Notes from the Citizens' Panel meetings

In March, the panel discussed the presentation for the forthcoming public meeting on the Hospital Services Review at The Source, Meadowhall. They gave comments on the content and asked that there was more background detail available to enable members of the public to give their feedback. They asked for more information on:

• The current workforce and where they were located
• What workforce numbers needed to be
• The current and future costs of running the services 
• Future parking provision and the costs of travel
• Safe and best working practices for the services

They made comments on:

• The importance of involving ambulance services and public transport planners and providers in the work
• The need for clarity around options (as they are developed)
• The need to consider access and public transport 
• The importance of helping the public understand how to get the best from their services
• The need to make South Yorkshire and Bassetlaw an attractive place to work

The Panel also discussed the Equality Impact Assessment for hyper acute stroke services. They noted that the proposal in the consultation had only one option and suggested that future proposals include multiple options. They were pleased to learn that clinicians had been involved in developing the proposal.

They made comments on:

• The impact on people from minority backgrounds who might find it difficult to travel further to see relatives
• The impact on people on who have low incomes and those with mental health issues, as well as their carers and family members
• The impact on ambulance services and the need for more bariatric ambulances

In May the Panel met to consider:

• The latest hospital services review presentation
• Orthopaedics and the work looking at variances in follow up appointments for people who have had hip and knee replacements
• Lower bowel testing and work looking at the least invasive testing possible
• The latest hospital services review survey

In the hospital services review presentation item, the Panel commented on:

• How an overstretched workforce was measured
• The challenge of shortage of money and representing this in the presentation
• It would benefit from a statement to say this was just one area of work being looked at
• There was too much detail and too many acronyms in the presentation - it needed to be in plain English
• The need for more clarity on accountability
• The presentation was too long and needed to be shorter
• The need for more clarity on what a hosted network was
• Using infographics to help explain statistics

In the orthopaedics item, the Panel received a presentation on work just getting underway to look at the difference in follow-up appointments for people who have had a hip or knee replacement: The Panel was keen to be involved and as well as agreeing for the trial to be a regular item for discussion, one of the members volunteered to attend meetings of the trial work.

In the lower bowel testing discussion, the Panel heard about proposals for a process that would mean patients receive the least invastive tests possible. They were asked to comment on how best to involve patients views in the design.

In the survey discussion, the Panel asked for consistency in some definitions.

In June, the Panel met to consider:

• The Yorkshire and Humber111 service re-procurement
• A campaign to raise awareness of low cost medications

They heard updates from members on:

• Patient and public voice training
• A review of engagement events being attended by Panel members

In the 111 service item, they heard about the process underway to reprocure this service across Yorkshire and the Humber.  The Panel were asked to comment on the questions in the document which asked potential suppliers to participate in dialogue (a technical term which means enter into discussions about providing the service). The Panel fed back:

• The need to consider staff handling times and the economics of making it work
• The importance of staff understanding the geography of the region and helping people to do self-support
• The need to consider media, messaging and the cost of calls
• Accessibility to reliable interpreters
• Assessing anxiety-reduction trainiing
• The importance of the interface with the ambulance service
• The need to respond to any future changes to services
• The need to gather user feedback and how this would be done
• A suggestion to give a scripted example of someone accessing the service, ensuring this was done across diverse groups (like a mystery shopper)
• The importance of handling agitated and upset callers 
• The need to ensure the provision of a quality service for non-English speakers

The Panel put forward two members to continue to participate in the procurement process.

On the item about a campaign to raise awareness of the cost of medications, the Panel heard that following a national consultation, patients would be asked to pay for low-cost prescription medicine available over the counter at pharmacies and supermarkets to reduce the cost of cheap generic medication being prescribed on the NHS - for example, Paracetemol.

The ICS is developing a campaign to support this and is currently gathering insight into the barriers that people face to understanding the issue.

The Panel was asked to generate ideas for thoughts on who best to engage with in this insight phase and for their views on how to target and change behaviours.

They suggested:

• Presence at community groups to engage people
• Conversation with pharmacists - training pharmacists to support the work
• Ensure the information is on websites 
• Family hubs 
• Job centres
• Patient participation groups 
• Social media

In relation to effective messaging, they suggested:

• Talking about how the savings could be spent
• Consistency in the message of which drugs
• Using the TV screens in GP surgeries
• Public transport advertising
• Patients having the medication written down for when they go to the supermarket or pharmacy
• Working with local communities at sessions and events
• Consideration for people with learning disabilities, English as a second language and those on low incomes

For the update from members regarding their attendance at the training event, they reported the quailty of the training was good though it would have benefitted from more examples of where the patient and public voice has been used to good effect.

In the review of members' attendance at engagement events they reported:

• The supporting materials were helpful
• Leaving time for questions was important
• Lots of questions and discussions around mental health provision and maternity and what it means for local people
• Lots of questions about the training of staff
• Questions about the need to travel to hospital
• Relief that general hospitals are not going to be reviewed for closure
• Support for the Citizens' Panel and its work
• The presentation on the hospital services review was well received, with fair challenges

The Panel discussed how they could get involved in more conversations with local people, exploring the possibility of GP surgeries and hospitals. They also asked for a list of where conversations have already taken place, to help raise awareness with their local communities.​