LEYLANDS, WROSE & HEATON PATIENT PARTICIPATION GROUP
Zoom Meeting 5th November 2020 
Update to Minutes from 28th January & Zoom Meeting on 15th June 
Attendance: 
In attendance were: Michael Speed, Neil Bowring, David Barrett & Helen Procter.
Apologies were received from several PPG / PHC members who were unable to participate largely because of technical & access difficulties but also availability..
ITEM 2	Minutes of last zoom meeting 15th June 2020 

The Minutes of the last meeting had been approved 

ITEM 3	Actions Updates:  

DB ran through updates to open actions quickly & asked for comment & questions on   particular items, adding further updates as available.  For review & reflection, the current known status of the outstanding actions is as follows:
 
•	DB to consult with SO’S on the production of badges & display of photographs 
o	IN ABEYANCE. Discussed , but not pursued because of ‘lockdown’
•	DB to consult with SO’S on distribution of Minutes to PPG / PHC members without computers
o	COMPLETED. SO’S made copies for MR, MW & PK. DB delivered 
•	HDP to respond to CQC’s draft report by 30/01/2020
o	COMPLETED.  HDP responded & final report published  
•	DB to draft a PPG / PHC response to CQC inspection after official publication 
o	COMPLETED.NB alerted DB to online availability; DB contacted HDP, exchanged views & shared with PPG / PHC members. 
•	SO’S to outline her role & priorities at the next PPG / PHC meeting 
o	IN ABEYANCE SO’S & DB discussed briefly. To be included on agenda after meeting with PHCs on Waiting Room Support & other support services to be offered 
•	HDP to discuss production & dissemination of Monthly Performance Report with Jino Peter
o	 IN ABEYANCE.  HDP indicated that only the key information, predominantly financial, has been produced for the Practice. It is not possible to show percentages of in- surgery & remote consultations without significant manual effort.     
•	DB to have follow up discussion with TD, EB & PK on Waiting Room Support & then arrange meeting with SO’S 
o	IN ABEYANCE. DB had discussion with TD, EB & PK on focus & issues, spoke with SO’S, but unable to arrange meeting. In abeyance. DB to schedule a meeting with SO’S when appropriate
•	DW to report back on the dementia support refresher training provided to volunteers after the next Wrose Dementia Support session 
o	ONGOING. DB reported that Review / Refresher training had been provided, with responsibilities & approach emphasized to ensure clarity & consistency. Regular reviews are taking place & volunteers are being consulted in order to establish a development plan according to volunteer interests.
•	HDP to have a letter prepared to encourage Wrose patients diagnosed with dementia & carers to try out the Dementia Support sessions 
o	IN ABEYANCE. To be addressed when restrictions are lifted to enable more than 15 members to attend. 
•	DW / TB / DB to report back on agreement on future relationship with The Memory Tree 
o	ONGOING. The group continues to employ the MT ‘model’ & provide feedback on opportunities for improvement. Regular updates are being provided to The Memory Tree & discussions held on issues & the potential path forward.
o	A bi-annual review meeting was to be held, but postponed. DB confirmed that The Memory Tree group is still keen on having a workshop when restrictions are lifted
o	DB reported that there has been little input from Meri Yaadain. Contact with Ahklak Rauf has indicated that the focus is on ‘fire-fighting’ the impact of covid-19 on the BAME community.
•	DB to publish Dementia Training opportunities provided by Alzheimer’s Society 
o	ONGOING. Email sent out. Further Discussions were  held with AS on opportunities; but now in abeyance. Discussion have been held with all volunteers about interests in order to create a Development Programme & involve them more in the service delivery
•	DB to confirm agreed promotion of Patient Survey fulfilled
o	COMPLETED. Emails sent out on agreed promotion & monitored.
•	ALL to notify DB of availability to support patients in completion of Patient Questionnaire 
o	COMPLETED. Good response received, with welcome flexibility to encourage patient participation. 
•	DB to produce a schedule of PPG / PHC attendance at surgeries during the survey period.
o	COMPLETED. Produced, issued, updated & reissued.
•	DB to contact Simon Hicks re the online completion of the Patient Questionnaire 
o	COMPLETED Several follow up emails sent & Heaton Surgery attended to check. Final corrections to online version could not be completed.
•	DB to complete the analysis & draft report for review by the Subgroup (MS, YS, NB) before submission to HDP & the full PPG / PHC.
o	IN ABEYANCE Analysis completed & Draft Report issued. Some feedback received. Decisions to be made on format for presentation to patients, given the new operating environment
•	HDP to reflect on the Practice’s name & have further discussions.
o	IN ABEYANCE

ITEM 4   Practice Update

•	Staffing

HDP reported that 2 new GPs have been appointed: Marian Qureshi & Ursula O’Brian, with the former becoming a GP trainer. She intimated that good progress was being made to increased self-sufficiency in terms of providing the whole range of services to the c.19000 patient population by Practice staff, with Locums being introduced to cover holidays & sickness.

Sadia Parveen has been appointed an Advanced Nurse Practitioner & is now fulfilling that role. In addition xxxxxxx has been appointed as a Trainee Advanced Nurse Practitioner. Claire Hern left the Practice as an ANP in August & is now employed by Rockwell & Wrose Practice.

Lizzie Hannah, previously employed by the Practice & until recently a nurse taking care of covid-19 patients at the Bradford Royal Infirmary, has rejoined as a Practice Nurse

Helen advised that there had also been a number of personnel changes in Reception. She repeated that only 2 Reception staff are on duty within each surgery at any point in time.
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In terms of the way in which The Practice is organised to cope with the restrictions under covid-19 & enable services to continue to be delivered, Helen explained that staff had been arranged within a number of support bubbles. Many were working from home, with one GP resident at Heaton & Wrose surgeries. Because of the number of registrars, there were more GPs in attendance at Leylands, but a number were working from home.

With the number of GP trainers now employed by the Practice, Helen anticipated that, next year, there could be 6 or 7 registrars within the Practice undergoing training. She indicated that the training scheme had changed somewhat & so they would not be ‘shadowing’ GPs full-time, but gaining broader knowledge & experience within other areas of NHS

•	Premises
Helen announced that the funding application had been approved. However, this was based on the original design & did not incorporate modifications that had subsequently been discussed with the architect. This week, she had a meeting with the architect, who is looking at the options to accommodate the desired adjustments. Helen showed the participants a plan of the revised design & highlighted the key changes, predominantly around the waiting room & reception area, with security glass on the reception desk & modifying the walls circumscribing the waiting area, to make it is more open whilst retaining the privacy element originally included between the consulting rooms at the back & the waiting area. In addition, HDP indicated that the architects were evaluating options to address the ventilation problems in the window-less treatment rooms along the Nurses-corridor. Four additional consulting rooms will be constructed at the end of this corridor, which will initially impact the number of parking spaces at the rear of the building.

Given the current restrictions & the need to finalise the design, Helen anticipates that building work will not commence until the Spring, April or later.

As yet, no response has been received on the changes requested for Wrose.

•	Practice Performance
As mentioned, the Practice Performance reporting for the PPG / PHC members will be revisited when there is some stability in terms of the transformed service delivery processes.
In addition, given that the CCG will no longer require the quarterly Practice Access Plan updates, this will provide an opportunity for the Practice to review its workplan & process to determine its continued value to the Practice & propose any upgrades. Perhaps, it was suggested, this would be addressed at an early stage when the PPG / PHC members are able to meet in person.

•	Process / Organisation Changes & Impact
Helen confirmed that, although some of the solutions currently being employed would need upgrading, the principles of service delivery introduced as a result of the pandemic are likely to remain & there would not be a reversal to the standard operational practices prior to the pandemic. For safety, Helen also mentioned that, currently, to arrange a face-to-face appointment at the surgery there was a validation process requiring the signature of 2 GPs.
She confirmed that she would expect the telephone triage process to be enhanced & the product employed for video consultations, AccuRx, will be re-evaluated.

Questions were posed on the level of consultation with patients expected on their experiences, concerns & needs, before a solution was designed & implemented. The when & how would need to be addressed so that there was a meaningful consultation on the requirements before a specification was developed. It was emphasised that the needs & capabilities of the whole patient population should be registered so that no segment viewed themselves as an after-thought in the implemented solution.
Helen acknowledged the need for absorbing an understanding of patient experience & indicated that she would raise the point with the Primary Care Network Clinical Director, Dr Bhamani.

Mick raised two specific points regarding his experience with the current operation, namely the confirmation of appointment times via SMS & the documentation requirements to submit an EConsult admin inquiry. Helen is to speak with Simon Hicks & request that he liaise with Mick to address the SMS issue & acknowledges that the EConsult process may require some reconstruction & enhancement 

•	Primary Care Network
HDP reported that the Primary Care Network had been having regular fortnightly Zoom meetings, predominantly supporting the Practices & recently involving Pharmacists & Physio First. However, Helen did remark that, despite the original view that the work of the Clinical Director could be accomplished within one morning & one afternoon per week, the demands placed on the PCN have continued to increase such that there are concerns that the function is now overloaded. Such is the concern that some CDs are openly questioning their availability to fulfil the role.
Helen was asked whether a development plan for the function was in place & if there were actions being taken to ensure alignment, if not integration of the PCN & the Community Partnership. Although there is a plan, the focus has been on the Practices’ immediate support needs & there is not capacity to engage on the Community Partnership’s work programme. The view was expressed that, if time & resources are not available, decisive decisions should be made to suspend initiatives which do not appear to be in line with the longer term strategies

ITEM 5	Practice Health Champions/PPG Initiatives

•	PPG Patient Survey 2020 Analysis & Reporting 
o	Given the reduction in the numbers physically attending surgeries in the current ‘new normal’ we need to examine if / how / where we ‘publish’ the summary results & recommendations from the 2020 Patient Survey
o	It was felt that, with the limited attendance in surgeries & the time since completed, it was perhaps not critical to pursue this at the moment.

•	Wrose Dementia Support / Reminiscence Sessions
o	The Dementia Support sessions were resumed in September after Council approval of our Risk Assessment
o	Attendance was limited to 15 members, with no limit on the number of volunteers. On that basis, The Practices were notified that attendance would be by invitation only & referrals would be sought only after the restrictions were lifted.
o	It was reported that volunteers had noted a significant deterioration in Patients living with dementia &, from discussions, it was recognised that the extended isolation had also caused the Carers to experience increasing stress as they provide support 24 x 7 with reduced third –party assistance.
o	3 additional volunteers have been recruited since the resumption,  including Cllr Vanda Greenwood
o	We are continuing to revamp the agenda, within the endorsed framework, creating smaller segments to retain interest & enjoyment of the members & also to increase the involvement in delivery by volunteers.
o	Unfortunately, because of the lockdown, after consultation with the Council, the members have decided, collectively, that the next session will be cancelled. The infection rate in Bradford will be monitored over the next two weeks & volunteers & members then consulted on whether they believe that it is safe to resume.

•	Wrose Dementia Friendly Community Initiative Progress 
o	Because of the pandemic, the group’s concentration has been on the Support sessions, with limited contact being made with businesses & community groups in the area to increase awareness. 
o	At a recent Steering Group meeting, it was agreed  that action should be taken to expand  the Group to include Local Business & Health Provider
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•	Leylands / Heaton Dementia Friendly Community Opportunity
o	Discussions have been held with Moh’d Akhlak Rauf of Meri Yaadain to follow up on progress made on the project for which CP10 contributed funds. Because of the timing, limited work has been undertaken, with the Meri Yaadain’s focus being on the impact of Covid-19 on the BAME community  
o	Discussions have been held within CP10 Leadership Team both on the progress being made in Wrose, the contacts with Meri Yaadain & the opportunities to assess the demand for such an initiative in the Heaton area.
o	Contact has also been made re possible Dementia Friendly Community development in Clayton in order to discuss the scope & intent of its initiative & collaborate if there is agreement on the strategy.

•	Community Partnership S10 Leadership Team
o	After a lengthy gap, the S10 CP Leadership Team is now holding zoom meetings on regular basis. Unfortunately, because of the impact of covid-19 infection & the Practices’ workload, attendance has varied considerably, making continuity of discussions difficult
o	Two significant points made at the last meeting to address the effective use of our limited resources were:
•	Contact needed to be made with the PCN to ensure that there was a degree of alignment on paths being followed to ensure that effort was being expended productively.
•	Priority within the commissioned projects should be given to projects & initiatives that reduce demand for GP appointments, with minor ailments being highlighted.

•	S10 CP PPG Collaboration: Manor, Hollyns, Ashwell
o	DB has continued to provide updates to PPG Chairs & exchange emails, but there has been no opportunity to meet. Unfortunately, there has been little feedback, although contact has been made with the Hollyns PPG co-chair who has indicated some early involvement in a Dementia Friendly Community programme in Clayton.

•	S10 CP Contracts Awarded
o	As previously reported, the S10 CP Leadership Team confirmed the awarding of the 4 contracts to fulfil specific projects & a number of grants to vcs organisations to undertake projects which support the CP priorities
o	Communications & Engagement – Awarded to HALE: The pandemic has restricted its opportunities to get out into the community. However, there has been interaction with the Bridge Project to agree responsibilities & align the approach on the Self Care initiative. In addition, HALE has focused on the development of branding & increasing CP10’s social media presence.
o	Self-Care Champion – awarded to The Bridge Project:  After many months of debate, there has now been a re-alignment, with a decision made to change the position of Self Care Champion to Living Well Champion. The Living Well Programme is managed by BMDC & so attention will be paid to how the LW Champions are involved both in decision-making & in delivery. Zahir Dahi, the Bridge representative, has set out some Themes & a timetable for promoting specific activities & has been trying to encourage wider collaboration to take advantage of the expertise available for the whole district. 
o	Youth Health Champions – awarded to Bradford Youth Development Partnership. The project was significantly delayed, initially because of problems with recruitment & subsequently as a result of the pandemic. This has altered the intended approach, with the group seeking collaborations. Its initial actions have been devoted to engaging with schools & building relationships.

o	Reducing Loneliness & Isolation – a service extension was confirmed with HALE in order to speed up the activity rather than pursue the tendering process. HALE reported that it had processed c. 40 referrals & was providing an agreed support package to meet the specific needs of each patient. In addition it is working on creating a newsletter & looking at the potential of zoom meetings for quizzes etc. Furthermore, it is undertaking a risk assessment in order to hold small, physical groups.
o	ABCD (Asset-Based Community Development) Funding: 13 projects were allocated some funding (ranging from £600 to £3000, with the majority mid-range) which would contribute to the fulfilment of S10 CP’s declared priorities. Limited feedback was forwarded from Bradford Care Alliance on the expected interim progress reports from the organisations awarded grants. Efforts are being made to obtain more detailed information on the status of each project to verify whether it is ‘active’ & the intent is still aligned with CP10 priorities.

o	S10 CP Work Programmes / Plans

DB reported that, at the last CP10 Leadership Team meeting it was agreed that:
•	Priority needed to be given to projects and initiatives that reduce demand for GP appointments, with particular attention given to minor ailments
•	A high priority for the CP now was to liaise & work with the Primary Care Network to support identifying future priorities 

ITEM 6   Practice Health Champions / PPG – Basis of Future Meetings &   
                                                          Areas of Participation.
•	It was confirmed that, given the pandemic, Zoom Meetings were the most appropriate vehicle for maintaining PPG / PHC meetings. Nevertheless, despite the limited number available or able to access, it was concluded that these should be continued & summary minutes issued to all members so that there was an opportunity to maintain a relatively up-to-date awareness of the current operation, questions, issues, concerns etc & to exchange views.
•	Although there is much uncertainty about the future ‘normal’ the impact of the pandemic of the patient population suggests that PHC support services may be worth resurrecting after return to ‘normality’ if sufficient volunteers are available & willing to contribute. 

   ITEM 7   A O B

A good discussion took place on the need for continued, regular meetings, albeit using Zoom, to ensure that we, as a team, are prepared to contribute to the transformation of service delivery & recognise where our support of patients may be of greatest value when many of the current restrictions are lifted. It was already evident that mental health issues will be a major concern.

It is acknowledged that an open debate on how the patient view may be represented to the Practice at the point of the definition of requirements & design of solutions to meet the changing needs will benefit all parties in the long term. ‘Empty’ consultation on solutions that have already been created will not suffice. Helen has already agreed to present that perspective to the PCN Clinical Director, Dr Bhamani. It is hoped that early consultation on the how & when will take place.

Given the need for the PPG / PHC members to be ‘primed’ to participate, with as much knowledge as is available as we prepare for the ‘new normal’ Helen agreed that it would be useful, when safe in the new year, for a workshop to be arranged so that all members can be involved in face to face discussion on the intended framework for the delivery of primary care & also on the role & responsibilities of the Patient Participation Group & Practice Health Champions & how they should be modified in response to the changing health & well-being structures. 

   ITEM 8 Timetable For 2020 PPG- PHC Meetings

	Next Zoom Meeting:  Thursday 10th December at 10:00am