practice volunteers.

Supporting Practice Engagement

The Bradford Patient Network continues to thrive as a forum for learning, sharing ideas, and spreading

information for PPG members and volunteers in practices.

The Patient Network in Airedale, Wharfedale and Craven is being refreshed, with support from our

Engaging People team. They've been meeting with practice managers and PPG members to provide

practical advice, gather examples of good practice and find out what support is needed. In May 2019

we'll relaunch the network and bring people together. Ongoing development and support is planned

across Bradford district and Craven in 2019.

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Engaging People - working with voluntary

and community sector partnersEngaging People is a voluntary and community sector (VCS) partnership project. It is commissioned by

Bradford City, Bradford Districts and Airedale, Wharfedale and Craven CCGs to carry out public

engagement on our behalf. The partnership includes local organisations CNet, HALE, BTM and

Healthwatch Bradford and District.

Engaging People carry out projects that link to CCG priorities and workstreams, helping us reach out to

hear the voices and views of diverse groups or communities, particularly potentially disadvantaged

groups.

All Engaging People reports are published on the CCGs' websites, and the Engaging People

organisations also use their own communication channels to publicise the work and feedback to

people about the difference that is made.

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Women's Health Network

The Women's Health Network identifies and

addresses health issues and inequalities affecting

women and their families living in Bradford

district and Craven, and is supported by the

Engaging People grant from the CCGs.

In the past year the Women's Health Network has

thrived, developing an action plan and setting its

own direction based on the issues that matter

most to members, as well as the issues that the

CCGs want to address.

For example, members identified that women can

often experience challenges due to a lack of

information about menopause. They highlighted

the negative impacts on women's wellbeing and

that menopause was often considered a taboo

subject.

As a result, the Women's Health Network is

piloting Menopause Cafes across Bradford to

provide a safe space for conversations about

menopause. They aim to increase the awareness

of the impact of the menopause on those

experiencing it, their friends, colleagues and

families. The sessions are unstructured and open

with free flowing discussions in a confidential

space where people can express their views safely.

Women's Health Network members have also

been active participants in our Talk Cancer

programme, and as a result went on to create a

show on BCB Radio about the importance of

cancer screening.

The engagement team has created a short film

about the Women's Health Network to encourage

more people to get involved. You can view this on

the CCGs’ websites.

A meeting of the Women’s Health Network

Co-chairs of the Women’s Health Network

Michelle Taylor & Masira Hans

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Domestic Violence

In summer 2018, the CCGs asked Engaging People to gather views and experiences to help develop

support for people experiencing domestic or sexual violence.

The engagement was focused around six key areas.

1. Who do people talk to about domestic and/or sexual violence?

2. What are the priorities of people when they seek support?

3. What is missing from the support currently offered?

4. What could be done earlier to prevent domestic and/or sexual violence?

5. What is going on in our communities which might contribute to the problem?

6. What's most important to people?

Engaging People teams worked with community groups and organisations that work with people who

have experienced domestic or sexual violence.

Commissioners came to the Women's Health Network to discuss these questions and hear directly from

people about the issues they see in their communities and the types of approach that are needed. The

report from the engagement work highlights commonly occurring themes and key issues for

commissioners to take into account when developing services. It has been used to help design the way

this support is offered across Bradford district and Craven, ahead of a joint procurement process led by

the council in 2019.

Over the Counter medicines

Between December 2017 and March 2018, NHS England ran a public consultation on reducing routine

prescription of medication for minor and short term conditions, where over the counter (OTC)

treatment is available. NHS England published a consultation report and guidance for Clinical

Commisioning Groups. To help us consider how to implement this guidance locally, we asked Engaging

People to find out the views of local people.

Across Bradford district and Craven, Engaging People had detailed conversations with 227 people.

Based on the groups identified as most likely to be affected by the changes, they targeted older people

from both White British and BAME backgrounds; parents of young children; and people on low income

or income support.

The report found:

“People gave a lot of time were generally in favour of the proposals but wanted to make

sure that people who are worst off financially would not suffer as a result. Even when

people thought that they would be affected personally by the changes, they were rarely

against all proposals.

“People gave a lot of time and thought to answering the questions. The proposed changes

gave rise to conversations on much more than just a list of conditions - people talked about

their relationship with the GP, priorities for NHS spending, barriers to self-care, how changes

to health services are communicated, education, and health inequalities.”

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Talk Cancer

Talk Cancer Workshops enable health professionals, community workers, volunteers and others to learn

together and share ideas about how to improve outcomes for our population.

The workshops develop the skills, information and confidence to talk about cancer; helping people

reduce their risks, take part in screening programmes and spot signs earlier.

Twenty four workshops will have taken place by the end of the programme with over 200 people taking

part. We've targeted people from a range of different backgrounds and professional groups, aiming to

get the skills and information to those most likely to have influential conversations with people about

their health, including: community connectors, practice nurses, pharmacists, community volunteers,

interpreters, health trainers.

Feedback from participants has been positive, with 95% of trainees saying they would recommend the

workshops to others.

Cancer Research UK is working with the CCGs to raise cancer awareness and to help health

workers feel confident talking to people about ways to reduce the risk of cancer, spotting cancer

early and screening. The three-hour sessions are hands-on, interactive and positive and are led by

Cancer Research UK expert trainers who have nursing backgrounds.

As part of our commitment to accessible information, we worked with BTM to deliver a BSL interpreted

session for the D/deaf community – the first time that Cancer Research UK has done this. We're now

working with them on the potential for delivering similar sessions in community languages.

Highlights from 2018/19

“That night, when I came home from the Talk

Cancer workshop, I was talking to my daughter

and her friend and her friend mentioned that she

was supposed to be going for cervical screening

the following day.

“She said 'I'm not going to go' and I said 'No, you

must go' and we had quite a long conversation

about it. It was fear of just putting a foot over the

doorway – it was fear of the unknown – that was

putting her off going.

“I'm really pleased to say that she went, and she

went because of that conversation. And it's a

conversation I might not have continued if I hadn't

been to the workshop.”

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CarersThe role of unpaid carers is estimated to

contribute over £900 million to the health and

care economy in Bradford district and Craven.

As part of our work to improve the experiences of

carers and support their vital contribution, the

CCGs and local councils work together to

commission a carers' support service.

Throughout June and July 2018, we carried out an

engagement project to hear the views and

experiences of local carers. Around 450 carers

took part, telling us about what matters most to

them, what challenges they face and what helps

them keep going. This insight is being used to

develop the support service for carers across our

district, for example:

Carers told us that some of the things

that can make the biggest difference to

them are good quality advice and

information, social support from peers,

and a carers support service that's is

easy for them to access in their local

community. Based on what we heard,

the service specification for carer's

support will now include elements to

address these needs.

People from BME backgrounds and

working carers told us that they often

found it particularly hard to get

support. The new carer's support

service will be asked to address this by

making sure they establish good

relationships with local communities

and make their services accessible to

all carers.

The new Carers' Support Service will be in place

from April 2019. The contract has been awarded

to Carer's Resource, working to a new service

specification shaped by what carers told us they

needed. The charity will also now run the district's

young carer services, enabling services to be

offered to whole families.

The People's Board were involved throughout this

process, helping us develop our approach to

engaging carers. They offered advice about

effective approaches and challenged

commissioners to make connections with different

communities to help us reach 'hidden carers'. Two

members of the People's Board, who are both

carers themselves, were involved in the evaluation

of bids for the Carer's Support Service contract.

Claire Weaver, a carer and one of the People's

Board members who took part in the panel

evaluating the bids, said: “I felt my views were

valued and that they were given genuine

consideration in the evaluation of the bids.

Being given the opportunity to express my

views as a parent carer, alongside other

carers with different needs, ensured our

experience was key part of the process”.

The insight from our engagement with carers will

also be used to develop a refreshed strategy for

supporting unpaid carers across Bradford district

and Craven.

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Care Navigation

NHS England is introducing Care Navigation to ensure patients

receive the right care from the right person, first time. To prepare for

the local rollout, we discussed our approach to Care Navigation with

the Patient Network:

People said it was particularly important that patients

understood the change and why it might help them;

they said we needed to make sure this information

reached people with different communication needs and

from different backgrounds.

People felt we should emphasise to patients that they

would not be refused a GP appointment if needed and

that their confidentiality would be protected.

We developed a communications toolkit for practices so that patients across Bradford district and Craven

were getting good information about Care Navigation. We created press releases, radio advertising, pop-

up banners and posters for every practice, information leaflets, a British Sign Language explanation, and

videos. We also encouraged practices to work with their PPGs and practice volunteers.

In line with the feedback from the Patient Network and comments coming through Grass Roots, we

tried to make sure that people understood why they were being asked questions and emphasised

patient confidentiality and choice.

Engaging People teams took information about Care Navigation out to the community and talked to

people in different locations, such as mosques and churches, community centres, knit and natter groups,

and schools.

The feedback that people gave was presented to practice staff in workshops set up to continually

improve the way Care Navigation works for patients.

At a discussion with an older people's social group in Shipley, some people were concerned regarding

confidentiality and still being unable to see their GP. However, all were in agreement that if the service

leads to GPs being able to see patients quicker it has to be a good thing.

Engaging People estimate that between November 2018 and January they've reached around 2000

people and will continue to spread the messages about Care Navigation as part of their ongoing

outreach work.

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Community Partnerships development

Community partnerships are the name we give to Primary Care Networks, a national model of

delivering primary care through local decision-making and partnership working. Each partnership

focuses on a community of between 30,000 and 60,000 people - you can find more information about

the community partnerships on the CCGs’ websites.

As community partnerships develop across Bradford district and Craven, it's vital that local people and

the voluntary and community sector (VCS) are represented.

The CCGs are supporting each community partnership to develop their own plans for engaging and

involving people, in the way that best works for their population.

We are promoting the values and principles of the Asset Based Community Development (ABCD)

approach. This builds on the strengths that are found within the community and helps individuals,

associations and institutions come together to further develop.

In the 10 Bradford community partnership areas, VCS Anchor Organisations have been identified to

connect communities with this new way of working.

Small grants funding has been invested to support and activate grassroots community activities and ideas

which will improve the health and wellbeing of local people. You can read more about them online.

There are a number of transformation programmes which are being supported by these grants. An

example of this is South Bradford Yoga, supported by the Royds Community Association, which

has enabled a local software engineer to set up these community sessions.

In Airedale and Wharfedale, the community partnerships held successful 'open space' events to

understand what local people care about and what action the community wants to take forward to

improve wellbeing. Craven Community Partnership is working with ‘Nurture Development’ to become a

learning site for asset based community development over the next two years.

As community partnerships develop, it will be important to make sure that they are involving local

people and taking their views into account. In 2019-20, we'll be working with local Healthwatch to

help us design a good practice toolkit for community partnerships.

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Healthy MindsThe inaugural Healthy Minds Summit took place in Bradford at the end of January with over 380 people

coming together to focus on mental health and wellbeing for everyone.

The event was organised by the Mental Wellbeing Partnership Board, responsible for delivering better

mental wellbeing for everyone in Bradford district and Craven. Attendance at the summit included staff

from health, care, voluntary and community organisations from Bradford district and Craven, young

apprentices from Bradford Council and members of the public.

A taster stress buster session, life size Jenga and Connect 4 games, arts and crafts interventions; and an

uplifting tribal drumming session helped people to focus on their healthy mind. A market place where

staff showcased their services allowed people to network and find out about the services provided

across the district.

Throughout the day, there were conversations

across social media using #healthyminds2019 -

you can view our Twitter moment online.

The feedback will be used to further develop the

Mental wellbeing in Bradford district and Craven:

a strategy 2016-2021.

To close the event, two music productions created

by young people from the Youth in Mind service

were shared. 'Hope' by Alex Hutchinson and

Alessio Cavallaro and 'Bread and roses' by

Rosema Nawaz, youth café coordinator and

People's Board member.

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Assurance on patient and community engagement

NHS England ratings

NHS England has a statutory duty to conduct an annual assessment of every CCG in England, using the

CCG improvement and assessment framework.

CCGs are rated as Red (inadequate), Amber (requires improvement), or Green (good or outstanding). All

three CCGs were rated Green (good or outstanding) in 2017/18.

In 2017/18, for the first time, CCGs were rated on an indicator for Patient and Community Engagement,

which looked at information on our websites and our Annual Reports for 2016/17. This indicator is

further broken down into five domains:

We have worked with our People's Board, the Involve group and local Healthwatch this year to look at

the ratings and how we needed to improve our approach to engagement. We've reviewed and

refreshed our website to make it easier to find information. We've focused on improving the way we

report back to people, with more information about the outcomes and impact of engagement –

including this report which is published alongside the annual reports for each CCG.

Ratings for 2018/19 will be published in July 2019 and we will share this information on our

website.

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Lay members of the governing bodiesEach CCG governing body includes lay members with a specific role around patient and public

involvement (PPI); their role is to champion engagement in CCG decision making:

Airedale Wharfedale and Craven CCG: Pam Essler

Bradford City CCG: Max McLean

Bradford Districts CCG: David Richardson

Max McLean will be standing down in 2019 and David Richardson will be taking on the role for both

City and Districts CCGs.

Involve Group and Involve Tracker

The Involve Group brings together the communications, engagement and equalities teams within the

CCG, lay members for patient and public involvement, patient participation groups (PPGs) and

networks, the People's Board and other stakeholders.

The Involve Tracker is produced by the communications, engagement and equalities teams of Airedale,

Wharfedale and Craven, Bradford City and Bradford Districts CCGs. The tracker shows what activity has

happened, next steps and the expected impact or outcomes. The red/amber/green rating helps us

identify where things are going well and areas that may need more focus or action.

It is reviewed at each governing body meeting and provides assurance that our communications,

engagement and equalities work meets our objectives, achieves the requirements of the NHS

constitution, and creates meaningful dialogue with local people. The tracker is published on our

websites.

West Yorkshire & Harrogate Health & Care Partnership

We are proud to be part of the West Yorkshire and Harrogate

Health and Care Partnership which was formed in 2016. It

brings together all health and care organisations in our six

places: Bradford district and Craven; Calderdale, Harrogate,

Kirklees, Leeds and Wakefield to meet the needs of people as

close to home as possible.

Our organisation is one of the partners which make up this

unique partnership.

In February 2018, the partnership published 'Our Next Steps

to Better Health and Care for Everyone' which describes the

progress made since the publication of the initial plan in

November 2016. You can read it at

https://www.wyhpartnership.co.uk/publications/next-steps

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Priorities for 2019/20We will continue to work closely with our colleagues at the West Yorkshire and Harrogate Health and

Care Partnership, sharing good practice and collaborating across the region to engage people most

effectively.

Within Bradford district and Craven we will work with the local authorities, provider Trusts and the

voluntary and community sector to join-up our approach to engagement where possible.

Key engagement projects planned for 2019/20:

End of Life Care – understanding people's experiences and opening up conversations

about what a good death means for people.

Following up from the 2017 Big Conversation on changes in health and care, working

with local Healthwatch to report back to the public on what's changing and how

people can get involved in their local community partnerships.

Developing youth participation and volunteering with funding from NHS England's

Takeover Challenge Fund.

Other engagement activities will be developed throughout the year, in response to feedback from the

public or in response to new developments and decisions which need patient and community insight.

For further information about how to get involved or about any of the projects in this report please

contact the CCGs' engagement team on 01274 237546 or email: engage@bradford.nhs.uk