Neera Tyagi – Non-Executive Director Patient & Public Involvement in OOHs & Urgent Care Conference 19th March 2009

Intro to LCD... Who we are What we do Where we work A social enterprise What we do Urgent care services Primary care services Where we work West Yorkshire North East Lincolnshire South Yorkshire Owned by our members who have an influence on what we do and how we work. They help us identify weaknesses, improvement opportunities and future development in local health services. Involving them remains a cornerstone of our ethos as a social enterprise provider of health services.

The evolution of Local Care Direct LCD Vision Advancing unscheduled care LCD Vision Advancing out-of-hospital care LCD Vision 24/7 Primary Care Introduction of APMS contracts Direct Enhanced Status NHS pensions Birth of LCD 7 GP co-operatives Primary Care – 1st GP practice 3 x GP-led Health Centres Clinical Integration with NHS Direct Co-location A&E streaming 2004 2005 2006 2007 2008 2009 Changes to GP contract – Out of hours ‘Our Health, Our Care, Our Say’ White Paper Darzi Review GP- led health centres DoH Urgent Care Strategy – Single point access Sir George Alberti Independent sector review

Scale One of the largest social enterprises in health in the country – leading provider of OOH & Urgent Care in the North £20m turnover Staff includes: GPs, ANPs, Practice Nurses, Health Care Assistants, Patient Care Advisors, Call Handlers, Drivers 2.5m population covered 12 Primary Care Centres, including walk-in centres 3 Contact Centres 1 General Practice 1 Dental Practice 2 GP-led Health Centres – General practice and walk-in centre Primary Care Centres in all major population centres in West Yorkshire i.e. Leeds, Bradford, Wakefield, Huddersfield, Airedale, Dewsbury. Contact (call) centres in Wakefield, Huddersfield and Leeds General practice in Bradford Dental practice in Leeds GP-led health centres in Bradford and Dewsbury. Another centre will be opening in Wakefield in May 2009.

Why PCTs believe in us Value for money / no shareholders Public service ethos and values Local knowledge Experienced and trusted management team Integrated services Patient care standards Innovation, flexibility and responsiveness Collaborative approach LCD is less hamstrung than the NHS and therefore has more freedom to innovate in service design and planning, provide more flexibility and respond more quickly to issues raised by both patients and commissioners. Collaborative approach means working with all major stakeholders to achieve common aims and goals.

Patient and public engagement Community Leaders Feedback & consultation Key Stakeholders Sector Engagement (other providers) Research – Health Inequalities Patient Experts (Advisory Council) Membership Research – working with local community groups and key stakeholders we are able to tackle health inequalities and address issues at a very local level, clearly people such as outreach workers and neighbourhood action teams already know the issues on their patch and, by closely working with them, LCD can tap into knowledge and help them to formulate solutions. Working in this manner avoids duplication and ensures consistency. 6

PPI Strategic Plan Close working with LINks groups Community partnership working Local authority/ health economy networks Voluntary sector engagement Work with other agencies (i.e. support for homeless, asylum seekers, travellers, ethnic minorities) Patient/ member forums (*starting in 2009) Patient forums will be established in each PCT area/ some of them linked to our Equitable Access Centres in Bradford, Wakefield and Dewsbury. LCD member forums will also be established in each PCT area in 2009 7

Engage every community Patient and public engagement... Put patients first Engage every community Keep talking... Listen & involve “Mutuality means community ownership. Without this, there is no viable organisation.” LCD Communications & Community Relations Manager, Alan Whitaker 8

Membership Comprising staff, GPs and people living in the communities we provide services More than 800 members 19 member representatives on our Advisory Council 2 Advisory Council members on the LCD Board Attendance at our AGM by diverse groups of members LCD is committed to encouraging greater involvement by its members. The most significant in 2009 will be to invite members to join local forums in their own areas. We will start by seeking expressions of interest before deciding how the forums will be set-up and how many members will be involved. 9

Role of Non-Executive Directors Background Health inequalities Demography Board Concerns 10

Manningham Medical Practice Waiting area Admin office Outside the practice

Role of Non-Executive Directors Visit to the surgery Consultation with Patients GP, Staff Report to the Board Manningham Medical Surgery Improvement Group Action Plan 12 12

Improvements so far…. Refurbishment of the premises 1.5 Salaried GPS – consistent service, avoid locum Training & Development of Staff Scored 90/100 points in the prescribing incentive scheme 13 13

Future Plans Patient survey to determine need for extended opening hours Community Health Worker to work with the practice testing for diabetes (shops/mosques/ local community) Quality incentive scheme Improving data quality (summarising and read-coding) Secured funding for testing equipment for diseases with high prevalence in the practice to avoid referring elsewhere 14 14

Manningham PPI – key relationships Partnerships with: Neighbourhood action teams BME representative groups (e.g. Council for Mosques, other faith organisations) Asian Women’s Forums Business partnership groups Outreach workers for the homeless Housing associations See further details on attached sheet. 15 15

Conclusions Local Community, Local Needs, Local Solutions Holistic approach to meeting health needs Added Value of Independent and Objective View Making a difference 16 16