1. Welcome to our first PPG Chairs event
Chaired by
Bill Mackay - Interim Patient Participation Group Representative
Litsa Worrall – Interim Patient Participation Group Representative
Welcome to this our first event in

2. Today’s agenda
Welcome and feedback from the last meeting (you said, we did)
Explaining the role of CCGs and the new NHS system
How Enfield CCG wants to work with PPGs
Locality working in Enfield
Group work including your feedback on how we can support you to work together
An update from NHS England on care.data
How PPGs are involved in CQC inspections
Training, future meetings and any other business
Welcome to our first PPG Chairs event. Introductions of the interim PPG reps
Firstly - we hope that you have been able to have some lunch and enjoyed networking with each other. Please feel free to continue to help yourself to food and drink throughout the afternoon.
We have a busy agenda today including: list items. We also would like to welcome a guest speaker from NHS England – Robin Burgess who has come to talk to us about care.data which is a national information sharing programme. Robin is interested in hearing your questions and views about the programme.
We would also like to introduce – Dr Mo Abedi who will be talking to us later about how GPs are working together to improve health services for patients and Rathai Thevananth, Practice Manager of Arnos Grove Surgery who introduce a discussion about the CQC visits.
We also want to involve you as much as possible in today’s event. The event is informal in style, we will be getting you to do some group work and we want lots of feedback from you. This event is about finding out how we can support your PPG, how your PPG can work with the PPG representatives to ensure your views are heard by the CCG and also to help you to network together.

3. What happened at our last event?
On 5 February 2014 we held our first PPG event and invited everyone in Enfield who is a member of a PPG.
26 PPG members attended representing 14 practices from across Enfield.
A short report from the inaugural meeting of PPG members is in your pack.
As requested our next all PPG members meeting will be in September. We would be grateful for your suggestions on days/times/venues
We would also like you to suggest how often you would like to meet, for how long and how you would like to work together between meetings.
Did anyone come to the last event?

4. You said………we did!
You said: You would like a Chairs event in about 3 months time and another all PPG members event in about six months time We did: Today is our first Chairs event and we would like you to suggest topics for an all PPG members event in September You said: You wanted to be able to feedback to the CCG on issues that your PPG comes across that are outside of your GP practice. We showed you a draft form we have developed for you to feedback to the CCG. You generally gave positive comments on the form. We did: We have brought the form back to the Chairs meeting today for final approval. We have also set up a new address just for you to send us feedback – You said: You were interested in having some training. Some of you are experienced chairs and other people felt they might like additional training. We did: We have found a training session provided by Enfield Voluntary Action that we would like your views on (details of the course are in your pack) If you would like to take part in this training, we will book a special session just for PPGs. The dates available are 12 June AM and/or 17 June AM or PM

5. You said…………..we did!
You said: You wanted to find out more about the CCG and the new NHS We did: We are going to be doing another quick presentation on this today and we are happy to answer questions at any time. We have also brought copies of our Prospectus from last financial year. We are going to be updating this in June and would love to hear your views on how we could improve it! Please share it with your groups and send us comments. You said: You would like to hear from guest speakers and also for us to arrange guest speakers for you. We did: Today we are welcoming Robin Burgess from NHS England as our first guest speaker! We haven’t had any requests from any individual PPGs yet but we are happy to hear from you. We also are pleased to share an invitation with you on behalf of Latymer Road practice who would like to invite you and your group members to their next patient talk on Dementia. We will share further details with you soon. You said: You would like your own section on the CCG’s website. We did: We have started a new section for you and are exploring how we can make it interactive for you. We welcome your views and help developing this.

6. You said…………..we did!
You said: You wanted to find out more about NHS developments We did: We would like to ensure that you know that the CCG has three public events a year where we talk about the main local developments. Our next event is on 10 June and everyone is welcome. We will also send you other invitations or news from other NHS partners if we think this would be interesting for you. You said: You would like help marketing and promoting your groups We did: We are working on a marketing toolkit for you. If anyone here has any hints and tips they would like to share please let us know. We are also encouraging patients to join PPGs by contacting their practice. You said: You would like help networking and sharing best practice We did: We hope this event will help with this. We want to develop the network and the way we work with you. We would like your advice on how many events you would like and we will try to design events that enable you to network better together. From these events the CCG can also build up a contacts database so we can write to you. You could also agree to share contact details directly with each other.
Is there any issues we haven’t covered?

7. Special announcement!
We are pleased to announce that we are in the process of purchasing membership of the National Association of Patient Participation Groups (N.A.A.P.) for every GP practice in Enfield. The CCG will also become a corporate member.
N.A.P.P. is a registered charity and the only national umbrella organisation for PPGs. N.A.P.P. was formed in 1978 by Patient Participation Groups (PPGs) that wanted to network together nationally and to promote patient participation within GP surgeries.
We have bought every practice membership so that you can benefit from help and support from N.A.P.P. individually and we can collectively work together on their toolkits. We have paid an annual membership fee and we welcome your feedback on the resources N.A.P.P. provides as we will want to audit whether we should continue with this membership.
There is more information on N.A.P.P. in your packs and a letter will be going out to your practices shortly. We will copy this to you if you share your address with us.

8. King’s Fund video “An alternative guide to the NHS in England.”
This is a very simple diagram that represents only a small part of the new NHS system.
It shows that primary care services are now commissioned by NHS England, and that public health is now part of the local council.
The King’s fund have produced a good video overview of the new system, although it doesn’t capture all the new organisations.
King’s Fund video “An alternative guide to the NHS in England.”

9. The role of CCGs
CCGs are led by GPs and are intended to improve clinical leadership and patient involvement in commissioning.
Every GP practice is a member of a CCG and has signed up to our constitution. The CCG constitution is available on our website:
Enfield CCG plans and buys health services for patients including:
planned hospital care such as outpatients appointments and operations,
mental health services
continuing healthcare
urgent and emergency care services such as GP Out of Hours, 111, urgent care centres and A&E
end of life care
community services
prescribing and
learning disability services.
We also work closely with partners such as Enfield Council, NHS organisations and the voluntary sector to plan a joined up systems of care.
What is a CCG? How many

10. What are patient participation groups?
A PPG is a group of patients who are interested in health and healthcare issues and who want to get involved in and support the running of their GP practice.
The National Association for Patient Participation (NAPP) describes a patient participation group (PPG) as a group of people who: “…..work with their practices to provide practical support, to help patients to take more responsibility for their own health and to provide strategic input and advice. They are based on cooperation between the practice staff and patients. They help to improve communication.”
Most groups also include practice staff and meet at regular intervals to discuss how to improve services for local patients.
Some groups in Enfield are chaired by patients, some by practice managers.
We know that our PPGs meet at different intervals and some meet face-to-face while others are virtual groups.
Currently we have 48 PPGs in Enfield. We would like all our GP practices to have a PPG and we are supporting them to achieve this.

11. Why we want to develop a new network for Patient Participation Groups (PPG)
We are a membership organisation, and we want to extend the concept of membership to patients
We see PPGs as an good way of engaging with patients in our member practices
PPGs have the potential to become an active network that can give valuable feedback to the CCG on the services it currently commissions and new services it intends to commission.
We want PPGs to help improve the quality of primary care by sharing best practice and work in positive partnership with practices
Where we have roles for patient representatives, we would like to increasingly recruit people from PPGs.
The CCG is supporting the PPGs to network together and design their own engagement structure.
In the future we want would like to empower the PPGs to work in localities as well as a borough wide network.
Our constitution states that we can co-opt an elected patient representative from our PPGs.
But we cannot run an election process in 2013 as not all GP practices have PPGs.
We have recruited two interim PPG representative posts will help us to ensure that we can deliver better patient representation to our committees and our Governing Body while our PPGs develop.

12. The role of interim PPG representatives
Two interim PPG posts. Both attend Governing Body meetings in public and the CCG’s patient and public engagement committee which is a sub- committee of the Board.
So far influenced development of Communications and Engagement Strategy, Equality and Diversity Strategy as well as helping to develop other key initiatives.
The posts are being developed in partnership so that in November 2014 we can develop new role descriptions for four elected and selected representatives, one of whom will sit on the Governing Body.
We think we are the only CCG in England to be preparing for an elected and selected post to be added to our Governing Body and this will strengthen the CCG’s commitment to patient engagement.
CCG Governing Body
Patient and Public Engagement Committee
PPG Chairs
4 locality PPG groups or one network

13. How we are engaging with patients in Enfield
PPG network
Public engagement
We are co-designing a PPG network with you
We want all our member practices to have PPGs. We see PPGs as critical friends who can help GPs and the CCG improve the quality of local primary care services
We want the PPG network to collaborate and share best practice
We have a duty to involve patients in the work of the CCG.
One of the key ways we do this is to hold three public events a year around our commissioning cycle
Our next event is 10 June 1:15-5pm at the Banqueting Suite, Forty Hall. All PPG members are welcome but these events have a more general focus.
We also involve patients in projects and other work we are doing. We might ask you to: comment on a document we are working on, join a project group, fill in a survey.
We also share invitations that other NHS organisations extend to our patients such as events or public involvement opportunities.
Elected PPG representatives
All PPG members
PPG Chairs
PPGs: Talking, collaborating and reporting – strong patient ownership
Public Engagement: Communicating CCGs objectives, engaging on work plans, reporting up to the GB via PPE committee – corporately planned but designed around the interests and influence of patients.

14. Tell us about your patient participation group
How long has your group been established?
How many members do you have in your PPG?
How do you recruit members
How often do you meet?
Do you set your own agenda?
What types of topics do you discuss?
Would you like to have guest speakers or suggested topics to discuss? The CCG could help with this.
Would you like to work with other groups either locally or across Enfield?
New, months, years
1-10, 10-20, 20-30, 30+
Adverts in the practice, the practice manager/chair invites patients to join, through the GP practice website or NHS Choices, people ask to join, the PPG group recruits members
Monthly, bi-monthly, quarterly, biannually, annually, virtually
Yes, No, with help from the practice
Issues only related to the GP practice, local NHS services, national NHS services, quality issues
Yes, No, maybe
Yes, No, maybe with help from the practice

15. About Enfield Coterminous with Enfield Council
3 main local NHS providers:
Barnet, Enfield and Haringey Mental Health Trust
Barnet and Chase Farm Hospitals
North Middlesex University Hospital
Population 2012: 312,000 (source: ONS)
Ethnically diverse: 154 languages spoken in Enfield schools and largest Greek and Turkish Cypriot population outside of Cyprus.
The top five languages spoken by Enfield school pupils apart from English in 2012, were Turkish, Somali, Bengali, French and Albanian
51 GP practices
We have divided Enfield into four localities. Each one has elected two GPs to join the Governing Body.
We work closely with the London Borough of Enfield and other local partners including: NHS partners, other public services and voluntary sector to plan services for our residents.
Enfield CCG is the lead commissioner for Barnet, Enfield and Haringey Mental Health Trust and Barnet and Chase Farm Hospitals.
Questions:
How many people live in Enfield?
How many languages are spoken in Enfield schools?
What are the top five languages apart from English spoken in Enfield schools?
How many GP practices are there?

16. Our health challenges Female life expectancy in Enfield
Between our infant mortality rate was the third highest in London
Immunisation rates are still below the national average and the levels required to prevent outbreaks of disease
Childhood obesity rates are amongst the highest in the country
Cardiovascular disease and cancers remain our biggest killers and survival rates are lower than neighbouring boroughs
1 in 3 adults in Enfield over 55 have a limiting long term illness
There is a large gap in life expectancy in Enfield, greater for women than men
People in the more deprived parts of the Borough tend to experience worse health than the rest of the population
Female life expectancy in Enfield
Enfield is a diverse borough with diverse health needs.
The CCG wants to ensure it commissions services that meet the needs of our community.
We think that patient participation groups can help us do this.
Male life expectancy in Enfield

17. Group work

18. Let’s talk about What’s working What could work better
Three things your PPG has achieved that you are proud of.
How could we help you to share best practice?
How can we support PPG Chairs?

19. Designing the Chairs network
Tell us three things that network working would help you do.
Tell us three issues that you might like to keep just to within your practice.
Would you prefer to work in four localities or across Enfield?
We could start as an Enfield network and build towards having four that meet together as one annually.
How could we further support your PPGs to grow and develop?

20. NHS England
Welcome to Robin Burgess from NHS England to speak to us about care.data

21. CQC visits
The Care Quality Commission register and regulate GP practices. They check services to make sure they meet national standards of quality and safety and a central part of this is listening to the views of people who use the service, including working in partnership with PPGs.
A guide for working together – The Care Quality Commission and patient participation groups. The guide also includes examples of PPG activities which may help CQC inspectors make judgements.
Questions on the guide can be sent to
CQC consultation on they we regulate and inspect services

22. PPG awareness week
N.A.P.P. Patient Participation Awareness Week runs from 1
7 June 2014 near you
promoting the role and benefits of PPGs to patients, the public and health professionals.
We have printed a copy of the marketing pack for you.

23. Questions?

24. Thank you for attending today’s event
Thank you for attending today’s event! We will you the documents so please make sure you have completed a feedback form and left us your contact details. In the meantime any further questions or feedback you have can be sent to: or call Laura Andrews on