Patient Participation Group

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness, such as:

• Risk of airway obstruction
• Bite or sting around the eyes Signs of anaphylaxis including:
• Swollen eyes, lips, hands and feet
• Feeling lightheaded or faint
• Swelling of the mouth, throat or tongue, causing breathing and swallowing difficulties
• Abdominal pain, nausea and vomiting
• Collapse or unconsciousness Signpost patient to A&E or phone 999 in an emergency.

Insect Bites & Stings

Insect bites and stings can commonly cause redness, pain and swelling at the site. However, this does not always mean that they have become infected. It is important to ensure that nothing remains in the skin (www.nhs.uk gives guidance on removing stingers and ticks), and that the site is kept clean to help prevent infection.

Treatment for bites and stings can include:

• Using an ice pack on the area
• Antihistamines
• Steroid creams
• Painkillers

If a bite or sting does become infected, treatment with antibiotics may be necessary. The pharmacist will recommend the most appropriate treatment for the patient.

Ask the patient, parent or guardian to complete the Infected Insect Bite Patient Checklist prior to consultation with the pharmacist.

Once the completed checklist is returned to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need onward referral.
3. If the patient has ticked any boxes in section 3, Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply.

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness such as meningitis. Red flag symptoms include:

• Confusion or disorientation
• Muscle weakness
• Loss of bladder or bowel control
• Facial nerve paralysis
• Neck stiffness
• Mottled skin
• Sensitivity to light Signpost patient to A&E or phone 999 in an emergency

What is shingles?

Shingles is caused by the same virus that causes chickenpox. If someone gets chickenpox, the virus stays in the body and can be reactivated later if someone’s immune system is weakened due to stress or other reasons, presenting as shingles. The first signs of shingles can be a tingling or painful sensation in an area of skin (followed by a rash a few days later), and a headache or feeling generally unwell. The rash usually appears on one side of the body only. The shingles vaccine is available for some patients on the NHS, and there is also a private vaccine available. If the patient is eligible for the Pharmacy First service, the pharmacist will recommend the most suitable treatment option to best manage the patient’s symptoms following a consultation.

Patient Checklist

Ask the patient to complete the Shingles Patient Checklist prior to consultation with the pharmacist. Once the patient returns the completed checklist to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need urgent onward referral.
3. If the patient has ticked any boxes in section 3, Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply. 4 If the patient has ticked any boxes in section
4. Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service and these questions will help the pharmacist recommend the most appropriate treatment.

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness such as meningitis, such as:

• Non-blanching rash
• Drowsiness
• Neck stiffness
• Sensitivity to light
• Facial nerve paralysis Signpost patient to A&E or phone 999 in an emergency.

What is acute otitis media?

Acute otitis media infections (ear infections) are very common, particularly in children. It often resolves itself within 3 days, but sometimes treatment can be necessary. Symptoms include those listed in section 3 of the Patient Checklist. Treatment may include:

• Self-care advice such as a warm or cold flannel on the ear
• Over-the-counter products such as painkillers
• Antibiotics If the patient is eligible for the Pharmacy First service, the pharmacist will recommend the most suitable treatment option to best manage the patient’s symptoms following a consultation.

Patient Checklist

Ask the patient, parent or guardian to complete the Acute Otitis Media Patient Checklist prior to consultation with the pharmacist. Once the completed checklist is returned to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need urgent onward referral.
3. If the patient has ticked any boxes in section 3, Refer to the pharmacist. The patient will need an otoscopic exam by the pharmacist. This may result in advice, referral, OTC sale or PGD supply

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness, such as:

• Widespread infection
• Systemically unwell
• Confusion
• Raised heart rate
• Raised respiratory rate/breathlessness Signpost patient to A&E or phone 999 in an emergency

What is impetigo?

Impetigo usually affects skin that is already damaged, for example cuts, insect bites, or eczema. To prevent impetigo, cuts and scratches should be kept clean, and treatment sought for any skin conditions. Anyone can get impetigo, but it is more common in young children. It is very infectious and infected people should practice good hygiene eg. hand washing and staying away from school or work until it stops being contagious (either when patches dry out and crust over if no treatment is provided, or 48 hours after starting treatment). There are two types of impetigo:

Patient Checklist

Ask the patient, parent or guardian to complete the Impetigo Patient Checklist prior to consultation with the pharmacist. Once the completed checklist is returned to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need onward referral.
3. If the patient has ticked any boxes in section 3, Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness such as meningitis. Red flag symptoms include:

• Non-blanching rash (a rash that does not disappear with pressure)
• Drowsiness
• Neck stiffness
• Sensitivity to light Signpost patient to A&E or phone 999 in an emergency.

What is an acute sinusitis?

Sinusitis is swelling of the sinuses, and common symptoms are listed in section 3 of the Patient Checklist. It can be caused by infection and most people get better within 2-3 weeks without the need for antibiotics. Treatment may include:

• Self-care advice such as drinking plenty of fluids and getting plenty of rest
• Over-the-counter products such as painkillers or decongestants
• Cleaning nose with a saltwater solution
• Antibiotics If the patient is eligible for the Pharmacy First service, the pharmacist will recommend the most suitable treatment option to best manage the patient’s symptoms following a consultation.

Patient Checklist

Ask the patient, parent or guardian to complete the Acute Sinusitis Patient Checklist prior to consultation with the pharmacist. Once the completed checklist is returned to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need urgent onward referral.
3. If the patient has ticked that they have a nasal blockage OR runny nose AND at least one of the other 3 symptoms, For 10 days or less - Antibiotics are not needed. Manage with self-care. Provide TARGET RTI leaflet. For over 10 days - Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply.

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness such as sepsis. Red flag symptoms include:

• Confusion
• Raised respiratory rate/breathlessness
• Raised heart rate
• Drop in blood pressure
• Stridor (noisy or high pitched sound with breathing) Signpost patient to A&E or phone 999 in an emergency

What is an acute sore throat?

Acute sore throat is often caused by a virus, and in these cases shouldn’t be treated with antibiotics. It usually resolves by itself after around 1 week, regardless of whether it has been caused by a virus or bacteria. Management of symptoms can include:

• Self-care advice such as drinking plenty of water and eating cool or soft foods
• Over-the-counter products such as painkillers or lozenges 

However, some patients may benefit from antibiotics. If the patient is eligible for the Pharmacy First service, the pharmacist will recommend the most suitable treatment option to best manage the patient’s symptoms following a consultation.

Patient Checklist

Ask the patient, parent or guardian to complete the Acute Sore Throat Patient Checklist prior to consultation with the pharmacist. Once the completed checklist is returned to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, Refer to the pharmacist. The patient may need onward referral.
3. If the patient has ticked 1 or no boxes in section 3, Antibiotics are not needed. Recommend over the counter treatment and adequate hydration. If the patient has ticked 2 or 3 boxes in section 3, Antibiotics are not recommended. Recommend over the counter treatment and adequate hydration. Ask the patient to return if no improvement within 3-5 days for pharmacist reassessment. If the patient has ticked 4 or 5 boxes in section 3, Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply

Before you provide the patient with the Patient Checklist to complete, it is important to first check if they are experiencing any red flag symptoms which may indicate serious illness such as sepsis. Red flag symptoms include:

• Confusion
• Raised respiratory rate/breathlessness
• Raised heart rate
• Drop in blood pressure
• Rapid or significant worsening of symptoms Signpost patient to A&E or phone 999 in an emergency

What is a urinary tract infection (UTI)?

Uncomplicated lower urinary tract infections affect a patient’s bladder or urethra. Symptoms may include those listed on section 4 of the Patient Checklist. Management of symptoms can include:

• Self-care advice such as drinking enough water to pass pale urine regularly during the day
• Over-the-counter products such as painkillers or cystitis relief sachets
• Antibiotics If the patient is eligible for the Pharmacy First service, the pharmacist will recommend the most suitable treatment option to best manage the patient’s symptoms following a consultation.

Patient Checklist

Ask the patient to complete the UTI Patient Checklist prior to consultation with the pharmacist. Some of the questions are sensitive in nature so ensure you are mindful of this during your discussion. Once the patient returns the completed checklist to you, use the following guidance on appropriate next steps:

1. If the patient has ticked any boxes in section 1 of the checklist, They are not eligible for the Pharmacy First service. Advise patient to seek treatment from their GP or out of hours service.
2. If the patient has ticked any boxes in section 2, They require an urgent same day referral to their GP or relevant out of hours service.
3. If the patient has ticked any boxes in section 3, Refer to the pharmacist. The patient may need onward referral to GP, sexual health clinic or other provider.
4. If the patient has ticked any boxes in section 4, Refer to the pharmacist. The patient may be eligible for management within the Pharmacy First service. This may result in advice, referral, OTC sale or PGD supply.

Dear Patient,

Welcome to our PPG. The Patient Participation Group (or PPG) has been set up by the four GP practices who work together to form the PRIME (Putney & Roehampton Integrated Medical Enterprise) Network.

Our practices work very hard to ensure they provide the best care to all its patients, so with our help and collaboration we aim to work closely with our practices to help achieve their mission in providing excellent patient care. The group aims to provide a forum to give feedback on the services offered by the practices and the network and make suggestions for how they can be improved.

The PPG can meet in different ways i.e. with each other, or with a practice representative, or with a network representative. We hope that the ability to meet at different levels will encourage more representation and ideas in our groups. The PPG will feedback to the practice on the issues raised by its members. The practice will provide a platform for this information to be disseminated. In the meantime please take the time to read our terms of reference (ToR) and guide to forming a productive PPG. 

We look forward to welcoming you to our next meeting. Best wishes. CHAIR OF THE PPG IN COLLABORATION WITH PRIME NETWORK

Patient Participation Group

The collaborative group shall be known as the PRIME Network Participation Group.

Purpose

The purpose of the Virtual Patient Participation Group is to establish a system of communication with registered patients in the Practices within the PCN so that their views and concerns are fed back. We also aim for our patients and VPPG members to have a better understanding and knowledge of the Practices, its staff and its viewpoint. It is hoped that by establishing a VPPG, a more diverse and regular group will emerge.

Structure

The structure is comprised of a Virtual Patient Group, with communication between the group and the Practice/Network via an online platform such as Zoom or Skype, and also via the practice.

The key points:

• The group will aim to represent the diversity of our practice population;
• To work collaboratively and positively with the practice to improve services and facilities for patients
• Create and improve two-way communication between patients, the Practice and the community it serves;
• To build a sense of partnership between Practice and patients;
• Provide constructive feedback on patient needs, concerns and interests;
• Support the Practice in good health promotions, preventative medicine and health literacy.
• Collect patient opinions and experiences to help the Practice to evaluate its services.
• Communicate to the Practice community and/or the wider community information about the Practice;
• The practice does not expect membership of the group to take up too much of our members’ time, unless members choose to give more;
• Membership of the group will have no impact on your medical care, in any way;
• Members can choose to leave the group whenever they wish.

Confidentiality and code of conduct

All members of the PPG must be made aware of the need to maintain absolute patient confidentiality at all times. Any member whose work on behalf of the PPG includes work in the practice or consulting with other patients or members of the public should sign and return a copy of the Patient Confidentiality Agreement before undertaking such activity. All PPG members must abide by the Code of Conduct.

Patient participation is

Patients working with a practice to:

• Contribute to the continuous improvement of services;
• Foster improved communication between the practice and its patients;
• To make sure that the patient voice is listened to and not necessarily always to be the voice itself;
• Help patients to take more responsibility for their health; and
• Provide practical support and help to implement change. Varied to suit local needs
• Each group determines its own activities according to the wider needs of the community and the practice itself. Based on co-operation
• VPGs work by building a relationship between the practice and its patients that breaks down barriers and shares information.
• VPGs can develop to influence the wider NHS, most notably the decisions that are made on behalf of patients about the services that are to be available to them.

Patient participation is not:

• A forum for complaints
• Clear ground rules are declared to ensure that VPG members do not use the VPG as a vehicle to resolve their own personal issues and/or complaints.
• A time-consuming activity for practice staff
• Some effort is required to get VPGs going but thereafter they should be self-organising and patient led and will often undertake activities that save the practice time.

Review

The terms of reference for both groups will be reviewed on an annual basis or if the NHS requires change to be made to the regulations. 

1. You must be a registered patient of either of the following practices to be a member of the VPG:

• Chartfield Surgery
• Heathbridge Practice
• Mayfield Surgery
• Tudor Lodge Health Centre

2. Complaints and personal issues will not be addressed from this site. If you have a complaint, please ask at your reception site for a copy of the complaints procedure. If you have a personal issue relating to services provided to you as a patient, please contact the practice manager at your site who will be able to assist.

3. We do not need to meet face to face, discussions can be held online;

4. We will all be flexible, listen, ask for help and support each other;

5. We will demonstrate a commitment to delivering results, as a group;

6. Recommendations/suggestions for improvements to the Practice and/or services should be discussed and agreed within the VPPG before presenting to the Practice for comment. Suggestions will not be considered by the Practices/network until agreement has been reached;

7. The VPPG will nominate one or two representatives who will liaise with the Practice on suggestions and recommendations;

8. All views are valid and will be listened to;

9. Silence indicates agreement – speak up;

10. The purpose of the virtual group is to hear from our patients and to share constructive conversations on topics of interest. Your views and suggestions will help to inform future service improvements for all patients;

11. Honesty is welcomed, as is challenge between individuals, but we ask that your tone and language remain courteous and respectful at all times. Posts which are inflammatory or offensive will be deleted and you may be removed from the VPPG;

12. The VPPG members and practice representatives should be treated with dignity and equality. Respect towards each other’s opinions must be adhered to at all times. Members should not be made to feel their opinions and suggestions are disregarded.

13. Members should be able to openly report in confidence any behaviour that constitutes verbal abuse, bullying, harassment, unfair treatment or similar. Such behaviour will not be tolerated, and members will be removed from the group. Please note, in some cases it may also lead to your practice issuing you with a warning and could result in removal from the practice list.

14. Patients can serve on the VPPG for a fixed term of two years. Representatives of the VPPG can be voted in for a longer term by the VPPG members and Practice/PCN but their term will not exceed four years;

15. The ground rules of the VPPG may change from time to time at the discretion of the Practices/PCN;

16. It is the responsibility of the patient to inform the chair and/or practice manager that they no longer wish to sit on the group, or that they are leaving the practice. Membership to the group will then be revoked. (Please note: a monthly audit will be conducted on the patient group list to ensure that everyone within the group still maintains the right to sit on the group).

17. Important – Please note that no medical information or questions will be responded to. The information supplied to us will be used lawfully in accordance with the Data Protection Act 2018. The Data Protection Act 2018 gives you the right to know what information is held about you and sets out rules to make sure that this information is handled properly.

PPGs have a key role to play as they help ensure that patients and their carers can influence their local services.

PPGs support the practice in developing services to ensure the needs and wishes of the patient population are met.

The Role of the PPG

The role of the PPG includes:

• being a critical friend to the practice
• advising the practice on patient perspective, providing an insight into the quality of services
• encouraging patients to take greater responsibility for their own health
• researching the views of those who use the practice
• participating in health promotion events
• regularly communicating with the patient population
• works in partnership with the practice, contributing to continuous improvement of services and standards of care to the patient population

Structure of the PPG Committee

A typical PPG committee comprises of a:
chair person
vice chair
secretary
treasurer (optional)
Any additional posts as deemed appropriate (created at the AGM if proposals are made)
Members can be part of the face-to-face or virtual PPGs.
Members of the PPG who cease to be registered at the practice, will cease to be a member of the practice PPG with immediate effect.
The PPG will be a representative sample of the practice population.

PPG Membership

PPG members should:

• be registered as either a patient or carer of a patient at either of the practices in PRIME
• remain objective
• work collaboratively
• listen to views of the group
• adhere to the TOR for PPG members
• commit to the 7 principles of life: Selflessness, Integrity, Objectivity, Accountability, Openness, Honesty and Leadership

What do Members do?

PPG Members:

• liaise with patients and carers, discussing concerns and comments pertinent to practice services
• champion the PPG, actively engaging with the patient population and local community
• attend and contribute to meetings
• remain objective throughout meetings
• represent the patient population effectively, expressing the views of the population objectively

What happens at meetings and when do they occur?

PPG meetings:

• take place at least quarterly
• follow an agenda (issued by the secretary)
• are a forum to discuss patient issues, concerns, suggestions etc.
• an opportunity to listen to speakers from the practice about developments or initiatives which will affect the patient population
• an opportunity for members to represent the patient population

How do PPGs support the Practice?

• The CQC expect the practice to comply with key lines of enquiry (KLOE).
• KLOE W4 asks ‘how are people who use services, those close to them and their representatives actively engaged and involved in decision-making, including through a patient reference group or PPG.
• Being able to demonstrate effectiveness in this area will support the practice an help achieve a positive outcome following a CQC inspection

Where Can I Learn More?

• The National Association for Patient Participation (N.A.P.P.) was commissioned by NHS(E) to develop a resource to help PPGs work effectively.

If you are happy for us to contact you periodically by email please leave your details using the form linked below.

Signing up means you acknowledge that you will be allocated to your own practice’s PPG. The PRIME PPG is a network formed by four practices, and will only require attendance to the quarterly meetings if necessary and usually represented by the Chair or board members from your own group. You will continue to meet with your GP practice’s own PPG.

PPG - Signup Form

Role

The role of the Quality Stakeholder Reference Group (QSRG) is to update the community and patient representatives on the services offered, seek their views on any changes and to get updates from community groups and patient representatives. 

Definitions

“The Trust” means Central London Community Healthcare NHS Trust
“The division” means South West Division of CLCH

1    Membership

1.1    The membership of the group will be flexible and open to new members from interested external stakeholders. Members of the Quality Stakeholder Reference Group will include:

• Healthwatch representatives 
• Clinical Commissioning Group representatives
• Voluntary Sector Representatives
• Patient and Carer Representatives
• CLCH Staff and Board Members    

1.2    Any clinician or administrator within the division can be invited if requested

1.3     The chair of the committee will be the Divisional Director of Nursing & Therapies. In the absence of the chair, an appointed deputy will chair the meeting.    

2     Secretary

2.1     The Patient Experience Facilitator shall act as the secretary of the group.

3     Quorum

3.1     The quorum necessary for the transaction of business shall be:

• Divisional Director of Nursing & Therapies (or nominated representative)
• Patient Experience Facilitator 
• Patient Representative or community group representative from at least 3 groups

4     Frequency of meetings and attendance requirements

4.1     QSRG will normally meet quarterly at appropriate times in the reporting cycle.

4.2     The Secretary of the forum shall maintain a register of attendance.

5     Notice of meetings

5.1     Unless otherwise agreed, notice of each meeting confirming the venue, time and date together with an agenda of items to be discussed, shall be forwarded to each member of the QSRG, any other person required to attend, no later than 15 working days before the date of the meeting. 

5.2    Supporting papers shall be sent to members and to other attendees as appropriate, no later than 5 working days before the date of the meeting.

6    Minutes of meetings

6.1     The Secretary shall minute the proceedings of all meetings including recording the names of those present and in attendance. 

6.2     Members and those present should state any conflicts of interest and the secretary should minute them accordingly.

6.3     Actions from the meeting should be circulated within 5 working days to all members of the divisional quality forum.

6.4      Minutes will be circulated with the papers for the next meeting

7    Duties

The divisional quality stakeholder reference group should carry out the following duties:

7.1    Quality    

7.1.1     To review implementation of all elements of the quality strategy, as set out in the underpinning quality campaigns as follows. In particular to discuss and ensure that plans are in place to ensure that the measures for success are achieved within appropriate time scales.

7.1.2     The Quality Campaigns:

Campaign 1 A Positive Patient Experience: Enhancing the experience of our patients and their families

Campaign 2 Preventing Harm: Keeping our patients, their families and our staff safe

Campaign 3: Smart, Effective Care    Ensuring patients and service users receive the best evidence-based care, every time

Campaign 4: Modelling the Way    Providing innovative models of care, education and professional practice

7.2    Positive Patient Experience: Involving and learning from service users

7.2.1    To obtain assurance that the experience of users, carers and voluntary groups are central to each services work.

7.2.2    To obtain assurance that the implementation and maintenance of programmes for measuring, monitoring, and improving the experience of service users and carers are appropriate and relevant.

7.2.3    To obtain assurance that lessons learnt from involving service users are used to improve the quality of service provided.

8     Reporting responsibilities 

8.1     The chair shall raise any issues to the Chief Nurse or Deputy Chief Nurses where action or improvement is needed.

9     Monitoring and Review:

9.1     Terms of reference agreed by Chief Nurse and Divisional Directors of Nursing on XXX

9.2    The terms of reference will be revised with the launch of the new Trust Quality Strategy in April 2025

• 10.00am: Welcome and Introductions - Luisa Brown – Divisional Patient Experience Facilitator - All group members - Verbal
• 10.05am: Divisional and Trust Quality Update - John McLinden – Divisional Director of Nursing and Therapies (DDNT) - Verbal
• 10.15am: Sickle Cell Animation - “Breaking the Silence” - Luisa Brown – Divisional Patient Experience Facilitator - Verbal 
• 10.30am: Community Nursing – “Quick Reference Guides” - Gemma Gilmore – Head of Clinical Services - Verbal
• 10.45am: Shared Governance Updates – Quality Councils within the SWD - Nicola Ireland – Shared Governance Programme Lead - Verbal
• 11.00am: Newsflash - (Members share their updates and any news of key issues affecting their external organisations.) - Stakeholder Representatives. - Verbal
• 11.15am: AOB - Feedback Form - All - Luisa Brown (Patient Experience Facilitator) - Verbal
• 11.25am: Close - Luisa Brown – Patient Experience Facilitator - Verbal

Attendees:  

Luisa Brown (LB- CLCH NHS Trust), Gemma Allen (GA- CLCH NHS Trust), Campbell Flack (CF -CLCH NHS Trust), Emma Tomlin (ET– CLCH NHS Trust), Sheena Rufus (SR – CLCH NHS Trust), Amelia Russell (AR – CLCH NHS Trust), Charlotte Allen (CA Age UK Wandsworth),  Edwina Curtis (EC – SW London NHS), Ruth Lister ( RL - Patient Representative Heath bridge GP Surgery) , Shaleen Simmonds (SS – St Georges NHS Trust), Eglionna Treanor (ET – Wandsworth Carers),   Liz Harrington (LH – Patient Representative heath bridge GP Surgery), Senia Dedić (SD – Women of Wandsworth), Dave Curtis (DC – Healthwatch Merton)

Apologies:

John Mclinden (JMc- CLCH NHS Trust), Kuan Peng (KP – Heathbridge Practice), Alan Kummer (AK- Patient representative), Paul Scharakowski (PS - Alzheimer’s UK), Beau Fadahunsi (BF – Merton Connected), Hayley Conyers (HC – Spectra London UK), Gemma Ayres (GA – Alzheimer’s UK)

 1.     Welcome and Introductions.

• All attendees welcomed to the meeting. Introductions made.

2.    Divisional & Quality Trust Updates for the South-West Division by the Divisional Director of Nursing & Therapies.

Gemma Allen presented (Divisional Clinical Quality Lead).

GA provided an update on various quality improvement projects across the Southwest Division, including the Merton Community nursing team's work with the transforming wound care programme, the development of quick reference guides for community nurses, and the school nurses' asthma-related project.

Wound Care Programme: The Merton Community nursing team has been working with the transforming wound care programme, which aligns with the National Wound Care Strategy. The independent evaluation results have been positive for patients, sustainability, and workforce impact.

Quick Reference Guides: Quick reference guides have been developed for community nurses to provide easy access to key support documents, even in areas without internet connectivity. This initiative has been well-received and showcased at the Quality Forum.
 

Asthma Project: School nurses in Merton have been involved in an asthma-related project with the local authority, focusing on the impact of air quality on asthma symptoms. An animation has been produced to educate on air pollution's effects on children's asthma, and training is being provided to schools.

Insulin Self-Administration: A patient leaflet has been co-produced with patients to support self-administration of insulin. The leaflet, developed by community nurses in Wandsworth, has received positive feedback for its accessible language and useful information.
Catheter Pathways: A trust-wide catheter review is being led by 1S, in collaboration with NHS 111 and Saint George's, to reduce hospital attendances due to catheter problems by supporting care in the community. The project is exploring available technology to aid this effort.

• SS requested to share the community nursing guide with the C RCH community team for the sickle cell project, and Gemma agreed to check with colleagues and share the guide.
• NHS Volunteer Responders: AR explained the NHS volunteer responders service, which offers check-in and chat or companionship calls for patients experiencing loneliness. She also mentioned that patients, family members, and staff can refer individuals to the service. The service provides two options: check-in and chat, which may involve different volunteers calling daily, and companionship calls, where a consistent volunteer calls one to three times a week over six weeks.

EC Just to say thank you very much, Gemma, wide breadth of innovative work that's really meeting the needs of the population. So, thank you. If there's anything we can do around supporting with comms, particularly around the asthma video or you know anything, please let us know and we can liaise with the comms in our teams around sharing that more widely.

ET Sounds brilliant. So, we have a newsletter, so if you could send me some information and get, we can help get the information out there.

CA Yeah, also the information would be great because obviously we have a befriending service, which is face to face. But we do have people that we can't always support, and we have a long waiting list. So, if somebody would like telephone friending, that would be handy for us to know about as well.

3.    Wandsworth Discharge to Assess and Maximising Independence Services

Patient Story

LB shared a powerful patient story about Mrs. A, a 92-year-old patient who benefited from the collaboration between the discharge to assess team and the maximising independence service. The story highlighted the importance of teamwork, patient engagement, and self-management in improving recovery outcomes.

The discharge to assess (D2A) team, particularly a therapist named Name, played a crucial role in Mrs. A's rehabilitation. Despite initial doubts from hospital staff, the D2A team provided extended therapy, which significantly improved Mrs. A's mobility and quality of life.

Mrs. A's family, including her daughter and brother, were actively involved in her care plan. They advocated for her rehabilitation and worked closely with the D2A team to support her recovery at home, avoiding further hospitalizations and pressure sores.

With the support of the D2A team, Mrs. A regained her independence, improved her mobility, and avoided further health complications. The story emphasized the importance of personalized care, effective teamwork, and listening to both patients and their families.

GA and ET provided positive feedback on the patient story, emphasizing the importance of including patients and their families in care planning and goal setting. They also inquired about the multidisciplinary teams involved in the discharge to assess and maximising independence services.

GA and ET praised the patient story, highlighting it as a demonstration of effective teamwork and the importance of including patients and their families in care planning and goal setting.

ET inquired about the skill mix of clinicians in the discharge to assess (D2A) and maximising independence (MI) teams. 

CF explained that the teams include physiotherapists, occupational therapists, rehab assistants, and speech and language therapists.

4.     New Service Model for Sexual Health:

ET presented the new service model for Southwest London Sexual Health, which includes a five-day-a-week schedule with one nurse-delivered care day. She discussed the benefits of the model, such as maintaining Level 3 care and improving patient experience.
CLCH has delivered integrated sexual health services in Southwest London since October 2017. The service initially covered Merton and later expanded to Wandsworth and Richmond. The contract is with local authorities, and services are open access.

Due to financial constraints, the bid for the new contract was withdrawn in February 2025. After negotiations, a two-year contract fitting the financial envelope was agreed upon, ensuring continued high-quality care.

The new service model, effective from January 2025, includes a five-day-a-week schedule with one nurse-delivered care day on Wednesdays. This model maintains Level 3 care and aims to improve patient experience by optimizing staff schedules and service delivery.

The model allows for better skill mix, increased Level 3 appointments, and more robust workforce planning. Challenges include ensuring appropriate nurse prescribing and managing patient triage to match the right patients with the right appointments.

Efforts to improve patient experience include staged walk-in services to reduce waiting times and online booking for specific services. The goal is to provide a seamless and efficient patient journey while maintaining high standards of care.

GA- Thank you, Emma, I know this has been a long and complicated process and you've worked so hard as well as the team to try and find the best outcome for patients, recognising that you know the climate is changing the efficiencies need to be made. You know thinking about how to work differently. I know it seems really challenging, but there's been some positive outcomes, and I know you are making sure the workforce was supported and felt valued through and that was key.

And so yes, thank you for sharing that and for all your hard work along the way because it's been, it's been quite an undertaking.

ET -It has been quite a journey as they say, and reassuringly through all of that, you know, LB supports with our patient experience. And our patient feedback is always good. We have very high levels of patient feedback and that in some ways it makes me a little bit sad because people are just so grateful to get the care, and we get people say I've run around loads of places, and I couldn't get in. So yes, we absolutely love the high feedback, but it's sad that people are just so desperate to have received the care. Thank you so much. 

LB - We received lots of comments, don't we, Emma, around a 5 star service at SWLSH and they all mention how you may have to wait for a period of time, but they're so appreciative that they've got this service on their doorsteps and I think that's so rewarding for the clinicians to know that, OK, people are having to wait, but they're happy to wait because they're just so happy that they've got that service right there on their doorstep that they can access into as they need to. Great feedback from our service users.

5.     Sheena Rufus - Quality Improvement Project - 

SR presented a quality improvement project for Merton Children and Young People's therapy services, aiming to develop a multi-professional pathway for children with complex health needs. The project involved service user feedback and process mapping to create a more efficient and family-centred pathway.

SR and LB emphasized the importance of involving service users in the development of the new pathway, noting that their feedback was valuable in creating a more efficient and family-centred process.

EC - I just wanted to comment, you know, it looks great. It's great that you've had that service user engagement and feedback, and you've really looked at where the kind of waste is in the system that you currently had and made it a much leaner process. And I really hope that then that's reflecting the patient feedback that you get from your pilot, so well done.

LB - Service user feedback has really playing a part with this new pathway process and I think from our new 5 borough mobilisation, it's kind of a key thing that if you have service user involvement from the very beginning all the way through it's very rich, very valuable feedback and needs to be included to gain that insight all the way through its just you know fantastic. It works well for everyone. So, it's something we try to do now throughout the Southwest Division with anything we've got going on.

Thank you for your feedback, Edwina.

GA -I mean probably just echoing Edwina's comments and like you say, LB, we've been focusing on getting more patient feedback and this is a great example of where you've really employed that. And I think it'll be really interesting to see the outcomes and the impact that it has on those families. You know, like you say, it's really recognising the family as a whole and the impact, all these multiple appointments can have and the complexities of navigating it also it's going to be good to see.

SR - I think it is quite easy to forget that actually when we're offering therapy or services to children that we forget there's a whole family around them and that they have so much to navigate. So, you know, it's been really positive Experience to do it to, you know, look at it for the reality of it, for these families. 

ET - It sounds an amazing piece of work. I am just so impressed with you. Apart from the the visuals all being the presentation was beautiful, which I always like anyway. But I mean it just so demonstrates What you can do when you when you work with carers and things, and I just think you explained it beautifully and really understood, and I imagine your feedback is going to be great because people will have been really listening to so yeah, amazing bit of work.

LB - I think the feedback from our service users when we shared the new pathway with them, they were quite overwhelmed and happy to see that their thoughts and their feedback had been kind of really factored into it. And they were like, wow, you know, seeing it on there, if we can make this work, this will be making life so much easier for all of us. So, it's been very rewarding for Sheena and the team as well as for our service users. So yeah, it will be really exciting to see what the end result will be once we've finished this pilot.

And obviously do we need to do a second PDSA.

6.    Newsflash – members share their updates and any news of key issues affecting their external organisations.

LB shared updates on the executive Nurse Leaders Programme award received by  JMc SWD Divisional Director of Nursing & Therapies

LB shared the mobilisation of the new 5 borough hemoglobinopathy service for both Adults & Paediatrics is now live. 

EC acknowledged the ongoing changes in the NHS and the uncertainty surrounding them, noting that more information is awaited.

ET - We've recently in the last year started to do some work with young carers as well. And as I said earlier, we've got a new set of which goes out electronically and in paper form, which is I think pretty unique these days. So, if you've got anything you do want to get out to carers in Wandsworth, please send it my way. Thank you.

7    AOB:

GA – Thanked all for attending. Time is very precious.

Meeting closed.