In the February 2020 Citizens' Panel meeting, the following was discussed:
- Outpatients Programme – Equality Impact Assessments (EIAs)
- ICS new website user testing feedback
- Digital Citizen Offer
- Cancer Alliance Update
- Long COVID pathway
Outpatients Programme – Equality Impact Assessments (EIAs)
Juliet (SYB ICS Outpatient Transformation) and Rose (NHS England & Improvement North East and Yorkshire Region) joined the meeting to present an overview of the Outpatient Programme and the EIAs that have been drafted for each of the three areas - optimising virtual consultations, patient initiated follow up (PIFU) and advice and guidance. There had been draft impact assessments for all three areas shared with the group for comments and Rose welcomed questions from the group.
Brenda – In the information around virtual consultations, the word options is used, is video consultation optional or standard?
Juliet – it is down to individual trusts and their services, although we would expect them to provide options and have discussions between the patient and clinician.
Brenda clarified she was referring to post-Covid in the original question, and raised that video consultations have their limitations, so your health may require you to have a face to face appointment, or have a video consultation in the first instance and then face to face if needed.
Fiona – I have a question about access to technology; it needs to be very clear in the instructions what the process is if the technology doesn’t work and who is responsible for making contact, the patient or the clinician.
Juliet - there is variation across SYB at the moment, an analysis is being carried out on the current processes and we want to ensure it works for patients and clinicians, which could include text reminders or clear information about what to expect before the consultation. Trusts have different processes but good practice is to have protocols in place e.g. for someone to call the patient if the patient doesn’t join a call as expected.
Joan - it should be about patient choice, and people might still prefer virtual post-Covid as it takes out travel time.
Priscilla – asked question about digital divide and the pandemic, is there recognition that there are people who can’t afford laptops and smart phones to address those inequalities?
Katy – There’s a piece of work around digital literacy taking place to underpin all the work of the ICS and this direction of travel and understanding those communities that might be affected and the specific issues, which is not always access to technology but could be a variety of things.
Rose asked that any further feedback on the EIAs be sent to Katy and that this feedback will go into the equality impact assessment documents.
Action – KD to liaise with the Digital workstream about covering the Digital Literacy work at the next Citizen’s Panel meeting.
ICS new website user testing feedback
The Comms and Engagement Associate for the ICS (Adam) provided an update on progress made on the website since December, with comments taken into account. People confirmed that they had viewed the link provided prior to the meeting.
Action – Adam to circulate the survey again.
Fiona and Brenda highlighted a couple of use-ability issues they had encountered on mobile devises.
Action - Adam to flag the issue with the web developers
Adam thanked the panel for their feedback, and requested that any further feedback to be sent ASAP and offered to go through the draft site with individuals via Teams if they wanted to.
Digital Citizen Offer
Ben i(SYB ICS Digital) ntroduced himself and apologised for having to leave the meeting, and passed over to Andrea who gave an overview of the digital citizen offer.
Andrea (SYB ICS Digital) – The NHS Long Term Plan talks about digitally enabling care pathways. We want to ensure that SYB citizens have a common experience of using digital, and want to consider opportunities for having a common platform across SYB and across all workstreams. We have the agreement of system CEOs to pursue this vision, and now want to think about how to design and deliver the capabilities. Want to ensure we understand citizens’ needs and test the capabilities and outcomes with citizens ahead of any procurement.
Rachel Ward shared slides about the citizen engagement approach proposals, which is about gaining insight from existing work about public and patient views on digital, and working with a specific group to support with the different stages of the process.
Joan – what is a “digital citizen offer”? I thought it was going to be an online digital citizens’ offer so it’s unclear why it’s called that.
Andrea – yes when we talk to you, we need to think about what we mean and this might not be the right description. It’s a set of digital capabilities which you might use to interact with health and social care opportunities – accessing online, remote monitoring tools, there’s a whole range of capabilities that are available that we could provide.
Action – Andrea to open discussion within delivery group to find the right name to express what we’re trying to communicate.
Joan – are you saying citizens i.e. the public? It’s not a term normally used to mean public, associated with the Citizens’ Panel.
Andrea - Yes
Priscilla – Do you need anything from us to join a panel for the digital work?
Rachel – it felt right to invite people from the citizens panel to be a part of it if that’s what people are interested in, but we will report back to this panel at appropriate points as well.
Abigail –are you finding it’s harder to connect to those people we want to engage with when we are only able to use video technology and not face to face engagement?
Katy – we have done various work since the start of the pandemic and for the most part the people we generally find hard to engage with are the same in the pandemic, so we are still working with our partners in the voluntary and community sectors to make sure we can still reach into seldom heard communities, particularly those who are digitally excluded. We’ve done some work with South Yorkshire Community Foundation as they are good at getting into the seldom heard groups. Their perspective was they have still managed to reach into most communities.
Priscilla – What are trusted touchpoints?
Andrea – We did some work to find out the places or people or organisations that people who are digitally disengaged would trust to help them become more digitally enabled, become digital champions for that community potentially.
Action – Digital trusted touchpoints (which is part of the digital inclusion work) to be put as first agenda item for the next meeting.
Andrea, Rachel, and others from the digital workstream were thanked for attending.
Cancer Alliance Update
Sophie (SYB ICS Cancer Alliance Communications and Engagement) shared slides on the rapid diagnostic services ambition over the next 5 years for cancer services, including the pathway navigator roles, the quality marker weighting work with patients to prioritise elements of the service design, and the FIT testing in for colorectal cancer in primary care.
Joan – will the usual bowel screening service for over 60s continue?
Sophie – Yes this will continue alongside. This new FIT programme is for those who present with symptoms at their GP, who in the past would have been referred to secondary care but will now be offered FIT testing in primary care to help determine if a referral is necessary.
Priscilla – Is it for people over a certain age?
Sophie – No it’s for all people who are coming in with symptoms.
Brenda – is it the same test that the over 60s get?
Sophie – It’s basically the same
Abigail – when are pathway navigators assigned to patients?
Sophie – at the point of referral in most circumstances
Action – Sophie to share further information about the pathway navigator role to the panel.
Priscilla – There is a large backlog of cancer patients due to Covid, how does this work fit in with work to support people who will have been missed off lists or investigations postponed?
Sophie – There is important work being done on this. The RDS work will help by ruling out cancer sooner and therefore getting the people at most risk in sooner, there’s also work going on for patients being diagnosed but also looking at patients who are on the pathway. We could come back to talk about it at future citizens panel.
Joan – this is important and if it does work it will have a really big impact
Katy described the SACT work to the group, which is around the national ambition to bring chemotherapy closer to where people live, or provide that as an option. Services are already available at Doncaster delivered by Weston Park, but predominantly people across the region are currently going to the Weston Park site for chemotherapy. There has been a 14Z2 engagement piece done around this, but patient engagement will be continued throughout the process.
Brenda – some people might want to know whether their treatment or level of service be the same as at WPH and whether there would be enough staff.
Katy – Thank you, answering that will be built into the communications.
Mary – would that be linked to the PCNs and the way they are organised geographically?
Action - Katy to raise this query with the SACT team
Phill – Depending on locations being looked at - sometimes it can make it more difficult as access to some venues is an issue even if it’s closer (due to public transport routes etc).
Katy - that’s to be taken into consideration.
Long COVID pathway
Katy (Head of Comms and Engagement) - it is governmentally mandated that we have long COVID services in place, and Partners in SYB decided best to establish them at place. At system level we are coordinating, plugging gaps identified, sharing best practice. We set up a survey via social media and other networks, which had a good response rate, and a focus group which was well attended by people with experience of Long Covid. We also commissioned the South Yorkshire Community Foundation so we would hear from seldom heard communities e.g. BAME and we pulled the findings into a report which was shared with the meeting papers. The report has been used to inform a gap analysis and feedback to the places about where their services aren’t meeting what patients have feedback. Overall there’s a lack of information and reassurance for people who have had Covid but may not have long Covid, which we need to develop comms for.
Abigail – Are the current chronic fatigue volunteer services e.g. in Sheffield getting any more funding and support as they will be needed much more than previously due to Long-Covid?
Katy – This is a really good question, and the services are different in different places.
Action – Katy to go back and raise the question of the role of the voluntary sector in terms of Long Covid services
Fiona – are there plans to follow up on those you did speak to, was there any conversation around occupation, previous levels of fitness – where does that information go?
Katy – everyone in the focus group was asked if they wanted to continue being involved, and the focus group was a real mix of people and occupations and levels of fitness, but that’s a really good point and we need to continue to engage going forward.
Phill – this is really important work, especially as there are inconsistencies about e.g. vaccine roll out and analysis on Covid processes is a positive thing.