You said we did

This section is dedicated to information about how your feedback and comments are shaping services. North Central London CCG welcomes feedback and has a process in place for patients and public to raise queries, concerns, complaints and compliments.

North Central London CCG is committed to responding to queries, concerns and complaints within 25 days and as standard we include information regarding any actions being taken in response to feedback.

You said we did

As a result of the work Camden GP practices (N=32) now have a level of compliance with the AIS that we believe exceeds anywhere else in the country. Every practice now offers a registration form in Easy Read and Large Print formats, annual health checks in easy read and practices actively prompts patients to identify their communication support needs, has had basic d/Deaf training, has a working hearing loop and notes communication support needs using alerts on EMIS 

You will find below (extracts from our Patient Voice reports) examples of what we have done as a result of the feedback received from patients, local residents and stakeholders during the last 12 months.  

You said 
Feedback from consultation on the proposed move of the Moorfields Eye Hospital’s City Road services highlighted a number of challenges. The main concerns were with the last half-mile of the journey from the current transport hubs to the St Pancras site. Examples of these concerns included:

  • The size and complexity of King’s Cross and St Pancras stations, which may be difficult to navigate, particularly for people with sight loss and mobility issues.
  • The current journey on foot from the main rail and underground stations, which may be too long for people with mobility issues.
  • Issues concerning pedestrian safety in the King’s Cross area, particularly for people with sight loss. These include major road crossings and the lack of tactile demarcation of cycle lanes.

We Did
Camden CCG, leading the consultation on behalf of other commissioners, will host a Committees in Common 12 February 2020 to approve the proposals and ensure consultation feedback is addressed.

What Difference did it make
If proposals are approved on 12 February, Moorfields Eye Hospital Trust are committed to developing and implementing a robust accessibility plan, which is co-designed in partnership with sight loss charities, patients, transport providers, local authorities, commissioners and voluntary organisations. They will ensure plans and processes are in place to enable patients to travel to the new service safely. The work will be part of the development of a Full Business Case and Planning Application in 2020/21.

You Said
Healthwatch Camden did research among Camden residents who are deaf or visually impaired or have learning disabilities who told us that they face particular difficulties ifGPs do not meet their communication support needs. Feedback showed that many of Camden’s GP practices were not yet meeting the Accessible Information Standard (AIS).

We Did
Camden CCG in collaboration with the Local Medical Council supported Healthwatch Camden who visited every practice in Camden to help them become compliant with the AIS.

What Difference did it make
As a result of the work Camden GP practices (N=32) now have a level of compliance with the AIS that we believe exceeds anywhere else in the country. Every practice now offers a registration form in Easy Read and Large Print formats, annual health checks in easy read and practices actively prompts patients to identify their communication support needs, has had basic d/Deaf training, has a working hearing loop and notes communication support needs using alerts on EMIS

You Said
Deaf service users told the CCG that our staff and general practice staff should have a better understanding of using BSL interpreters and an understanding of what it is like to be a deaf person. 

We Did
Camden CCG approached and supported Asif Iqbal, MBE BA (Hon), Rehabilitation Officer for Deaf and Hard of Hearing People, London Borough of Camden who is also profoundly deaf and 12 deaf awareness training sessions were held over the last year. 

The aim of the training was to enable participants to have a greater understanding of deafness and the issues involved with communication and access to information.

What Difference did it make

Learning outcomes: To date over 80 attendees (CCG and practice staff (Clinical and Admin) were able to build up confidence to talk to deaf people directly. Gain a basic understanding of deafness and acceptable terminology.
Ability to use basic everyday signs and clear lip-reading skills, to be aware of technology and services available to meet deaf and hard of hearing client’s needs and know how to work with a BSL Interpreter.

You Said
Local Patient Participation Groups (PPGs) raised concerns with Camden CCG in relation to transfer of patients from the Royal Free London Hospital (RFH) to Chase Farm Hospital for elective surgery. PPG members felt that patient choice was not offered to patients as well as it should be and concerns were raised in relation to the adequacy of patient transport. The Chair of CPPEG also raised concerns at a CCG Governing Body meeting. 

We Did
Following the feedback received and the patient story that was presented by the Chair of CPPEG – Dr Neel Gupta, Chair and Kathy Elliott, Vice Chair of Camden CCG held a meeting (13 Dec 2018) with Kate Slemeck, Chief Executive and Chris Streather, Chief Medical Officer of the RFH to discuss patient and their families concerns.

What Difference did it make
A summary of the actions are as follows: 

  1. In terms of next steps the RFH has produced better materials for their clinical and operational teams to ensure they are more explicit in the choice that Camden patients have for their surgery and will also be working to improve the patient pathway 
  2. RFH are also working to be more explicit in that it is seeking to encourage Camden patients to have surgery at Chase Farm Hospital given the clinical advantages of a purpose built elective centre where operations are less likely to be cancelled due to pressures on beds. Crucially the RFL would also be clearer that patients do have a choice and can still ask for the surgery to take place at the RFH. 
  3. Improve pathway design to ensure Camden patients who are happy to have surgery at Chase Farm Hospital can have any tests associated with their surgery – blood tests and pre-operative assessments – at the RFH.
  4. Health inequality and transportation – The RFH agreed to explore how transport options to Chase Farm Hospital for those patients who choose to have surgery there from Camden could be improved.

You Said
Young people and parents told us that they were concerned about student wellbeing and lack of awareness of GP and mental health services.  

We Did
From January (2019) the Communications and Engagement Team started a higher education health and wellbeing campaign working with 4 universities in the borough, focusing on student mental, physical health and the best way to access NHS services.

What Difference did it make
Students have been made aware of local GP and mental health support services that are available to them when they register with a local practice. Students have also been informed and supported on how and when to use the correct services (e.g. GP extended access instead of attending A&E). 

You Said
Patients with long term conditions told us that they want to know more about self-care and when they should go to the pharmacist, GP and A&E

We Did
In response to the feedback a local GP and Pharmacist held workshops throughout Camden with patients with long term conditions and attendees learnt

  1. What self-care is
  2. What’s the most appropriate servicefor their symptoms
  3. When can you manage your symptoms at home?
  4. When you should see your pharmacist?
  5. When you should see your GP
  6. When do you need to go to A&E

What Difference did it make
More than 150 people have attended the workshops. The feedback received was positive and a quote from an attendee said : “It is not often I’m glad to be a Camden resident, but this sort of workshop really makes it worth it- it has been really useful” 

Self–care notice boards are also being introduced in a number of local general practices and with a virtual notice board also under development for the CCG public website and links will be forwarded to general practices to signpost patients to. The purpose of the notice boards will be to signpost people to help them manage their health and well-being and to access General Practices, A&E and Pharmacies appropriately. 


A self-care pack has also been developed and disseminated to attendees, PPGs and local residents to help them manage their conditions and use services appropriately. 

You Said
Strategic Partners Neighbourhoods: We recognised the need to strengthen our links London Borough of Camden Voluntary Sector Team and smaller community groups. The Lead Director of Voluntary Action Camden raised the issue with us. 

We Did
The Chair (Dr Neel Gupta) and Vice Chair (Kathy Elliott held a meeting with key smaller groups in Camden to talk about opportunities for joint working with the development of GP Neighbourhoods. Some of the groups that we meet during the last 12 months were the African Health forum, Kurdish Community Association, Sundanese South Health Women’s Group, Cristian Church of God and the Lights Foundation Mission

What Difference did it make
The groups have been connected to the development of GP Neighbourhoods, connected to the work of the local Public Health team and are working to get health information out to everyone in the groups that the CCG has met. The CCG and VAC are working together to get people from the community groups to join the volunteers who assist with the development of social prescribing in general practice in Camden. 

You Said
Camden Lesbian, Gay, Bi-sexual and Transgender Forum: The Lead Director for Transformation and Senior Engagement Manager meet with the forum to talk about the Local Care Strategy and Sustainability and Transformation Plan (STP). Forum members told us that the presentation pack needed to be more inclusive and welcomed the offer of the CCG to proactively promote LGBT issues to CCG and general practice staff. 

We Did
As a result of the discussion the presentation slides have been updated to ensure that the family model is representative of the LGBT community and LGBT awareness and access to the forum has been promoted to in the patient newsletter and internal CCG staff newsletter. Camden CCG has also launched the Rainbow Lanyard initiative with fellow CCGs in North Central London.
A Trustee of Camden LGBT forum has also visited the CCG to talk about LGBT issues and what is important to local people around healthcare in Camden.. 

What Difference did it make
The Rainbow Lanyard is regarded as an open and visible commitment to building LGBT equality within work and making us a LGBT inclusive organisation. The CCG has been explicit about our commitment to advancing LGBT equality and send a clear message to our staff, Governing Body members and any organisations that we commission services from that prejudice and discrimination towards LGBT staff is unacceptable.

You Said
The 2017/18 commissioning plan was presented and discussed at a PPG forum meeting and members welcomed the clarity given to the process of making decisions and plan for moving forward. 

We Did
The CCG has disseminated the plan to all PPGs (Including Healthwatch Camden and local community groups) via the patient newsletter and will present the 2018/19 plan at CPPEG for discussion and comment. 

What Difference did it make
The Patient Voice is maintained through the commissioning cycle with elected patients representatives involved at all stages of the commissioning plan (representation on commissioning and procurement committees) who ensure that decisions are patient sighted, based on evidence and patients and the public have been engaged and consulted.

You Said
Deaf Blind London Day – Local deaf blind London contacted the CCG as they had national concerns about people with the condition becoming increasing isolated due to the challenges people endure and asked that we assist in connecting people to a wider network. 

We Did
We helped promote and inform local people who were deaf blind and their family, friends and carers of deaf blind day on Wednesday 17 June via active and reactive communications and engagement connecting to other networks within and outside the borough to reduce the risk of isolations improving people’s health and wellbeing. 

What Difference did it make
Local deaf blind people have been connected to wider networks to support both dead blind people and their family, friends and carers. 

You Said
PPG success stories and building effective PPGs – PPG members asked the CCG to support PPGs. 

We Did
The CCG continues to promote PPG success stories to inspire ideas for other PPGs showing the difference they can make. Four PPG success stories are promoted annually and presented at the two PPG forum meetings. 

What Difference did it make
PPG members regularly give positive feedback in relations to the success stories as it inspires other PPGs to do similar work. For example, a local PPG facilitated diabetes prevention and early identification clinics at a local Mosque which resulted in another PPG undertaking a similar project at another part of the borough. The forum meeting also gives people the opportunity to network and support each formally and informally in the role of being a PPG member.

Barnet CCG is committed to responding to queries, concerns and complaints within 25 days and as standard we include information regarding any actions being taken in response to feedback. Examples of recent actions shared with patients and the public are outlined below.

Improving patient appointment letters

As part of an ongoing initiative to put patients and the public at the heart of decision making by learning from their experiences, a member of the public was invited to discuss their experiences accessing cardiology outpatient services at a large provider for which the CCG commissions services. The patient’s appointment had twice been cancelled for reasons unknown; with separate letters needing to be sent to confirm the new appointments, one of which was never received. As a result of cancelled appointments, the patient spent a considerable amount of time in discomfort. The patient felt that their negative experience could have been improved if the cancellation letter also included the details of the rearranged appointment. Healthwatch confirmed that they had received similar complaints about the referral process. The CCG worked closely with the provider and a patient representative over summer 2019 to find a solution to the problem with the letters. Although the provider’s system is unable to generate a single letter with the cancellation and new appointment details, a more patient-friendly cancellation letter is now automatically generated when patient’s re-book their appointments which is followed up with a new appointment confirmation letter. The provider is also exploring the implementation of a policy whereby the first member of staff with whom a patient had contact would be considered the ‘owner’ of the patient’s enquiry, and would see it through to resolution. This would support patients through the uncertainty which can arise when appointments are cancelled.

Supporting non-english speaking patients when they visit their GP

In June 2019, Healthwatch Barnet investigated GP interpreting services. As part of their fact-finding, they engaged with 59 patients through three community groups, Barnet Refugee Service, Somali Women’s Group and Farsophone Counselling Service. Patients were asked about their awareness and experience of interpreting services. Healthwatch also engaged with GPs and practice staff, community organisations and looked at practice websites. The findings showed that overall, general awareness of interpreting services for GP appointments was poor. As a result of the recommendations made to the CCG in Healthwatch Barnet’s report, the CCG has identified the top 13 languages spoken in Barnet and produced two posters for GP practices; one reminding patients that they can have a chaperone during their consultation and the other giving a reminder that patients are entitled to an interpreter during their appointments. Barnet CCG has also promoted the commissioned interpreting service to practices to ensure that staff are aware of it, provided information for their websites, made sure that practice websites have a “translate this page” function and regularly monitors the usage of interpreting services.   

Improving phlebotomy (blood testing) services

Following an increase in complaints about access to phlebotomy services we informed patients that we would undertake a review of the blood testing services to ensure equitable access and reduced waiting times. This work is currently in progress.

Young people’s mental health services

In response to concerns raised regarding young people’s mental health support, Barnet CCG provided a detailed overview of the transformation plan and a link to full details which were published on our website. We also invited further feedback to inform the plans going forward. This document includes a summary of engagement activities related to children and young people which have impacted on commissioning decisions.

More than 100 children and young people from across the borough gathered in February 2017 to voice their views during Barnet’s ‘Youthorium’. Participants from the borough’s schools, colleges, youth groups and charities took part, voicing their opinions on a range of topics from young people’s emotional wellbeing, to youth services and the best ways for young people’s voices to be heard. There was also a ‘voxpop booth’ to capture participants’ views on video. Feedback at the Youthorium event led to the development and commissioning of online support (Kooth) and to improving emotional wellbeing support in schools (Resilient Schools programme). Barnet’s Parent Carer Forum and young people with SEND were involved in commissioning such as our Integrated Therapies Service in 2018 and recommissioning of short breaks. There are ambitions to develop mechanisms for parents and families to be able to involve in monitoring of provision. 

Referral Management Service

Prior to the launch of the new enhanced Referral Management Service, a quality impact assessment was performed and a thorough engagement process was undertaken to review the impact of those involved and affected in this service. Barnet CCG engaged with local stakeholder groups including Healthwatch, local GP representative groups, local practice managers and patient feedback was acquired via a survey. Furthermore, two patients represented the patient voice throughout the service design and evaluation process for the Referral Management Service.

Dermatology waiting times

In response to concerns raised about dermatology service waiting times the CCG shared the following actions:

  • Extension of innovative ‘tele-dermatology’ service using technology and early advice and treatment from dermatologists. This should enable more patients to receive expert advice and treatment from dermatology clinicians early in their care pathway and should enable more patients to be managed effectively outside of the face-to-face hospital setting. This should also therefore help to reduce waiting times overall, improve access to clinical advice and treatment and provide a more efficient dermatology service for patients.
  • Review of triage process for dermatology: reviewing criteria for referral to community service to ensure this is appropriate and to see if any patients could be seen appropriately and effectively elsewhere (for example, a hospital based dermatology service if required) to free up capacity and reduce waiting times in community clinic.