Patient Participation Group

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.