​Patient Forum April 2019

On 16th April 2019, over 80 people came to our Patient and Public Forum, which we hosted with Croydon Health Services, to discuss how NHS England's Long Term Plan could best be implemented in Croydon

Questions from patient and the public

Question: Where are the 10-13 Primary Care Networks (PCN's) going to be? How will this fit with the current Personal Independence Co-ordinators areas? Will there be more PIC's to cover additional area?

Response: Primary Care Networks are currently being formed by GPs. It is anticipated that once the PCNs have been agreed there will be approximately 10 PCNs covering Croydon. These 10 PCNs will cover the entire population of Croydon within the borough boundaries in the same way that the six current GP networks/Integrated Care Networks currently do.  Each PCN will likely be smaller than the current GP networks.  As this won't mean an additional area to cover, we do not envisage additional PICs needed currently.

PICs are a vital component of the community model of care, and how the PICs align to the new PCNs will be designed in consultation with Age UK Croydon and colleagues from general practice, which will take place once the PCNs have formally been agreed.

Question: Has Outcome Based Commissioning (OBC) now called One Croydon reduced the demand on hospital beds and the emergency department?

Response: Since the Out of Hospital Transformation initiatives were launched across the One Croydon Alliance partner organisations, non-elective/emergency admissions have reduced by 15%, which equates to more than 3,000 people who have had their care provided in the community rather than having to have an emergency admission to hospital.

Question: How and when will you share care records e.g. NHS 111, GP Online

Response: The six Southwest London CCGs are working together to develop a Southwest London wide shared record schemes to improve patients' experience of care. Connecting Your Care, the name of the digital project which will bring together a patient's health information across south west London in a single shared view for direct patient care.

This is a new way of working, and the clinical processes, information governance and technology need to be developed and demonstrated before it can be used at scale. Places like London are paving the way.   As the five Sustainability and Transformation Plans (STP) have agreed to work together, we have secured 'Exemplar' status and an additional £13.25m funding (matched with local contributions) to invest in the design, development and implementation of Local Health and Care Records for London's STP areas.

Records will only be shared under specific circumstances and patients retain the right to opt-out of the scheme at any time in the future.

You can find out more about Connecting your care at the link https://www.swlondon.nhs.uk/ourwork/connectingyourcare/

Question: How will Patient Participation Groups work at a PCN level?

Response: In the short term, the PPGs will continue to engage within their Practices in the same way as they do currently. As the PCNs develop we will work with Practices and PPG members to develop ideas and plans about how PPGs can work across PCN areas.

Question: How is the voluntary sector being engaged?

One of the key partners to deliver the One Croydon vision is Croydon's vibrant voluntary and community sector. Over the last year, One Croydon Alliance has been developing a local voluntary partnerships model, which encourages local voluntary and community organisations to come together in partnerships to support local communities and each other in neighbourhoods. This work stream is called Local Voluntary Partnerships and supports smaller organisations in particular to work together, which builds on the sector's values of co-operation and reciprocity and focussed on a common local population.

Question: How are we engaging children and young people?

Response: The CCG work with local schools and have a particularly link with the Tudor Academy in New Addington. Pupils from the school joined us at our AGM and our Health and Care partnership event. The engagement team have also spent time working with Croydon College as part of their enrichment programme.

Across Southwest London, there are a number of children who self-harm. Croydon CCG have engaged with children, young people, parents and teachers to identify how local services can best help to prevent young people from self-harming and, importantly, what communities, including schools and colleges, can do to prevent young people from self-harming in the first place.

As part of this, we ran a face to face focus group facilitated by Croydon Drop-in, a local organisation that supports children and young people facing difficulties. We also promoted the SWLHCP online surveys aimed at children and young people, parents, carers and teachers. 

Question: There are many voluntary sector organisations in Croydon – how will you join them up?

Response: The One Croydon Alliance partners have employed two Local Voluntary Partnership (LVP) facilitators. Their role is to create ways for smaller community and voluntary sector groups to come together to share resources and work together to support their local communities.

One Croydon have met with infrastructure organisations as well as smaller groups to discuss the LVP funding opportunity. Several workshops and engagement events with voluntary groups have been held to support the development of the programme. We also hold a monthly steering group attended by several voluntary groups. We are working closely with Social Prescribing to ensure that our work is complementary. We are mapping the voluntary and community groups in Croydon supporting people over 55s to see which ones can work together locally.

Question: How will we know the outcomes of each table's discussions that will be taken forward by this local NHS organisation?

Response: The CCG produces a quarterly patient and public involvement report which documents who we have engaged with and the impact of those discussions. These summaries are available on our website here. The CCG also produces an annual You Said We Did document available here.

Question: When will both groups, CUH and the CCG, recognise the value of volunteers and all the value that volunteers can bring to the table? Only by working together will everything have a chance to improve.

Response: NHS Croydon CCG and Croydon Health Services very much value people who volunteer with us. We are grateful for the commitment, energy, wisdom and skills that they generously give to us. We wholeheartedly agree that improvement can only come by us all working together.

Question: Considering the shortage of staffing levels at various stages of the NHS Services, how will this vision/commitment be delivered? The plan mentions the challenge of staffing. What strategies are in place to ensure that future staff recruitment and training enables implementation of the Plan in the community and localities?

Response: The NHS Long Term Plan (2019) acknowledges that workforce is a significant pressure facing the NHS and that funding will be available for additional investment in the workforce, in the form of training, education and continuing professional development (CPD) through the Health Education England (HEE) budget.

The Plan states that a workforce implementation plan will be published later in 2019.

A national workforce strategy will be developed by NHS Improvement, HEE and NHS England who will establish a group to ensure that such workforce actions agreed are delivered quickly.

Croydon faces a number of workforce challenges that are affecting the health service nationally: the numbers of nurses (particularly in the community and mental health) and GPs have fallen and social care faces difficulty in recruiting to specialist roles for more complex work. The increase in demand means health and care professionals are overstretched. In addition, there are difficulties in attracting staff to Croydon, despite it being a vibrant and energetic borough. Croydon can only offer outer London wage supplements meaning it is hard to attract staff from neighbouring London boroughs.

Locally One Croydon Alliance have developed a recruitment delivery plan to help facilitate its ambitions for Croydon.