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

2. 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.

3. 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

4. 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.

5. 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.

6. 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

7. 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

8. 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

9. 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

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

11. Manningham Medical Practice
Waiting area
Admin office
Outside the practice

12. 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

13. 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

14. 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

15. 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

16. 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