developing patient and

1
developing patient and public involvement
in the eastern region
2
Shadow Patients Forums Hertsmere Healthy
Network Patient Advice Liaison Service (PALS)
Patients Forum Developing PPI in Norfolk,
Suffolk Cambridgeshire A pilot Independent
Complaints Advocacy Service for Norfolk, Suffolk
Cambridgeshire PALS ICAS - A Call Centre
Approach Overview Scrutiny underlying
principles Bedfordshire and Hertfordshire
Pathfinder Voices Projects in South East Essex
3
developing public and patient involvement
in the eastern region
Shadow Patients Forums the Hertsmere Healthy
Network Barrie Taylor - Chief Officer, SW Herts
Community Health Council Ian Brittain - Director
for Patient Public Involvement in Health,
Hertsmere PCT
4
Chronology For Patients Forums

• July 2000 The NHS Plan
• Patients Forums in every
• Trust
• July 2001 Shifting the Balance of
• Power within the NHS
• Sept 2001 Involving Patients and
• the Public in Healthcare
• document
• Nov 2001 NHS Reform and Health
• Care Professions
  Bill
• June 2002 House of Lords accepts
• enhanced role for PCT
• Forums

5
Mapping the Structures
Patient Public Involvement Structures (October
2002)
Monitoring
Commission for Patient and Public Involvement in
Health (CPPIH)
Performance management
Primary Care Trusts
Primary Care Trust Patient Forums
Information advice
Support / administration co-ordination / training
Other Trusts Forums Mental health Learning
Disability Acute Hospitals Ambulance services
Independent Complaints Advocacy Service ICAS
Representation Scrutiny
Overview Scrutiny by Local Authorities
PALS in each Trust
Strategic Health Authority
Performance management
6
Patients Forums Main Duties
Statutorily independent bodies - set up by
CPPIH The power to monitor review all
services To find out patient and carer views and
to represent community views to the
Trust To develop close links with to monitor
both PALS and ICAS
7
Shadow Patients Forums

• How Shadow Forums have been set up
• Using existing CHC regulations
• Methods of recruitment
• General publicity (flyers, adverts, etc)
• Organisational networks
• Via GPs (Hertsmere Network)
• Information packs
• Introductory meetings

8
Shadow Patients Forums
Composition status of Shadow Forums Made up
of a core of CHC members others Established
staffed as CHC sub-committees Non-CHC members
co-opted to CHC A Trust Non Executive Director
on each Forum
9
Hertsmere Healthy Network Project

• Aims of PCT / CHC Healthy Network project
• To develop a strategy that engages GPs with
  patients interests
• responds to
• 20 / 80 GP ratio (20 of patients
• create 80 of core GP workload)
• desire of GPs PCT to communicate
• with patient population
• fulfils the following needs
• development of PCT consultative
• mechanism (Section 11 of 2001 Act)
• tests Patients Forum model

SW Herts CHC
10
Hertsmere Healthy Network Project

• Developing the Network
• GPs letters to patients carers
• Open meetings briefings (160people)
• Identifying responding to patients interests
• questionnaires
• expert patient' groups

11
Hertsmere Healthy Network Project
Responses to questionnaires Shadow Patients
Forum 58 GP practices 47 PCT meetings
40 Care of the elderly 28 Disability
24 High blood pressure / heart conditions
22 Diabetes 15 Carers interests 14 Babies
and children 9 Ethnic minority healthcare
6 Mental Health 1
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Hertsmere Healthy Network Project
Organisation of the Healthy Network Briefing
sessions for Healthy Network members Capacity
building / training Healthy Networks
newsletter 4 monthly Talking Tables
events Formation of Shadow Patient Forum Shared
support by CHC PCT
13
Hertsmere Healthy Network Project Benefits
What are the benefits of the Hertsmere Healthy
Network? It addresses more than one priority It
widens the base of new volunteers with an
interest in health It provides more potential /
new members for Patient Forums It creates an
ability to form expert patient groupings It
addresses the PCTs duty to consult with patient
public interests It develops the role of GPs as
partners in the policy and their capacity to
consult with groups of patients
14
Hertsmere Healthy Network Project Learning
What has been learnt? You need clear criteria
for Forum membership New members face an immense
learning curve Hard to reach groups are a real
challenge Continuous training is required for
new recruits Maintaining the Network is a
shared duty and is not reliant upon the
establishment of Forums
15
Mapping the Structures
Hertsmere Healthy Networks Structure (October
2002)
Hertsmere Primary Care Trust
Professional Executive Committee
Training Capacity Building
Shadow Patients Forum
Talking Table Events
Community Health Council
Hertsmere Healthy Networks Newsletter
16
developing public and patient involvement
in the eastern region
Patient Advice Liaison Service (PALS) Carol
Fentimen Patient Advice Liaison Service
Manager East Cambridgeshire Fenland PCT
17
PALS at PCT Level
Working with GP practices and Community
Hospitals Changing the Culture Data collection
and Evaluation
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PALS at PCT Level

• Location of PALS
• PCT offices in Wisbech Ely
• outreach surgeries
• High visibility and accessibility
• Multi-Agency Steering Group
• Joint working across boundaries

19
Geographical Area
FENLAND AREA Population 82,915
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Geographical Area
EAST CAMBS AREA Population 61,135
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Working with GP practices and Community
Hospitals
Presentations to all GP practices/community
hospitals Discussed with all staff how PALS
could support their work Agreed first point of
contact when concerns arise Ensure PALS feedback
outcomes
22
Issues Raised by Patients

• High rooted in poor Communication
• Often health professionals seen as too busy to
  listen
• Some patients are reluctant to voice concerns to
  practice or hospital staff
• Difficulty in knowing who to contact

23
Changing the Culture

• Development of a Customer Care Toolkit
• Need to remember
• The customer IS the job, not an interruption of
  it.  
• You dont have a second chance to make a good
  first impression.

24
What Patients Want
To be taken seriously To have their views
acknowledged When appropriate a simple
apology An explanation of what happened and why,
in a language they can understand A commitment
to action so that it does not happen again
25
Data Collection Evaluation
CAMS Database Help identify recurring problems
and trends Allows regular reporting for PCT
Board and Clinical Governance Working with
Public Health using PALS material for Rowntree
Foundation Bid First evaluation being carried
out by NWA Community Health Council
26
PALS

• PALS should support all staff at all levels
  within the organisation to develop a responsive
  service. PALS must be seen as a culture, a
  function of the organisation rather than a job

27
developing public and patient involvement
in the eastern region
Developing PPI in Norfolk, Suffolk
Cambridgeshire Janice Steed Head of Patient
Empowerment Norfolk, Suffolk Cambridgeshire
Health Authority 11 October 2002
28
Strategic Health Authoritys Role

• To ensure the successful implementation and
  integration of the national PPI policy across the
  31 NHS organisations within its boundaries
• By-
• Facilitating development networks, sharing of
  information and the organisational development
  required to embrace this fully
• Sharing of good practice through learning events
• Building strategic partnerships between
  stakeholders (eg local authorities) to develop a
  shared agenda
• Monitoring performance improvement

29
Sharing of Best Practice

Learning Events - 11 September Event

• Objectives of the Day
• Build enthusiasm, capacity and knowledge to take
  forward this developing agenda
• Understand the national picture and direction
• Lead by example in providing practical support

30
Sharing of Best Practice

• Outcomes of the Day

Understanding of the Commission for Health
Improvements (CHI) role and the view of the
Commission for Health Audit Inspection (CHAI) in
determining what the culture, values, strategy
and the priority given to PPI are. Is it
- patient centred - socially inclusive? What
are the tools and techniques? Are they -
appropriate - robust - used to deliver the
necessary changes? Understanding of the
national policy drivers and new structures
1
2
31
Sharing of Best Practice

• Six Criteria for successful patient and public
  involvement

Effective in representation and strengthening the
voice of patients and communities Accessible at
a local level to people using health
services Accountable in a clear and transparent
way Integrated to match the structures of the
NHS Independent to be able to scrutinise Health
Services Adaptable building on the best of
existing local practice and ensuring high quality
32
PPI Structures

33
Sharing of Best Practice

• Outcomes of the Day

Practical tools, techniques and development
approaches - discussion, knowledge and sharing
and new ideas developed on. What is the Expert
Patient Programme? Developing in the UK of the
chronic disease self-management course developed
at Stanford University The West Norfolk Public
Involvement team a multi-agency group
comprising PI leads in health, social services,
education, police, three levels of councils and
the youth services who together have developed a
range of public involvement initiatives
3
34
Sharing of Best Practice

• Outcomes of the Day

Central Sussex Partnership Programme focusing
on the development of a citizens panel process
and its outcomes Health Overview and Scrutiny
Committees (OSCs) - progress in Norfolk
developing an understanding of what OSCs are,
how they might work constructively as a critical
friend with the NHS Customer Care in the NHS -
Peterborough Hospitals looking at the customer
care toolkit developed to provide practical
guidance and help to all grades of new staff as
part of their induction
35
Sharing of Best Practice

• Outcomes of the Day

The Community Legal Service (CLS) identifying
how we can benefit from partnerships with the
CLS e.g. CLS quality mark for PALs or CLS
Health Improvement benefits (link between debt
and depression) Health Information uses and
benefits of Norfolks Health Information
Database The Discovery Interview Method a
method developed to identify patient and carer
experiences with pointers on the patients journey
encouraging them to tell their own story
36
Sharing of Best Practice

• Outcomes of the Day

People who use services and their Carers a
training programme to support vulnerable people
to build their confidence and skills so as they
can get their voices heard Taking the PALS
Service one step further a pilot programme in
Central Suffolk to provide co-ordinated advice
for people using both primary and social
care The Development of Independent and
Complaints Advocacy Service (ICAS) a pilot
programme is being developed to cover the
communities served by the seven existing CHCs -
an opportunity to engage with this new
development
37
Sharing of Best Practice

• Outcomes of the Day

Patient and Public Involvement at Peterborough
Hospitals an opportunity to share the pleasures
and pitfalls, what worked and didnt and learn
from experiences Cambridgeshire Learning
Disability Partnership sharing experience of
real user involvement of a vulnerable group
leading to improved outcomes for service users
through a range of methods including a service
user parliament locality groups and service user
and carer representatives on service development
groups
38
Sharing of Best Practice
Overall Outcomes

• Lots of energy created
• Knowledge enhanced
• Networks built
• Ongoing development initiated

39
developing public and patient involvement
in the eastern region
A Pilot ICAS (Independent Complaints Advocacy
Service) for Norfolk, Suffolk Cambridgeshire
Name Title Norfolk, Suffolk Cambridgeshire
Community Health Councils
40
Context

• "Effective, in representing and strengthening the
  voice of patients and communities
• Accessible, at a local level to people using
  health services
• Accountable in a clear and transparent way
• Integrated to match the structures of the NHS,
  Independent, to be able to scrutinize Health
  Services
• Adaptable, building on the best of existing local
  practice and ensuring high quality.

41
Principles

• Anti-discriminatory
• Choice
• Confidentiality
• Empowerment
• Equality/equal access
• 6. Respect

42
Mission
To provide a specialist high quality service to
people requiring help, advice and support in
pursuing their complaint or concern.
43
Aims

• To provide information
• Telephone contact with the client or
  face-to-face meetings
• To determine what outcome the client is seeking
• Supporting the client by writing letters,
  arranging meetings representing the client at
  meetings
• 5. Support the client at Appeals / Independent
  Reviews and Coroner Court

44
Aims

• Act as an independent facilitator for those
  meetings
• Provide advice
• Monitor the complaints progress
• Empower the client
• Maintain confidentiality
• 11. Monitor trends and inform appropriate
  agencies of the findings

45
Aims
NSC ICAS will not provide
1. Legal advice for clients 2. Assistance with
benefits 3. Act on a clients behalf who is
pursuing legal action
46
Model

• Hub Spoke

• 7 Chief Officers form the Hub
• Bury St Edmunds - West Suffolk
• Cambridge - South Cambridgeshire
• Ipswich - East Suffolk
• Huntingdon - North Cambridgeshire
• Lowestoft - Gt. Yarmouth and Waveney
• Norwich - Norwich and District
• Wisbech - North West Anglia

47
Monitoring

• 1. Peer appraisal
• 2. Customer Satisfaction Survey
• 3. Quarterly reports with complaints data to be
  shared with local NHS service providers
• 4. Data identifying quality issues arising from
  the complaints
• 5. An early warning system
• 6. CPPIH appraisal
• 7. Reports to the PCT Patient Forum
• 8. An annual report/end of pilot report

48
Funding

• Asked for 307,000
• Lead Manager
• PA
• Training and Development Officer
• 13 Complaints Officers
• 6 Administrator
• Received 140,000!!

49
Training

Core Competencies Clinical Negligence NHS
Structure Rights and responsibilities Social
Care/Personal Care Voluntary Sector Children and
Womens Welfare Diversity/Equal
Opportunities Dentistry Drugs and restricted
treatments Training and Presentation Skills
50
Learning Points

• This option ensures

1. A locally provided service 2. Community
based 3. Consistency of service across a large
geographical area 4. Staff working locally but
part of a larger team so ensuring peer
support. 5. Links easily made with other
patient and public involvement organisations,
i.e. Patients Forums ,PALS, Overview
Scrutiny Committees
51
developing public and patient involvement
in the eastern region

• PALS ICAS - A Call Centre Approach
• Norma OHara, Chief Officer, Mid Essex CHC
• Kim Wilks, Public Patient Involvement Manager,
  Chelmsford PCT

52
PAL or ICAS?

• Do the public really know the difference between
  PALs and ICAS?
• Why a call centre?

53
Which PAL service?

• How do people know which PAL service they need?

54
Learning Points

• Has the Call Centre
• been helpful?

• Given public one number to ring
• Enabled Trust to concentrate on developing PAL
  service
• Provided a mapping exercise

55
Learning Points

• Need to close the loop
• Networks with dedicated staff
• Good reporting mechanisms

56
Experiences

• An example

57
Clear Information

• The importance of giving clear information

58
developing patient and public involvement
in the eastern region
Overview Scrutiny underlying
principles Barrie Taylor CHC Chief Officer (SW
Herts CHC) February 2003
59
(No Transcript)
60
Legislative Framework Health Act 1999
LOCAL AUTHORITIES
NHS
61
Legislative Framework Local Government Act 2000

LOCAL AUTHORITIES
NHS
62
Legislative Framework Health Social Care Act
2001
LOCAL AUTHORITIES
NHS
63
Legislative Framework NHS Reform and Health
Care Professions Act 2002
LOCAL AUTHORITIES
NHS
64
Statutory Instruments Regulation SI 2002 No
3048 - The Local Authority (Overview and
Scrutiny Committees Health Scrutiny functions)
Regulations 2002

• Came into force on 1st January 2003
• Provides powers for Local Authorities to
• Make reports recommendations to local NHS
  bodies and the local authority
• Be provided with adequate information by local
  NHS bodies to carry out its duties
• Take account of available information - in
  particular that provided by Patients Forums
• When making recommendations, expect a response
  by local NHS bodies within 28 days
• Be consulted on NHS plans for substantial
  development or variation in service provision by
  local NHS bodies
• Refer inadequateconsultations to the
  Secretary of State for consideration
• Delegate functions to other local authorities,
  form joint committees and co-opt members from
  other councils.

65
Significant change referral Extract - SI 2002
No 3048 The Local Authority (Overview and
Scrutiny Committees Health Scrutiny functions)

• Provides a power for Local Authorities to
• para 4 (1) where a local NHS body has under
  consideration any proposalfor a substantial
  variation in the provision of service, it shall
  consult the overview and scrutiny committee of
  that authority.
• Exceptions risks to the safety or welfare of
  patients or staff but OS to be advised why no
  consultation has taken place.
• para 5 In any case where an overview scrutiny
  committee is not satisfied that
• Consultation has not been adequate in terms of
  of content or time allowed or where inadequate
  reasons are given by the NHS for immediate
  decisions
• para 7 where an overview and scrutiny committee
  considers that proposals would not be in the
  interests of the health service in the
  (committees area).
• It may report the matter to the Secretary of
  State for consideration, final decision and
  direction.

NHS
66
Patient Forums

• Extract from NHS Reform and Health Care
  Professions Act 2002
• Creates Patient Forums for all NHS Trusts with
  power to refer matters to Overview and Scrutiny
  Committees
• Extract from SI 2002 No 3048
• The Local Authority (Overview and Scrutiny
  Committees Health Scrutiny functions)
• Provides powers for Local Authorities to
• Be provided with adequate information by local
  NHS bodies to carry out its duties
• Take account of available information - in
  particular that provided by Patients Forums

67
Patients Forums

• Duties
• To monitor and review the range and operation
  of services provided by NHS Trusts - from the
  patients perspective
• To seek the views of patients receiving
  services provided or arranged by the Trust
• To inspect premises where NHS services are
  delivered
• To make reports and recommendations to the
  trust management, with the trusts response being
  included in the trusts annual prospectus
• To refer matters of concern to Overview
  Scrutiny Committees / the CPPIH / Strategic
  Health Authority, Commission for Health Audit
  Inspection and the National Patient Safety Agency
  and any other person / body the Forum deems
  appropriate
• To nominate a Forum member for appointment to
  the Trust Board as a Non Executive Director.
  Appointments to be made by the NHS Appointments
  Commission in accordance with all other NED
  appointments (e.g. criteria)

68
Advice Information
Patient Advice and Liaison Services (PALS)
Independent Complaints Advocacy Services (ICAS)

• Resolve concerns on the spot
• Provide information to patients, carers and
  families
• Advise patients carers about the NHS
  complaints procedure and direct people to
  independent complaints advocacy
• Act as an early warning system for Trusts and
  Patients Forums

• Statutory duty on Secretary of State.
• Set up by Commission for Patient and Public
  Involvement in Health.
• 113 funded pilots across England being
  evaluated by ICAS Network.
• Current extension of schemes until end of June.
• Evaluation to help set national standards.

69
developing public and patient involvement
in the eastern region
Bedfordshire and Hertfordshire Pathfinder Six
Community Health Councils networking with
patients and citizens, voluntary organisations
local authorities and the NHS Project Directors
Richard Edwards Tony Tester
70
Project Objective for Developing the Local
Network to take a whole system approach,
facilitating the move forward into the new
structures in Bedfordshire and Hertfordshire.
Beds Herts PPI Pathfinder Project
71
What we have set out to do?

• Digest the emerging legislation
• Examine the concepts
• Relate them to the Community and its Local
  Networks
• Develop an Organisational Model which fits
  thecontext of our Local Communities
• The blueprint is the process
• not the detailed model

Beds Herts PPI Pathfinder Project
Beds Herts PPI Pathfinder Project
72
The Challenge
Finding new, non-bureaucratic ways of doing
things
Beds Herts PPI Pathfinder Project
73
The Concept of PPI
Beds Herts PPI Pathfinder Project
74
Patients Forum
Beds Herts PPI Pathfinder Project
75
A community map for a PCT forum might resemble
Beds Herts PPI Pathfinder Project
76
Structure of a Forum
Beds Herts PPI Pathfinder Project
77
The NHS Network
Beds Herts PPI Pathfinder Project
Beds Herts PPI Pathfinder Project
78
The NHS Reform Act 2002 - Final Amendments

• Cross membership from NHS Trust to PCT Forums

• Patients Forums must
• Cooperate with each other in the performance of
  their functions
• Exercise functions jointly with one or more other
  Forums

• PCT Forums to provide / commission ICAS

• The Commission for Public and Patient Involvement
  will appoint staff to support and work with every
  PCT Forum in England.

• Staff will support Forums on a day-to-day basis

Beds Herts PPI Pathfinder Project
Beds Herts PPI Pathfinder Project
79
Beds Herts PPI Pathfinder Project
80
THE LOCAL NETWORK
Beds Herts PPI Pathfinder Project
81

• Patients Forums Where are we now?
• Local Patients Forums have been set up
• 9 Patients Forums established
• The Hertsmere Project (Community Empowerment)
• 4 Patients Forums being established
• 4 Patients Forums yet to be arranged
• 4 are Joint Patients Forums with more than one
  CHC involved,
• Some have already undertaken a number of
  monitoring visits.

Beds Herts PPI Pathfinder Project
82

• What have we learned ?
• Challenges
• Not always easy to attract members, and there
  need to be clear criteria for membership
• New members face an immense learning curve the
  NHS and its structures can be off-putting
• Staffing puts a strain on current CHC staffing
• Hard to reach public present a real challenge
• County wide Forums are more difficult to set up

Beds Herts PPI Pathfinder Project
83

• What have we learned ?
• Successes
• Enthusiasm and new ideas
• First rate co-operation from Trusts
• Need for co-ordination between PFs
• Basic common materials can be produced e.g.
  Terms of Reference, application forms, agendas
• (Common) training is an urgent requirement

Beds Herts PPI Pathfinder Project
84

• What we still need to develop
• Community Empowerment
• Hard to Reach Groups
• Working with Local Strategic Partnerships
• Smarter Forum Networking
• (joining them up)

Beds Herts PPI Pathfinder Project
85
Independent Complaints Advocacy Service
(ICAS)
Beds Herts PPI Pathfinder Project
86
Independent Complaints Advocacy Service

• In developing a robust framework document for a
  whole system ICAS (across Bedfordshire and
  Hertfordshire) the local network focused
  initially on
• principles and feasibility,
• sought to check the viability of key elements of
  the service,
• create a vision of an ICAS to serve the needs of
  the population in a way which would
• be consistent with the legislation ,
• ensure a smooth transition,
• and build on its best elements from the past,
• add value to the other elements of the PPI
  proposals.

Beds Herts PPI Pathfinder Project
87
The model being proposed for ICAS Is based on a
Call Centre
Call Handling and Initial Assessment
Intermediate support Local Resolution of complaint, mediation support etc.
Specialised support Independent Review, Ombudsman submission, GMC referral support etc
Beds Herts PPI Pathfinder Project
88
Independent Complaints Advocacy Service

• KEY BUILDING BLOCKS OF THE SERVICE
• - Policy Framework - Skills, Training and
  Support
• - Location - Staffing and Accommodation
• - Finance - Professional and Quality Standards
• Reporting - Accountability, Perf. Management,
• Monitoring and Evaluation
• - Working with Key Partner Agencies
• - ICAS Reference Group

Beds Herts PPI Pathfinder Project
89
Independent Complaints Advocacy Service

• ADDED VALUE OF ICAS TO THE LOCAL NETWORK
• Data gathered from the whole ICAS, suitably
  anonymised, will help an important tool for
• performance management, informing the local
  network,strategic planning, commissioning of
  services
• Gaining added value for the whole local network
  by joining up data with others for trend
  analysis
• PALS data, Complaints data, NHS Direct Data,
  Local Authority Data, Survey Data
• Fit with other national initiatives
• An Organisation with a Memory and CHAI, NPSA,
  etc.

Beds Herts PPI Pathfinder Project
90
Implementation Plan

• Safety ! Safety ! Safety !
• Initial Implementation
• Putting in place the building blocks
• Complaints Handling Software
• Some sharing of caseload
• Integrated Call Handling across the Network
• Call Centre
• One Phone Number for the whole area (0845)
• Full Caseload Sharing
• Staff specialisation

Beds Herts PPI Pathfinder Project
91
To Summarise

• We have
• Digested the emerging legislation
• Examined the concepts
• Related them to the Community and its Local
  Networks
• Developed an Organisational Model which fits
  thecontext of our Local Communities
• The blueprint is the process
• not the detailed model

Beds Herts PPI Pathfinder Project
Beds Herts PPI Pathfinder Project
92
developing public and patient involvement
in the eastern region
Voices Projects in South East Essex Beryl
Furr, Chief Officer, Southend District CHC
93
Patient Voice and Patients Public Voice

• Aim of the Voices Projects in South East Essex
• To develop capacity for local people to become
  involved in health
• Patient Voice - Castle Point and Rochford
• Patients Public Voice - Southend on Sea
• Membership and recruitment
• Patient Voice - up to 100 people recruited
  through traditional methods media, leaflets,
  etc. plus stand on Market Day
• Patients Public Voice - over 100 people joined
  up at community health day organised jointly by
  PCT, CHC, Local Authority and CVS (attended by
  more than 700 people)

94
Learning Points

• 1. People are keen to get involved
• 2. NHS structures and working methods are
  complex and off- putting - participants need
  practical support and training
• 3. Get members on board early and be prepared
  to learn together
• Setting truly local priorities
• Stimulating debate within local communities
• Gathering evidence for OSCs
• Sounding out new ideas

95
A shared agenda

• 1. 28 workshops on the Modernised NHS with
  input from NHS Managers and Clinicians,
• 2. 12 training sessions covering
• A Stronger Voice
• Which Hat Are You Wearing?
• - role and structure of the NHS
• - Nolan Principles in Public Life
• Diversity Awareness
• Visiting health services
• - primary and acute
• - codes of conduct

96
A tailored agenda

1. Focus on local issues in the east and west
of the district 2. East group gathered evidence
on - non urgent transport - hospital
parking - access to NHS dentistry West group
held public information and consultation events
on access to GP services 3. Both groups
influenced the development of the Local
Development Plans for their PCT area 4. Both
are contributing to the development of their
PCTs website and communications strategies
97
Making progress

1. Independent evaluations 2. Potential for
accreditation of training programme 3. The
Voices Projects can help both PCTs to meet
their Section 11 responsibilities 4. We have a
skilled pool of potential recruits to
Patients Forums, NEDs, members of local and
national committees, etc. 5. Training funded
by the PCTs and Southend Borough Council will
facilitate mentoring of new members 6.
Voices members are now engaged in in Expert
Patients Programme, a variety of local (and
some national) planning teams and scrutiny
exercises