As a CCG it is vital that we involve others within our work and use their valuable insight in helping us to shape the decisions that we make. Below are some examples of what we have listened to and the actions that we have taken as a result.
- Engage in different ways
You said: We hear from our public that they would like to see more ways of being engaged and involved, and that we don’t just rely on lengthy surveys.
We did: We use a tool called Ketso which helps people share views in a creative way without having to use pen and paper. It offers felt leaves and welcomes collaborative ways of bringing together ideas. We used Ketso at a neighbourhood workshop in January 2020 to support our West Lancashire Partnership.
You said: Communication could be improved between inHealth, the new providers of the iHELP chronic pain service and patients being referred onto the service.
We did: The CCG has worked with inHealth to ensure that they are liaising directly with patients in a timely manner to arrange appointments and support them.
- Mental health
You said: You wanted mental health support services to be more accessible and closer to home.
We did: The CCG has commissioned the Ennerdale Centre, which is based in Skelmersdale and open to all West Lancashire adults who are facing a mental health crisis. The centre not only provides support to people who are experiencing mental health problems, but also practical support to address the underlying causes of this crisis.
- Mental health
You said: Children and young people have suggested that as part of a redesign of Children and Adult Mental Health Services (CAMHS), that we should utilise digital technology more, which will be useful for children and young people accessing the service.
We did: The CCG has commissioned Kooth (an online digital support service for children and young people.
- Welcoming feedback
You said: We heard from patients and clinicians about their experience of using the local Prescription Ordering Director (POD) service.
We did: We created an experience survey about the POD and called for views from our GP practice colleagues and local residents. The survey will allow us to identify themes and areas where we can make improvements. The survey will remain open and is available here (https://www.surveymonkey.com/r/WLCCGPOD).
- Improving services
You said: Patients and carers told us that there could be better provision for children needing support in the community.
We did: We carried out a review of children and young people services locally in West Lancashire in order to identify local need, where possible gaps existed and how we could improve. As part of this work, we created a survey for paediatric A&E to capture people’s views on local services and help us to understand why they had chosen to access A&E.
We also carried out some focus groups and 1:1 phone interviews to capture local insight to tie into the review. A full report of our findings will be available soon and will be made available on our website.
- Advice on health services
You said: We hear from patients frequently about the confusion of health options out there, and we similarly hear from people who routinely use a certain service when there could be others more suited to treating and caring for them. The importance of choosing the most suitable service means there is a reduced pressure on the system as a whole, which allows the hospitals to look after those who need that level of care and support.
We did: To tie in with the national campaign, Help Us Hep You, we aimed to create some resources which focused on what is available in West Lancashire, and how they can support our population.
We aimed to give a breadth of face to face services, as well as digital support, appreciating that everyone is different in the way they wish to access health advice and care. The resource has been circulated widely across the community in hospitals, community in hospitals, community centre venues, community and voluntary sector, libraries, children’s centres and many more.
The resource is available here.
Improving involvement in our meetings
You said: The CCG received feedback that it was not clear on how members of the public could be involved in and raise questions at our Primary Care Commissioning Committee meeting, and that our communication on this and our board meeting should be made clearer.
We did: The CCG brought the Primary Care Commissioning Committee in line with its Governing Body meeting, which is a meeting held in public that allows questions to be raised in advance on agenda items. Also, depending on time remaining at the conclusion of our Governing Body meeting, the CCG continues to allow for information netw
Sharing our views with the CCG
You said: We have heard through past AGMs and other forums that our patients and public would like us to be more accessible and that they would like opportunities to share their views.
We did: We carried out an engagement exercise from June until August 2019 across all three neighbourhood areas in West Lancashire: Ormskirk and Aughton; Skelmersdale and Upholland; and Burscough and the Northern Parishes. We visited community groups that are already in existence to ask a cross section of our population about their views on health and wellbeing. E.G. what good health and wellbeing means to them and their experiences of local health services.
Example of community groups engaged with include Nifty 50s, tai chi classes, toddler and rhyme groups, creative writing groups, army veterans’ football group; and health related groups such as the dementia café and PULSE. Feedback from this work contributed to the development of the partnership in West Lancashire. You can read about our findings here.
- How to share feedback
You said: We heard from our GP membership, staff, stakeholders and patients, that it is not always easy to know where to go to share feedback.
We did: We created a new leaflet and poster which called for local residents to share their views of using West Lancashire services. These have been shared with providers, in GP practices and other health based outlets. The leaflet and poster are available on our website, and printed versions are available on request. The CCG plans to continuously share these more broadly through events etc.
- Chronic Pain
You said: Patients are living with chronic pain and were having to see their GP or hospital for treatment and pain relief medication. However, often these patients had a far broader need than just pain relief.
We did: In 2016 the CCG started a procurement process to design a specialist community based, pain management service. After a period of co-design with potential providers and patients, the CCG designed the iHelp Pain Management Service, which will address patients social, physical and psychological needs. The service will be delivered from April 2019.
- Extended access programme
You said: We continue to advise and educate our local community on the range of local health services available to them, but a frequent theme we (and the NHS across the UK) hear about is that patients sometimes find it difficult to see their own GP.
We did: In November 2016, we launched an extended access pilot in Skelmersdale which allowed people to book an appointment in advance to see a GP during the evenings and weekends when their normal practice is closed. This has since been extended into all areas of West Lancashire covering seven days a week, with appointments available in Ormskirk, Skelmersdale and Burscough.
- Annual General Meeting (AGM)
You said: We continuously hear from patients that they would like to know more about what we do.
We did: Although there are multiple ways patients can hear more across the year, for example our My View newsletter, we wanted to respond to this feedback by evolving how we run our AGM. In 2018, we decided to make our event more public friendly and encourage individuals who live in West Lancashire to come along and find out first hand from the CCG staff what plans we are working on, how they can get involved and what the future holds. More than 100 people attended making it an interactive engaging event which received excellent feedback on the day. We plan to host a similar event in 2019.
- Report paths
You said: A patient reported to us that there were inequalities for patients obtaining Report Paths which should be free of charge. These forms are used extensively by some individuals to evidence illnesses and conditions they have in order to gain support allowances.
We did: We picked this up with our membership of GP practices to ensure all practices across West Lancashire were offering this free of charge to all patients.
- Patient listening exercise
You said: Patients registered to a GP practice who served notice on its contract wanted to stay involved in the changes that followed and have an opportunity to have their say.
We did: We created a patient listening exercise which involved a dedicated free phone number and email address for patients. We also wrote out to every patient with a survey which could also be completed online. This was promoted locally so patients knew how to share their views.
You said: Through patient focus groups we were told that accessing the appointments were difficult and complicated, especially considering factors such as travel requirements to and from appointments. Patient’s wanted to access a service which was close to their homes.
We did: Using this patient insight we worked with providers to shape the new services around what would best suit our patients. From 1st April 2018, we introduced a new tier 2 ophthalmology service, with iSight providing tier 2 ophthalmology services from the 1st April and SpaMedica providing community macular services from the 1st June 2018. These services are available locally in West Lancashire.
- Self Care
You said: For our promotional campaign materials for 2016’s Medicines Waste campaign, some patient and stakeholder feedback suggested that some of the materials were difficult to read, with the text being too small and the colours making it difficult for some people to read the text.
We did: For our 2017, ‘Saving Money is Saving Lives’ self-care campaign, we ensured that all font sizes were an appropriate size, that there was a clear offer for all materials to be made available in alternative sizes, formats and languages and that any colours used, were appropriate for any residents who may be visually impaired.
- Patient Participation Groups (PPGs)
You said: Patient’s told us they were unaware of their practice’s Patient Participation Group (PPG)
We did: We continued to develop the PPG Forum which established at the start of 2017, extending from our current PPG members, we have worked with practices to ensure that they are promoting the forum and asked practices to ask their PPG members to contact the CCG so that they can be kept in the loop for all PPG news.
We have also contacted residents via our My View newsletter and social media, to make them aware of PPG’s, to encourage them to sign up to their practices respective groups and to join the PPG Forum.
- Working with care homes
You said: Care homes told us they would like better access to medicine support.
We did: We set up a dedicated Ask The Pharmacist email address which is specifically for care home colleagues to use and is monitored regularly by our medicine management colleagues.
- Extended hours
You said: Our local community communicate their need to access a GP or primary care colleagues.
We did: To improve access to primary care, we launched an extended hours pilot in November 2016 which offered a range of additional appointments with GPs. This is on the back of NHS England’s GP practice Forward View which focuses on vision for primary care over the next five years. The additional appointments provided at some practices was then extended in September 2017 to offer more appointments.
- Medicines waste
You said: We were aware from the patient experience we gathered that some patients may struggle to use the new repeat prescription ordering system.
We did: We monitored all patients with a repeat prescription, identifying when they are due to order their repeat prescription and if any resident, after a week overdue, has not ordered their medication, the CCG rang them personally to check that they are ok and not having issues. If issues were identified then these were managed immediately.
You said: We were aware that some patients live in rural areas and/or may be unable to visit the practice in person to register for Patient Access.
We did: We worked with GP practices in West Lancashire to identify any vulnerable patients who they perceived may need extra support to get set up with the Patient Access system for ordering. The CCG worked directly with these patients to support them.
- Respiratory awareness event
You said: Patient and resident feedback was positive following a public event we hosted in Skem jointly with the voluntary community and faith sector and Well Skelmersdale. The event raised awareness of the health issues and encouraged patients to self manage after a diagnosis of COPD (Chronic Obstructive Pulmonary Disease).
We did: The CCG has committed to host more events like this in the future out in the community to highlight respiratory care and self management.
- Patient Participation Groups (PPGs)
You said: Patient groups contacted the CCG asking for more support working with other PPGs across West Lancashire
We did: In response, we set up a new PPG West Lancs wide forum. We hosted the first in January 2017., which was lead by the CCG lay member for patient and public involvement. We have agreed to work with the practices to develop a forum, which will be both face to face and utilise virtual options.
- Community health services procurement – pop up shop listening events
You said: In June 2016, we hosted a series of small pop up shop style listening events across West Lancashire, for example in supermarkets entrances and libraries. This was to support our community health services procurement and give you and us the opportunity to discuss how we plan to measure success.
We did: We published a report containing details of what you told us. This report was shared with all bidders during competitive dialogue meetings and helps to inform their understanding of our local community. The report is accessible here.
- Community health services procurement – engagement with incumbent staff
You said: As part of our proactive approach to engaging with incumbent staff throughout community health services procurement, we held four engagement sessions in January and May 2016. During this interaction between the CCG and incumbent staff, members of staff communicated that they would like to be involved in this process as much as possible.
We did: To further build on this engagement we had started through these sessions, we started to deliver regular updates through the various providers’ existing communication channels. We also identified some volunteer members of staff which were individuals specifically interested in being involved at a bigger scale. The details of these individuals, who we are currently referring to as ‘staff champions’ will be passed to the new provider(s) who we hope will work with them during the mobilisation phase (Autumn 2016 – April 2017). To support our regular briefings to staff, we also developed a set of Frequently Asked Questions, which focused on pensions, and terms and conditions.
Patient experience group
You said: As a CCG, our board, staff and membership value patient experience and understand how this is vital to any work we do. We wanted to strengthen our focus on patient experience and help the Quality & Safety Committee examine any emerging issues or themes.
We did: We set up a new Patient Experience Group, which is made up of representation from the CCG, GP practices, West Lancashire CVS and Healthwatch. External attendees are also invited in to take part in discussions. The group first met in Autumn 2015 and has so far focused on strengthening processes around how we report complaints and patient insight. The group has also created a signposting document to help people working within the system understand more about how to support and direct patients who want to complain and/or share feedback. Importantly, the Patient Experience Group produces a regular report to the Quality & Safety Committee which captures everything the CCG has been told and collated that quarter – this could be anything from letters from local residents to events we have hosted. The information within the report is then shared and considered as appropriate.
- Community health services
You said: We held a series of five pubic listening events in June/July 2015. These took place in community venues across West Lancashire and invited local people to drop in and share their views and experiences of the local community health services.
We did: The findings of this you said, we did report will be considered by the CCG and our partners that were in attendance and other relevant organisations such as Healthwatch. The CCG’s procurement of community health services will consider the views and experiences shared within this report.
- Involvement in our decisions
You said: Local people in West Lancashire continue to join our My View group, which allows them to stay informed of our plans, decisions and news. Many members of this group specify areas they are interested in and/or have experiences of e.g. cancer, mental health services or hospital services. Last year, we held a listening event which members of the public can drop into and share their feedback. A local gentleman attended one of our events expressing his views on how local services could be improved to further support cardiology patients.
We did: Within our plans for improving community services and delivering more care closer to home, we explored how a cardiology service offered in the community may further help patients and carers in West Lancashire. In doing this, we carried out a procurement exercise to invite potential providers to bid for this new contract. As part of this process, we invited the local gentleman (who is a cardiology patient) that we met last year to attend our meetings with potential providers to ensure the patient perspective was listened to and fully considered as part of this process.
You said: Attendees at our Annual General Meeting in September 2014 stated that carers are a crucial group for the CCG to engage with and wanted to see evidence that we have fully involved them
We did: In August 2014, with funding from the CCG, a community health co-ordinator and health liaison lead began working for Central & West Lancashire Carers based in Skelmersdale, to ensure carers are identified and receive services that promote their emotional and physical wellbeing. Healthcare staff, in both hospitals and GP practices, have received carer awareness training and advice weekly, as well as attending promotion and outreach events. A pilot is being planned to improve the referral process and support of carers identified within a local GP practice. We also fund Barnardos to provide a service to support young carers and their families. Recently, these two organisations have been closely working together to ensure the smooth transition from children’s to adult services. We also invited the local carers centre to two of our public listening events and continue to have a dedicated carers’ information page on our website.
- Local participation
You said: We held a series of five pubic listening events in 2014/15. These took place in community venues across West Lancashire and invited local people to drop in and share their views and experiences of the local NHS.Public listening eventsLocal participation
We did: Alongside attendees from Lancashire Care and also Southport & Ormskirk, we listened to your views and comments. In some cases these led to direct actions and for others the insight was considered by the relevant NHS organisation. This you said we did report gives an idea of the topics discussed at these events. Please note – in some cases full patient cases are shared at these events, which are not included in this report.
- Health services
You said: Service choice is confusing and knowledge needs improving e.g.“I don’t waste time with the doctors, I go straight to A&E.”Options of health services
We did: We continue to run the Examine Your Options campaign, which helps to educate our local communities which health services are available for them to access. This campaign activity highlights what each health service aims to cater for, how to access them, opening times and any changes in operations around busy times such as Easter and Christmas.
- Support for those living with cancer
You said: Via a cancer focus group, you said that clinical services offer good support but there is little information and support in the community and patients are left to seek out further advice to support them and their carers/families cancer support
We did: We successfully bid for Macmillan funding to deliver more support for those living with or beyond cancer, and their carers/families. A project officer will be appointed in spring/summer 2015. The bid considered the insight gathered in the focus group.
- Local participation
You said: Community wants to be involved in their own areas and would like CCG to recognise local needs and the differences across West Lancashire
We did: We amended our My View sign up system to include the opportunity for new members to indicate which of the five localities they are from. This will allow for further targeted engagement to support projects such as our vision for joined up care, Facing the Future Together.
- End of life
You said: From talking to patients and their families, we learned that most people want to die at home. However, national statistics show that the majority of people actually die in hospital.
We did: To help encourage our community to plan ahead with advance care planning and, to influence more people dying in their place of choice and to help people to talk more openly about death, dying and bereavement, we carried out various awareness raising activities such as producing a creative video about advance care planning and launching a community coffin project.
You said: There needs to be further support in the community for cardiology patients: e.g. reducing need to go to hospital.Cardiology
We did: Community cardiology service went out for procurement in April 2015, which once in place will allow patients to receive treatment and support outside of hospital.
- Quality improvement event
You said: Our local community said they value sharing their voice alongside the clinicians and people within the NHS
We did: We hosted a joint collaborative quality improvement event with NHS Southport and Formby CCG, Southport and Ormskirk Hospital NHS Trust and South Sefton CCG, which addressed the care and services provided for those with urgent care needs and/or long-term conditions. The event welcomed patient and public representatives, clinicians, commissioners, social care providers, CVS and many more to address patient journeys, and how both services and the flow of information to support them could be improved. All delegates at this event will now be kept updated with how their views and actions on the day will feed into addressing quality improvement in the local area.
- Community event
You said: We want to know who will be responsible following the NHS transition.
We did: In April 2013, we hosted six open meet and greet community events in various venues across West Lancashire, welcoming members of the public to come along and meet the local GPs involved in the CCG and hear more about how to get involved.
You said: Members of the public who could not make it to our public events wanted to know more about the CCG.
We did: The CCG created a mini guide called a prospectus which highlights who is who, the priorities, the finances involved and also how to get in touch.
- Board meetings
You said: We want to have access to the leaders and the decision makers of the CCG.
We did: We committed to holding our board meetings out in the community, which members of the public can observe. We also introduced an informal networking slot at the end of the meeting to allow attendees to talk to the board members.