2020/21 engagement work

Kent and Medway CCG has completed some engagement with people with autism and ADHD (attention defecit hyperactivity disorder) in Medway. We wanted to find out what people thought about the support offered and about diagnosis and how this could be improved. This follows similar engagement work in Kent. You can see what GPs, support staff, families and people with ADHD and autism have told us here:

• Medway neurodevelopment summary report
• Report of health data from Medway Council autism survey
• Medway neurodevelopment patient report
• Medway neurodevelopment staff report
• Autism ADHD summary from Involving Medway and Medway Voluntary Action
• Autism ADHD phone interviews

The CCG used this feedback to create a service specification for care for people with neurodevelopmental disorders and conditions. 

We changed the specification as a result of what we heard from service users. For instance we are requiring that services are available at weekends and in the evenings, with a flexible range of opening hours and online options for care. Also, more services will be available locally rather than expecting people to travel out of the area to London.  

New contracts to run neurodevelopmental services start in 2022 and people with experience together with their families will be invited to get involved in designing care directly.

We worked with Kent County Council and Medway Council to inform and engage with the community about Covid. The Covid champions have been supporting their local communities.

KCC and Medway Council public health teams recruited 180 Covid champions to disseminate messages about Covid within communities and feedback on issues. Monthly meetings were held for the Covid champions to hear from and feed back to the public health teams and clinical leads and a regular bulletin was produced.

Find out more and how you can get involved.

Our first piece of engagement work as a new CCG was to gather colleague, patient and carer experience of the service changes made during the first national lockdown to keep people safe.

We also gathered the views of our partners in the community and voluntary sector, local communities and local councils to find out how it worked for them and some of the benefits and challenges they faced. 

Find out what people told us and how that helps healthcare services to run during the coronavirus pandemic.

We spoke to more than 4,000 people about whether they intended to have the vaccine once it was available to them.

You can find out what they told us here.

We have been talking to people living with dementia, their loved ones and carers about proposals to improve services for people with more complex needs.

As part of this we spoke to:

• people living with dementia, their family members and their carers,
• care home staff, domiciliary carers, NHS and social care staff and those voluntary organisations offering support and assistance.
• the public about the principles which should improve the quality of care provided for people living with dementia. 

The feedback will help us determine the right level of support for people living with dementia in all parts of the health and care system, to respond to changes in people’s health - particularly when the symptoms are severe - and prevent, or manage, any crises.

You can find out more, including how to give your views

In May 2021, more than 3,000 patients registered with the West Malling Group Practice (WMGP) and living within a mile radius of The Hollies branch surgery were sent a letter to explain that The Hollies will be closing at the end of August 2021. This was due to the landlord giving notice to the practice to vacate. 

All patients sent a letter were invited to take part in a survey either online or via telephone to give their feedback about how the change may affect them.

The online survey link was also promoted on the practice’s website and paper copies were available to pick up from reception.  The survey closed on the 18 July 2021.

We collected feedback from more than 400 patients, who shared their thoughts and experience. Their answers will help inform and shape the future provision of GP services in the area.

You can read more in the report - The Hollies survey summary.

Following enforcement action from the Care Quality Commission, Medway Practices Alliance (MPA) held a 12 month temporary contract for St Mary’s Island Surgery, Green Suite at Balmoral Gardens Healthy Living Centre, Twydall Clinic, Pentagon Centre and the Sunlight Centre Surgery.

We are pleased to confirm that new, permanent contracts have now been awarded for all five sites from 1 November.

You can find out more about how we involved patients in the process

We have been talking to local patients to help shape the future of GP services at Orchard House Surgery, Lydd. A new provider has now been appointed to run the surgery from 1 May 2021.

We asked patients registered at this practice to complete a survey which was available online and as a printed version. In total 1,315 people responded to the survey (34 per cent of the patient population), and shared a wealth of ideas, and their experiences of the current service and their hopes for the future. 

We also held two online public meetings on 17 February at 2.30 – 3.30 pm and 6.30 – 8 p.m. The meetings were chaired by our Patient and Public Involvement lay member Cathy Finnis and attended by Bill Millar, Director of Primary Care for the Kent and Medway CCG, who listened to patients and local councillors who told us what is important to them.   

Our thanks to the 49 people who joined us and gave their views. We will return in the autumn and meet with patients again to ensure they are happy with the progress made. 

You can find out what they told us and how we considered the feedback.

Reports on the survey and events have been considered as well as all the feedback received via email and mail and have contributed to the proposal for the future provision of GP services at that location. This was considered by the CCG’s Primary Care Commissioning Committee (PCCC) at its meeting on 18 March 2021. The committee approved an application from Invicta Health to run the surgery.

DMC Healthcare held contracts to run a GP practice and GP walk-in service - as separate services - both operating from Sheppey Community Hospital.

The contract for DMC Sheppey Healthcare GP practice was due to end on 30 September 2021. NHS Kent and Medway Clinical Commissioning Group was unable to extend or renew this contract and had to find a long-term solution for patients registered at this practice.

We collected feedback from patients through an online and paper copy survey.  In total, 902 patients (11% of registered patients) completed the survey and shared their thoughts and experience.  To make sure every patient was given the opportunity to take part, we had the patient letter and paper copies of the surveys translated into nine languages which included: Turkish, Lithuanian, Arabic, Bulgarian, Russian, Latvian, Polish, Kurdish and Romanian.  

We also held an online meeting on Wednesday 23 June 6pm-8pm, which was attended by 12 patients. The meeting was chaired by our Patient and Public Involvement lay member Gillian Wells and attended by Bill Millar, Director of Primary Care for the Kent and Medway CCG, who listened to patients and heard what is important to them.  

Find out what they told us.

Reports on the survey and public meeting have been considered as well as all the feedback received via email, mail and social media have contributed to the proposal for the future provision of GP services at that location. We considered this feedback alongside other influencing factors, such as GP practice engagement.  This was considered by the CCG’s Primary Care Commissioning Committee (PCCC) at its meeting on 15 July 2021 alongside feedback from other stakeholders.

The committee approved the decision to close the GP practice and for patients to transfer to other practises. We have since written to all patients, letting them know how to register with other local practices, who all have capacity to take on patients. Read the full update, guidance for patients and next steps.

The practice closed on 31 October 2021. We supported patients to register with an alternative local GP practice whose boundary area covers their home address. Patients were informed directly by letter and details communicated to stakeholders and the wider public.

DMC Healthcare also ran a GP-walk in service at Sheppey Community Hospital, Minster, which offered GP appointments for urgent matters. The contract for this service also ends on 31 October 2021.

A new GP-walk in service was put in place on 1 November for urgent care needs and is now run by Minster Medical Group, a partnership of GPs who provide services at two locations on the island already

Patients can walk-in or may be booked in by NHS 111 if their condition is suitable to be seen in the service.

The walk-in service is for urgent health conditions that a GP would normally treat and diagnose, such as ear, throat or skin infections and minor illness.

In 2020/21, our Health Network members have had opportunities to contribute to our engagement activities and have received our e-bulletin to inform them about opportunities. Members have:

• Contributed to our survey on services during Covid
• Given feedback about us restarting services 
• Completed our survey and have told us their experience of dementia care 
• Contributed to discussions on essential primary care services during Covid.  

Healthwatch Kent and Healthwatch Medway are valued partners and sit on our Partnership Board, and contribute to many of our projects. 

During the pandemic they have supported us this year to regularly hear the views of patients and wider service users about the impact of Covid through their monthly reports.  They have also helped us to engage people with experience and their families and carers in improving services. 

Healthwatch has fed into our pandemic response and system learning with regular reports on their work and findings. 

You can find out more about their work on their websites:

 Healthwatch Kent 

 Healthwatch Medway

Involving Medway is a community development and engagement programme delivered by the CCG engagement team and partners Medway Voluntary Action, Kent Community Foundation and Tempo Time Credits.  

From April 2019 – April 2020 Involving Medway: 

• Trained community organisations to deliver focus groups on health-related topics 

• 17 focus groups were run by community groups in Medway and Swale involving 152 people 

• Trained community health researchers to deliver interviews on health-related topics 

• 33 community health researchers were trained and they carried out 112 interviews. 

• Trained community groups to use online platforms to deliver engagement – 4 Zoom training sessions delivered. 

Involving Medway contributed to seven specific areas of healthcare planning. 

In the year 2020/21, Involving Medway ran a community small grant scheme to improve social isolation in Medway and Swale.

• £24,551 was issued to 14 groups/individuals. A further grant round will be issued in March 2021.  

       • We also further developed the Medway Time Credits programme – successfully taking it online £8,247 Time Credits have been issued since 2018 – equating to 8247 hours of volunteering.

During 2020/21, Involving Medway contributed directly to six topics:

• Improving outpatient services at Medway Hospital
• Services for adults with autism/ADHD
• Experiences of healthcare services during lockdown
• Improving services at five Medway GP surgeries
• Engagement on dementia services
• BAME Covid-19 social marketing research.

The Involving Medway contract has been extended for six months to September 2021. During this time the CCG will be planning to extend the community development approach to other areas in Kent. 

The Maternal Mental Health Service is an integral part of the NHS Perinatal Long Term Plan.

In Kent and Medway, we applied to be an early implementer and for funding to undertake a pilot of the service in east Kent, while undertaking scoping and engagement work in the remaining areas of Kent and Medway. This will enable us to better understand the population in those areas that may access the service in the future (in terms of barriers to accessing healthcare services, social and financial demographics, health inequalities etc).

The focus of the survey was to obtain information from those with lived experience to help shape the pilot of the Maternal Mental Health Service. Following engagement with staff and those with lived experience, this has been named: Thrive – Psychological Support for Birth Trauma and Loss. Although at this stage we are undertaking a pilot in east Kent; in the coming years we will be rolling out the service across the remaining areas of Kent and Medway, so each locality will have a Thrive service with a clinical model tailored towards the population of those that may be accessing the service.

The survey provided us with some  useful information on what people would like the service to provide: 97  per cent of respondents cited ‘psychological therapy’ as being their most valued aspect of what a future service would provide, and felt this should be the priority for the service.

We also received information on where people would like the service to be held (not in a medical setting which could be potentially re-traumatising for those who had experienced birth trauma, and not in a children’s centre for those who had experienced birth loss and bereavement).  Based on this feedback we have been able to tailor the pilot clinical model to put a strong emphasis on psychology provision,and, when booking community venues for assessments and therapy to take place, we have actively avoided medical centres and hospital settings, and also venues where children could be close by. The patient involvement has therefore been integral to certain elements of the pilot, it’s clinical model and where services are actually provided across east Kent.

We used the feedback from the survey to better understand what those with lived experience of perinatal mental health difficulties, and those who had experienced maternity services in the past, would like the new Maternal Mental Health Service to provide (in terms of intervention, location, timing etc). We wanted to ensure the service is co-produced from the outset, and tailored based on the feedback put forward by those who know what it feels like to be in receipt of perinatal services of any kind.

Find out more about the service.

We are currently mapping the engagement work carried out by Medway and Swale Integrated Care Partnership (ICP) and will update this section soon.

Medway and Swale ICP ran an engagement event for the public on 11 November 2020 supported by the CCG. The session was designed to get feedback from patients/communities about ICP priorities for the coming year. This feedback is currently being considered.  

Further engagement is planned in 2021.

Outdated and old-fashioned dormitory wards in mental health facilities compromise the safety, dignity, and privacy of patients.

NHS England and the Government have pledged £650million in national funding to replace out-of-date mental health dormitories with single en-suite rooms, to help improve care for mental health inpatients across the country.

As part of the Government’s scheme to eradicate out-of-date dormitory wards, we are delighted to have successfully secured Government capital funding to develop modern, purpose-built accommodation for older adults with mental health issues, including dementia.

The investment in a new purpose-built building for these inpatient mental health services provides the opportunity to release Ruby Ward, Kent and Medway Health and Social Care Partnership NHS Trust’s (KMPT) only remaining dormitory ward (at Medway Maritime Hospital in Gillingham) meaning that patients would no longer need to be cared for in an outdated ward which compromises their privacy, dignity and safety and is not suitable for their needs.

To support the immediate response to the demands placed on the Medway Foundation Trust (MFT) by the COVID-19 pandemic, a temporary measure has already been undertaken to relocate patients on Ruby Ward to other KMPT inpatient units. This has provided additional capacity on the MFT site to manage the significantly increased acute and critical care activity caused by the pandemic.

We are currently (March 2021) undertaking engagement on our early progress in reviewing locations for a new, updated facility for Kent and Medway residents and how this fits with our ambition to provide high-quality and safe accommodation for patients.

A report went to the March 2021 meeting of the Medway Council Health and Adult Social Care Overview Committee (HASC). You can read more on the council website.

The last year has given the NHS some huge challenges, especially when it comes to making sure people can continue to share their experience of health and social care services with us.

At the beginning of the first lockdown, it became clear there was a need to change the way we communicate, engage with and provide information to people in a different way.  This led to all our patient groups, which were meeting face to face, starting to meet online.  To support the groups, we created an online user guide.

Across Kent and Medway, there are eight patient groups made up of patient participation group (PPG) representatives and some groups have voluntary and community organisations represented.  The geographical areas of these groups include:

• Ashford
• Canterbury and Coastal
• Dartford, Gravesham and Swanley
• Medway
• South Kent Coast
• Swale
• Thanet
• West Kent

The purpose of these groups is to bring patient voices together and continue to link with patient and public representatives from local health and social care providers, reflecting greater integration of services across the health economy. They have regular discussions with representatives on the broader issues involved in planning, designing and paying for health services. The groups meet every one to two months to discuss individual commissioning priorities, review engagement plans and contribute to the consideration of services by the CCG.

This year the groups have been actively involved in: 

• Helping to ensure the patient voice remained represented during Covid-19 by continuing the work of PPGs.  They took part in discussions and polls to share support strategies to enable them to carry out their roles ensuring patients voices remained represented.

• Helping with the early stages of development of the community bulletin which was set up in response to the pandemic.  They did this by contributing to the content and design and shared with their practices and networks to help generate awareness.
• Supporting Kent and Medway CCG to restart some services in General Practice by collaborating with the practice PPG members to help ensure no groups of patients were missing out or being disadvantaged with the new systems in place and to provide ongoing feedback in relation to this.
• Developing the Kent and Medway Local Area Group Terms of Reference by providing feedback on content.
• Sharing ideas and feedback on the proposed models of engagement for the Engagement Framework.
• Supporting the engagement process for the older people’s mental health review by taking away questions and discussing with their networks and sharing responses.  They also shared their own experiences of dementia and dementia services.
• Listening and sharing information about local social prescribing initiatives, provided by Primary Care Networks or voluntary and community organisations.

Other topics and information some groups discussed and promoted were:

• Kent Carers App – west Kent PPG Chairs Group helped publicise and promote this through their networks and wider population
• Medway PPG Chairs’ Group and Swale Patient Liaison Group discussed and approved the two groups coming together to reflect and acknowledge the Medway and Swale ICP
• Discussing Primary Care Networks and advising how they could engage with their patients in the future
• New ways of accessing GP practices through the use of online consultations, particularly e-Consult
• Particular health services e.g. dermatology, virtual fracture clinics and minor injury units/urgent treatment centres.

Across Kent and Medway, there are 42 Primary Care Networks (PCN).  These are groups of GP Practices who have come together to build on the provision of primary care services, working together with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas.

Each PCN provide services for approximately 30,000 – 50,000 patients and like all NHS services, has a responsibility to engage and listen to patients.  How PCNs do this can vary, with many of them having a patient participation group who meet regularly.  Other PCNs are working with voluntary and community organisations, borough councils and other stakeholders to develop a robust engagement plan for patients in the future.

Some Primary Care Networks (PCNs) have started to engage with their local communities about services in their GP practices. We are currently mapping this work and more information will be added to this section soon about the work carried out.

The CCG’s in-house communications and engagement directorate is developing a guide to engagement for PCNs.

We are also engaging with PCNs about patient and public involvement within the Integrated Care System (ICS) and the role PCNs will play. A paper will be developed and taken to the STP/ICS Partnership Board.

We have been working with our partner Kent County Council (KCC) to hear from people in Kent and Medway about their experiences of accessing support and services for children and young people with special educational needs and disabilities. A strategy was developed as a result and we have also spoken with families and charities and support groups for their views on that strategy.

The strategy sets out the joint ambitions of the NHS and KCC to make sure that all children in Kent have equal access to support, health care and education to meet their unique needs. Children and young people with special educational needs and disabilities and their parents and carers helped develop the strategy.

You can tell us what you think about the strategy by visiting the KCC website. The consultation on the strategy took place from Wednesday 2 December 2020 to Thursday 4 February 2021.

Building on engagement carried out by the West Kent Alliance, the West Kent ICP Stakeholder Engagement Advisory Group (SEAG) advises the Integrated Care Partnership Board.

Key organisations concerned with local health and care come together to discuss the development of the ICP and to share activities. The group includes Healthwatch Kent, representatives from the community and voluntary sector as well as local authorities and the NHS.

The group has conducted stakeholder mapping and created a shared repository for engagement and local experience. SEAG is actively seeking to identify opportunities for collaborative engagement with the public to promote better local health and wellbeing.

Our Associate Lay Member for Patient and Public Engagement in West Kent, Gerald Heddell leads the West Kent ICP Stakeholder Engagement Liaison Advisory Group. Stakeholder mapping and regular updates to key stakeholders were part of the work of the group during 2020/21. 

In March 2021, as part of a review of  urgent treatment centres (UTCs) in west Kent, we engaged with staff working in these services to find out:

• the benefits from the introduction of UTCs
• the ability of NHS 111 to book appointments into these centres
• where service improvements could be made.

The feedback was extremely helpful and recommendations have been made as a result. 

UTC staff survey

UTC staff survey responses

The findings of this engagement will now be considered by Maidstone and Tunbridge Wells NHS Trust to drive forward the development of the urgent treatment centres and help improve patient experience.