Plan of Action 200405

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Plan of Action 200405 ...

Patient and Public Involvement Forum Papworth Hospital

    ‘Patient and Public Involvement in Health Forum

    The Public’s voice in Healthcare’

    Plan of Action

1. Background

In September 2001, the Department of Health published Involving Patients and

    the Public in Healthcare. Its development acknowledged the recommendations made in the Kennedy Report following the Bristol Royal Infirmary Inquiry, „The

    perspectives of the patients and the public must be heard and taken into account‟.

    The document proposed new methods of involving the public within the new NHS

    structures established to support modernisation, as described in Shifting the

    Balance of Power within the NHS.

Section 11 of the Health and Social Care Act (2001) has placed a duty on

    strategic health authorities, PCTs, and NHS Trusts to involve and consult with

    patients and the public, the most important people in the NHS, both operationally

    and in service planning from the beginning of the process. It should be

    underpinned by the following values:

    ? Shape services around needs and preferences of patients, families

    and carers

    ? Respond to different needs of different populations

    ? Work together with others to ensure a seamless service for patients

    ? Respect the confidentiality of patients and provide service, treatment

    and performance information

User involvement is also linked to other policy initiatives that have followed the

    publication of the NHS Plan, such as Modern Matrons, who along with Ward

    Managers work with Patient Advice and Liaison Services (PALS) to address

    patient concerns “on the spot”. Clinical Governance guidance focuses almost as

    much on the role of public involvement as it does on measures to improve the

    quality of clinical care.

The response to the consultation document supported the establishment of PALS,

    Patient and Public Involvement in Health (PPI) Forums, in every NHS Trust. In

    January 2003, an independent statutory national body called the Commission for

    Patient and Public Involvement in Health (CPPIH), was established to create

    patient forums, set standards, provide training, and monitor the new

    arrangements. The NHS Reform & Health Care Professions Bill received its royal

    assent in June 2002.

PPI Forums were established in December 2003. The PPI Forum for Papworth

    Hospital is supported by the work of its Forum Support Organisation based at the

    Cambridge Council for Voluntary Service. Forums have in part replaced

    Community Health Councils. The PPI Forum is made up of local volunteers who


    PPI Forum Papworth Hospital Action Plan

are enthusiastic to help review health services in their area and to look at the

    wider health issues that affect everybody. Forum members come from a wide

    variety of backgrounds and have a range of experiences and skills to offer.

2. Introduction

This is the first action plan to be produced by the PPI Forum for Papworth

    Hospital and as such it is a working document to be revised with the increasing

    benefit of experience. The progress to date is reviewed in the Forum‟s Annual

    Report (to 31 March 2004).

This Action Plan sets out the general intentions of the Forum. In version 1 of the

    CPPIH „Standards of Conduct Policy and Procedures for Members of PPI

    Forums‟ document it states that a forum member‟s behaviour will be seen as not

    in the interests of the Forum when acting outside the agreed action plan

    (paragraph 7). As such this Action Plan sets out the limits of action for the Forum.

3. Model for Assessment of Patient and Public Involvement Activity

This model for assessment of PPI activity was set out in Signposts, 2001, for the

    Welsh Assembly. It is the same model as used by CHI in their clinical governance

    reviews to assess PPI.

The model (in figure 1 below, showing possible examples) identifies 2 main levels

    that PPI needs to be carried out across, namely:

    The Individual: the involvement of patients in discussions and decisions

    concerning their own individual care and treatment

    The Collective: the involvement of patients and the wider public in

    decisions concerning delivery and planning of service

At both the individual and collective levels, there may be different degrees of

    involvement that reflect a spectrum of engagement that ranges from provision of

    information to patients and/or public, through feedback from patients and/or

    public to patient and/or public influence over decision making.

At the individual level involvement might mean receiving information about

    access to services, what to expect from care and treatment and treatment

    choices (information); having the opportunity to spell out needs, concerns, or

    make a suggestion or complaint about the service (feedback); getting involved in

    choices about treatment (influence).

At the collective level, involvement might mean the wider public receiving

    information about health concerns e.g. health promotion or NHS service

    performance (information); mechanisms for feeding back the aggregated views of

    patients to NHS organisations (feedback); the capacity and opportunity to

    represent patient and public views at the planning and policy level (influence).

The Forum needs to assess Papworth Hospital NHS Trust‟s development of PPI

    policy initiatives and actions against this model.


    PPI Forum Papworth Hospital Action Plan

    Information Feedback Influence

    Individual Possible examples: Possible examples: Possible examples:

    Patient leaflets Individual complaints Patient advocacy

    Patient held records Patient diaries Expert Patients

    Copying letters to Patient comment cards Programme


    Internet provision

    Collective Possible examples: Possible examples: Possible examples:

    PPI Strategy Patient surveys Lay representation on

    PPI Action plans Focus groups NHS Bodies

    Performance Patients Panel Lay role in Clinical

    information Community Governance

    Clinical governance consultation about Patients‟ Forum

    reports health needs

    Press and media


     Figure 1: Model for assessment of patient and public involvement.

    4. Overall Objectives

    The over-arching objectives of the Forum are as follows.

i. The Forum exists to ensure an independent voice for patients, their

    carers, and the public in shaping healthcare provision by Papworth

    Hospital NHS Trust; simply better decisions for better health focussed

    around the needs of patients;

ii. The Forum has the right to visit NHS premises but is not a watchdog;

    its focus is to influence health decisions through the building of

    relationships with health Trusts, other relevant decision makers with

    particular focus on Papworth Hospital NHS Trust;

iii. The Forum will help ensure that the views of patients and the public

    are taken seriously, thereby shifting power in decision making about

    healthcare provision;

iv. The Forum sees itself as having a role wherever the provision of

    healthcare may be affected. As Papworth Hospital NHS Trust is a

    recognised national resource for the provision of specialist

    cardiothoracic services the role of the Forum is accordingly seen as

    national and not just focussed on local needs;

v. Over time, the Forum will engage with diverse communities in its area,

    including disabled, minority ethnic communities, older and younger

    people, so as to ensure the views of the Forum reflects those of the

    communities it represents.

vi. Be a key resource for people, helping and supporting community

    groups focussed on healthcare;

vii. Promote better public involvement in health matters;


    PPI Forum Papworth Hospital Action Plan

    viii. Encourage others to get involved;

    ix. Find out what people really think about health and take appropriate

    considered action;

    x. Independently watch over the quality of healthcare;

    xi. Help shape decisions which impact our health;

    xii. Influence local and national decisions as part of a growing network for

    public involvement; and

    xiii. Be a force for fairness and change in the provision of healthcare.

5. What the Forum Will Focus On

The Forum will act as a central hub drawing on:

    ? Patient Support Groups (PSGs);

    ? Patient representatives nominated by Papworth Hospital NHS Trust;

    ? Patients not represented by PSGs;

    ? Local Government officials;

    ? The Local MP;

    ? Other PPI Forums on health issues common to all;

    ? Other NHS Organisations; and

    ? Members of the public interested in health matters (but not in being

    Forum members).

The PPI Forum for Papworth Hospital will help all partners in health to work in

    ways that best meets local and in some cases national community needs and

    raise awareness of health issues.

Since a significant number of services provided at Papworth Hospital NHS Trust

    are highly specialised, it is an important focus of the Forum to ensure that access

    to these services is uniform across the nation and not simply well known locally

    with disparate post-code provision of services. In some cases the access to these

    specialist services can mean the difference between life and death.

The Forum will need to:

    ? Establish an identity for the Forum - Point of contact for the Forum;

    establish links between Trust, public and Forum;


    PPI Forum Papworth Hospital Action Plan

    ? Implement process for patients and public to contact the Forum leaflets,

    talks, press releases, produce joint statements with partnership Forums

    (Addenbrooke‟s, Hinchingbrooke, Huntingdon);

    ? Press and media work Develop a publicity plan, investigate publicity flow,

    develop joint publicity with other PPI Forums;

    ? Ensure contact with hard to reach groups Form contact with all voluntary

    groups and organisations in the area;

    ? Evaluate publicity work Establish measurable performance indicators for

    the Forum‟s publicity after a few months in active operation (i.e. 2005).

Current PSG leads are listed in Appendix A. Regular feedback to the Forum will

    be an essential part of each meeting. At those meetings emerging issues will be

    discussed and agreed together with the relative importance of the identified


The Forum will comment and influence the management of key areas affecting

    the patient experience at the Trust, including inspection of facilities and services

    (across a range of departments such as Cardiac, Thoracic, Patient Services,

    Cancer, Transplant, TCCA, Pharmacy, Clinical Governance/Risk Management,

    Research & Development). Services that affect all patients such as infection

    control will form a key part of the Forum inspections. In particular the Forum will

    focus on:

    ? Investigating local health issues;

    ? Seeking people‟s views;

    ? Checking out information;

    ? Linking with local networks; and

    ? Visiting trust services and meeting with staff delivering health services on

    the ground.

6. Priorities and Timing

The Reference Guide for Members of PPI Forums (see Appendix C) provides

    adequate guidance on dealing with issues raised by contact with the above


7. Monitoring Performance

Following work with contacts in the healthcare community, actions will be

    identified as appropriate for the Forum. A sample form for monitoring process

    against these actions is provided in Appendix B. This shows three Action points

    agreed with the objectives and outcomes listed. A nominated Forum lead will

    monitor progress and report back to the Forum on a monthly basis (if appropriate).

8. Review


    PPI Forum Papworth Hospital Action Plan

    This Action plan will be reviewed annually in April/May of each year with revisions

    by full agreement of members through the year.

Acknowledgements: Sections of this plan are taken from or based on member guides

    written by the Commission for Patient and Public Involvement in Health (CPPIH) and

    from Royal Brompton & Harefield NHS Trust, Patient & Public Involvement Strategy

    Consultation April 30 June 2004.

Dated: May 2004


    PPI Forum Papworth Hospital Action Plan

PPI Forum Papworth Hospital Appendix A

Patient Support Group Leads

British Cardiac Patients Association, Cambridge, Peterborough, Bedford,

    Suffolk groups and Norfolk Zipper Club Tony Ward

British Heart Foundation Tony Ward

Heart Beat Group, Cambridge Tony Ward

National Transplant Support Network Michael Kemp

    Pulmonary Hypertension Support Group Ruth Clapham

Cancer Patient User Group Sarah Mercer

    Mesothelioma Patient Support Group Sarah Mercer

Cancer Research UK Sarah Mercer

Pulmonary Thromboendarterectory Patient Journey Interest Group Philip


Cystic Fibrosis Trust Philip Cork

Papworth Hospital NHS Trust groups/committees

    Patient Experience Panel Papworth Hospital Elizabeth Gambier

    Papworth Hospital NHS Trust Board Meetings (in public) Elizabeth Gambier

Commissioning Leads within Norfolk, Suffolk and

    Cambridgeshire (NSC) Strategic Health Authority (SHA)

Lead for NSC SHA Commissioning Group (Derek Mortimer) Tony Ward

    Commissioning Lead for Cambridgeshire PCTs Sarah Mercer

    Commissioning Lead for Norfolk PCTs Michael Kemp

Contacts with other health bodies

Huntingdonshire PCT Ruth Clapham


    PPI Forum Papworth Hospital Action Plan

    Appendix B

    PPI Forum Papworth Hospital Action Monitoring Form - Example Items

    Action Objective Action Required & Contacts/Referred Intended Outcome Monitored Progress

    Timescales to by to date Encourage patient Place PPI at Identify patients willing to be Brenda Bush Each Directorate representation the centre of involved in regular feedback, has a nominated

    involvement in management consultation planning and other lead for PPI development of Trust decision management decision making

    management decision making within

    making process Papworth

    Hospital NHS


    Identified leads to To reflect real Named leads to action by As listed in the Contribution to PPI Forum establish link with needs of August 2004 previous minutes of action plan Papworth allocated patient service users the PPI Forum Hospital as support group and Papworth Hospital standing explore potential agenda item issues they may at monthly contribute to the meetings action plan

    Explore the Essence To ensure Invite appropriate staff member Jane Osgathorp Patient involvement of Care toolkit and that patients to PPI Forum meeting by July in partnership with

    how this is are involved 2004 professionals to implemented across in shape clinical

    the hospital benchmarking services



    PPI Forum Papworth Hospital Action Plan

     Appendix C Identify issues- from your

    mapping and consultations

    what topics have been suggested for you to take Are there any actions that up? you can suggest to those NO who raised it that they can For each topic, consider do? whether it is an important

    issue that affects local YES people? Find out what information do YES No need? NO Do you have enough How can you find it? Yes information?

     YES YES Is it a topic that the PPI Can the PPI Forum ask NO Forum can take up others to take this up locally effectively? or nationally (OSC, CPPIH)? YES YES

    Who else can the PPI Forum Discuss with other partners NO work with to address the to see if you can work jointly issue? YES YES

     Discuss resources required NO What activities are involved? with Regional Centre CPPIH

    Do you have the resources you need?


     Draw up the action plan

     With targets and review


    Review activities and

    action plan and adjust

     as necessary


    PPI Forum Papworth Hospital Action Plan

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