Removing barriers to participation

Our approach to patient and public engagement, enables us to bring the voices of some of the most vulnerable members of the community to the decision making table

The three lenses approach to our equality analysis process in decision making and governance requires all commissioners to make decisions based on an analysis of the Equality, Engagement and Health Inequalities duties which mandates them to:

  • Complete equality impact assessments which then informs PPE action plans
  • Complete in all Board and Committee reports a section that asks for evidence to demonstrate how the three lenses approach have been met

We are committed to tackling health inequalities. We work closely with Newham council and other partners through the Health and Wellbeing Board to drive forward improvements to health and social care services. We also recognise that it is more important than ever to integrate equality considerations into all aspects of our commissioning and key to doing this meaningfully is to embed patient voice in what we do. Which is why our equalities, diversity and inclusion strategy underpins our approach to patient and public engagement.  Engagement that is inclusive and representative of our community ensures the services we commission works for everyone. 

Some of our success stories to removing the barriers in participation include:

Improving primary care access for deaf patients

Since 2016 the CCG has been working in partnership with deaf patients via the Newham Deaf Forum and Healthwatch Newham to understand deaf patients’ experience of accessing primary care services. Deaf patients have told us, they find it challenging communicating with healthcare professionals and frontline staff in primary care.  Though the CCG commissions a language and interpreting services in all GP practices in Newham, patients have told it’s not always easy accessing BSL support in practices.

As a result of what deaf patients have told us we have:

  • Developed a protocol for reception staff for booking interpreters via the Language Shop, with specific reference to BSL support. The protocol illustrates what the booking process should look like to ensure a seamless service for patients (based on feedback from deaf patients).
  • Developed a protocol for reception staff for booking interpreters via the Language Shop, with specific reference to BSL support. The protocol illustrates what the booking process should look like to ensure a seamless service for patients (based on feedback from deaf patients).
  • In partnership with deaf patients, we developed ID cards for deaf patients that will make it easier for them to access information and communication support, as well as raise awareness in GP practices.
  • Based on feedback from Deaf patients and Healthwatch Newham we have coproduced our deaf awareness training offer for practice staff in Newham.  Developed by the Royal Association of Deaf People (RAD) the sessions will be delivered at the end of March 2019 and in April 2019 by RAD and will cover:  terminology, deafness – what is it?, British Sign Language, communication and interpreters – how to book/work with them.  Outcomes of the sessions will empower practice staff with the skills to communicate well and serve customer needs, meet our duties under the Equality Act 2010 and demonstrate that we are committed to inclusion.   6,395 Deaf patients are registered in our practices so we hope the sessions will help to address some of the key issues raised by Deaf service users around improving communications and support in primary care.
Improving primary care access for the Roma community

Based on feedback from service users from the Roma community, the Roma Support Group (RSG) delivered 12 Roma cultural awareness sessions for GP practices in Newham.  The topics covered in the sessions included an overview of the discrimination faced by Roma communities, barriers they face in accessing health services and practical tips for successful engagement with Roma patients.

The key outcomes include:

  • The service now offers telephone interpreting with one of their in-house Roma Romanian linguists.
  • The Language Shop will recruit more Roma Romanian interpreters as well as other Roma dialects.
  • We are exploring opportunities to deliver a more comprehensive training and development package for primary care practice staff across Newham. 
Newham Older People’s Reference Group

In partnership withNewham Council, we joint fund local groups to participate in co-production. One of the groups includes Age UK who facilitate the Older People's Reference Group, the largest service user/patient group in the borough with over 100 members.  TheCCG has engaged extensively with its members around hospital discharge, NHS 111 and the Urgent Care treatment Centre procurements, as well as our primary care and estates strategies. For 2018/2019 engagement and involvement activity please see the engagement tracker in downloads.

Maternity Voices Partnership (MVP)

The MVP operates to support commissioners, clinicians and management leads to establish a user-led approach to informing their commissioning priorities. We commission a local voluntary sector organisation, Social Action for Health (SAFH), to deliver the MVP to enable the forum and local women to have autonomy and independence from maternity providers and commissioners.

SAFH invite women to talk about the positive and negative aspects of care alongside delivering outreach to meet and hear women where they are. Members meet regularly to share their experiences and feedback is formally given to NCCG and maternity providers at quarterly meetings.  This feedback is used to inform service improvements and to improve local services.  As part of this network, SAFH is able to operate a ‘live feedback’ approach and is required to ensure recruitment and representation according to the demographics and local needs highlighted by women in Newham. 

See the Social Action for Health PPE outcomes 2019 summary for details about engagement activity and impact over 2018 and 2019 in the download area. 

Newham Carers Service - putting Carers first

Newham has approximately 24,555 residents who are informal Carers, this includes over 1,200 Young Carers.  In partnership with Newham Council we commission Newham Carers Network, a local Carer-led voluntary organisation to deliver an integrated carers support service. 

The primary function of the service is to raise awareness of and identify Carers in the borough; and to support them to recognise their needs, provide information, advice and  referral to activities and services (universal, specialist and targeted) that will enable them to meet these needs, as well as provide feedback about health and care services. 

The contract expires on the 31 March 2019, so we went out to procure a new service at the end of December 2018.  Five Carers were involved in the procurement as evaluators during two evaluation workshops in January 2019, as well as evaluating the bids.  Prior to the procurement, to help us develop the service specification extensive engagement was done with Carers from April to July 2018 as outlined in the engagement tracker in downloads.

Designing new approaches to community participation
Engaging hard to reach groups

In partnership with West Ham United Foundation (WHUF) who deliver the community engagement element of our patient and public engagement service, we want to identify and explore a new approach to engaging with groups who don’t always get involved. WHUF have been tasked with building relationships with seldom heard groups so that we can seek to understand what good patient and public engagement practice looks like to them.

Citizens UK

We have partnered with Citizens UK, experts in community organising, to develop an alternative way to mobilise our community. Following Board approval, we are working in partnership with Newham Citizens and Birbeck College to develop a model for participatory budgeting to help us engage more meaningfully with a diversity of voices.  We are hopeful that the techniques of community organising, which harnesses the social capital in our communities by drawing on the power of community leaders to bring communities together, will bring us closer to our patient and public engagement vision to put the community at the centre of what we do.

The Citizens UK Participatory Budgeting Report February 2019 outlines how Citizens UK’s community organising approach mobilises people to have their say about health and care, through these neighbourhood house meetings their leaders will help identify the key issues at the grassroots.  These issues will then be presented to Board for further discussion with the aim of using the feedback in commissioning decisions.   

Over last quarter of 2018 a number of house meetings with a diverse range of community leaders and groups have been held, the Participatory Budgeting House Meetings Summary, captures the key themes raised by participants.  The 5 steps for achieving change with Citizens UK presents the NHS with a new way forward in involving communities in commissioning decisions.