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Involving People
and Communities

2020-21

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Foreword

For the people of Cheshire and the local NHS, 2020-21 was a year like no other – presenting unprecedented challenges that none of us could have envisaged.

 

Despite coming together as a new organisation during the early Coronavirus response and spending much of the year co-ordinating the county’s efforts to protect local people from COVID-19, NHS Cheshire Clinical Commissioning Group’s commitment to involving local residents remained undimmed.

 

Of course, almost overnight, the restrictions we all experienced during 2020-21 made traditional methods of face-to-face engagement nigh-on impossible. But it also presented opportunities for innovation, closer working with health and care system partners and the adoption of new technologies and ways of working – many of which have helped us reach new audiences.

 

Supported by our Governing Body Lay Members with a dedicated focus on engagement, our commitment to equality, inclusion and tackling health inequalities remains at the forefront of our work and our response to COVID-19.

 

At NHS Cheshire Clinical Commissioning Group we're really clear with all of our staff that engagement is everyone’s business. Our organisational values ensure that our standards of care, courage, compassion and challenge are met with every single interaction with NHS partners, local authorities, stakeholders, the people of Cheshire and those who access local health and care services.

But it’s also about engagement with a purpose to ensure that residents’ views are fundamental in shaping our work and decision-making. Involving people and communities in our work isn’t always easy and can take time but – done well – enables us to improve patient safety, patient experience and health outcomes as well as supporting people to live healthier lives.

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Dr Andrew Wilson    

Clinical Chair

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Clare Watson    

Accountable Officer

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Reaching our communities in different ways

While there may be an understandable perception that the CCG has been limited in its ability to involve residents in 2020-21, our ongoing commitment to reaching communities across Cheshire in the most convenient way for them enabled us to adapt quickly when COVID-19 struck.

We quickly established daily briefings to support staff, GP colleagues and health and care system partners in their interactions with friends, family members and patients about COVID-19. We were also proud to be the first CCG in the North West in 2020-21 to broadcast our public Governing Body meetings, enabling interaction with attendees during dedicated public question and answer sessions.

Digital channels such as our website and social media platforms became increasingly important as sources of trusted information during lockdown and the COVID-19 response. In 2020-21 our channels achieved more than 1.3m Twitter impressions, 3.2m Facebook impressions and 50,000 LinkedIn impressions.

In May 2020 we became the first CCG in England to launch its own TikTok channel to help us reach new audiences and, to further diversify our engagement, we developed a range of “talking heads” videos for use both across CCG platforms and by health and care partners – supporting Cheshire to speak with one voice.

Traditional media coverage was also achieved, helping us to ensure that important mass communications – such as key COVID-19 updates – were as visible as possible to the people of Cheshire.

Media coverage

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Ensuring your voice is heard

The people of Cheshire are right at the heart of everything NHS Cheshire Clinical Commissioning Group does. The only way we can plan and buy healthcare services that the people of Cheshire really need is to involve the people of Cheshire in our work.

That’s why, in 2020, we commissioned an independent audit of our approach to embedding the resident voice in the commissioning cycle – to scrutinise our approach to patient and public involvement, securing “substantial assurance”. This means the CCG has the right processes in place to consistently ensure that your views are central to our work.

In addition to the work of our dedicated Communications and Engagement Team, we work alongside people with lived experience via our programme teams who are right at the heart of a wide range of meetings and programmes of work involving people with lived experience.

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Working in Partnership

Ethnic communities


  • Cheshire, Halton and Warrington Race and Equality Centre (CHAWREC) recruitingcommunity connectors to share translated information and gather insight into vaccine hesitancy
  • Pathways CIC engaged in Cheshire East to reach out to Eastern European communities through a network of connectors and social media messages in their first language
  • Insight gathered from the work with Eastern Europeans has been used to inform national public health messaging
  • Working with large employers and recruitment agencies to encourage Eastern European workers to take the vaccine
  • Faith sector engaged to address vaccine-hesitant cultural concerns
  • Text messaging and letters to digitally-excluded communities




Marginalised communities


  • Healthwatch working in collaboration with the River Chaplaincy to engage with Cheshire’s boating community. GP Access cards used to support residents of no fixed abode to register with a GP
  • Cheshire’s Gypsy and Traveller Liaison Officers sharing key messages and videos via WhatsApp community groups, undertaking lateral flow tests and engaging with the community to discuss the vaccine. Clinical Directors working with Gypsy and Traveller Liaison Officers and community services teams to vaccinate traveller communities
  • Local Gypsy and Irish Traveller support group commissioned to work with the community to create videos and picture-book style information leaflets for those who find reading a challenge
  • Farming Community influencers identified to support messaging to this community
  • Working in partnership with Reaseheath Agricultural College to engage students from rural communities as local influencers




Learning disabilities or autism


  • National resources tested with people with learning disabilities or autism to determine the most appropriate assets to use
  • Cheshire Disability Access Forum providing information and reasonable adjustment care plan
  • Adjustments made at vaccination hubs to accommodate needs such as quiet spaces and numbing creams for needle phobia. This was supported by a video in simple language to explain what to expect at vaccination centres




Mental illness


  • Staff toolkit developed to support visits and online conversations
  • Messages shared from Clinical Director, lead nurse and pharmacist




Homelessness and rough sleepers


  • Health Protection and homelessness teams providing access to a COVID-19 vaccine for local people experiencing homelessness and rough sleeping – including “couch-surfers” and those in hostels
  • Foodbanks and homeless centres providing vaccination information
  • Community sector organisations helping to identify the most appropriate locations to vaccinate people




Asylum seekers


  • Worked with housing providers to identify additional locations where homeless people live to ensure they were offered a COVID-19 vaccination
  • Worked with the Asylum Seekers and Refugees Partnership Group to ensure key messages were shared about the COVID-19 vaccine




Young People


  • Pathways CIC engaged to recruit young people to develop messages and gather insight from people aged 18-30




Maternity


  • Focus Group held in partnership with Healthwatch to understand concerns of women of childbearing age about pregnancy, fertility and contraception
  • Videos produced by clinicians to address concerns





To maximise the impact of our work to involve local residents in 2020-21, we worked closely with health and care system partners including GP practices, NHS trusts, local authorities, Healthwatch Cheshire and community sector organisations.

 

Cheshire’s health and care partners have arguably never worked together as closely as they did through 2020-21 – brought together by the common aim of protecting people from COVID-19.

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Engaging with minority communities and our most vulnerable

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Ethnic communities


  • Cheshire, Halton and Warrington Race and Equality Centre (CHAWREC) recruitingcommunity connectors to share translated information and gather insight into vaccine hesitancy
  • Pathways CIC engaged in Cheshire East to reach out to Eastern European communities through a network of connectors and social media messages in their first language
  • Insight gathered from the work with Eastern Europeans has been used to inform national public health messaging
  • Working with large employers and recruitment agencies to encourage Eastern European workers to take the vaccine
  • Faith sector engaged to address vaccine-hesitant cultural concerns
  • Text messaging and letters to digitally-excluded communities




Marginalised communities


  • Healthwatch working in collaboration with the River Chaplaincy to engage with Cheshire’s boating community. GP Access cards used to support residents of no fixed abode to register with a GP
  • Cheshire’s Gypsy and Traveller Liaison Officers sharing key messages and videos via WhatsApp community groups, undertaking lateral flow tests and engaging with the community to discuss the vaccine. Clinical Directors working with Gypsy and Traveller Liaison Officers and community services teams to vaccinate traveller communities
  • Local Gypsy and Irish Traveller support group commissioned to work with the community to create videos and picture-book style information leaflets for those who find reading a challenge
  • Farming Community influencers identified to support messaging to this community
  • Working in partnership with Reaseheath Agricultural College to engage students from rural communities as local influencers




Learning disabilities or autism


  • National resources tested with people with learning disabilities or autism to determine the most appropriate assets to use
  • Cheshire Disability Access Forum providing information and reasonable adjustment care plan
  • Adjustments made at vaccination hubs to accommodate needs such as quiet spaces and numbing creams for needle phobia. This was supported by a video in simple language to explain what to expect at vaccination centres




Mental illness


  • Staff toolkit developed to support visits and online conversations
  • Messages shared from Clinical Director, lead nurse and pharmacist




Homelessness and rough sleepers


  • Health Protection and homelessness teams providing access to a COVID-19 vaccine for local people experiencing homelessness and rough sleeping – including “couch-surfers” and those in hostels
  • Foodbanks and homeless centres providing vaccination information
  • Community sector organisations helping to identify the most appropriate locations to vaccinate people




Asylum seekers


  • Worked with housing providers to identify additional locations where homeless people live to ensure they were offered a COVID-19 vaccination
  • Worked with the Asylum Seekers and Refugees Partnership Group to ensure key messages were shared about the COVID-19 vaccine




Young People


  • Pathways CIC engaged to recruit young people to develop messages and gather insight from people aged 18-30




Maternity


  • Focus Group held in partnership with Healthwatch to understand concerns of women of childbearing age about pregnancy, fertility and contraception
  • Videos produced by clinicians to address concerns





 

COVID-19 brought into sharp focus the disproportionate impact of the pandemic on some of the most vulnerable people in our communities.

Ahead of the roll-out of the COVID-19 vaccination programme, a number of groups were identified as being especially vulnerable to serious illness, hospitalisation or death – including those who do not typically engage with mainstream health and care services.

Local insight led to a targeted engagement approach – co-ordinated by NHS Cheshire Clinical Commissioning Group – which included:

 
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Campaigns

NHS Cheshire Clinical Commissioning Group developed, co-ordinated and supported a wide range of behaviour change campaigns throughout 2020-21 – aligned to our priorities – to support better health and better care for the people of Cheshire.

Examples include:

  • Help us Help You – Reassurance campaign during the first lockdown of 2020 to advise anyone who needed care to come forward as health and care services, including Cheshire’s GP practices, remained “open for business” (related infographic below).
     

  • NHS 111 First – Awareness-raising campaign around the introduction of NHS 111 First by Cheshire’s hospital Trusts. Timed appointment slots are now available at A&Es across Cheshire for people with urgent, but non-emergency, health issues.
     

  • Winter and flu – Multi-media campaign centred around encouraging people to get their flu vaccination. Of the nine CCG areas across Cheshire and Merseyside, Cheshire was top of the vaccination league table for 10 of the 12 cohorts of eligible people - and second in the other two.
     

  • #LetsGetVaccinated – High-profile regional COVID-19 vaccination campaign which spreads positive messages via ethnic community leaders.
     

  • International Nurse’s Day – We encouraged the people of Cheshire to "shine a light" to mark International Nurses Day to recognise the extraordinary work that nurses were doing in the fight against COVID-19.
     

  • Mental Health Awareness Week – Chris Lynch, one of our Governing Body Lay Members, fronted a powerful campaign themed around kindness.

Throughout the COVID-19 response Cheshire's GP practices responded to your healthcare needs.

From April 2020 - March 2021 there were:

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1.3m

Telephone and video appointments with General Practice

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13.8m

Prescriptions issued

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1.37m

Face-to-face appointments in General Practice

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45,627

Appointments scheduled

or cancelled using an

online service

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50,227

New patients registered

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815,893

Prescriptions ordered using an online service

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127,044

Fit notes issued

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43,185

New 'online patients' registered for at least one online service

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52,057

Referrals processed

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109,028

Patients registered to access their records online

 

Case studies

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Ethnic communities


  • Cheshire, Halton and Warrington Race and Equality Centre (CHAWREC) recruitingcommunity connectors to share translated information and gather insight into vaccine hesitancy
  • Pathways CIC engaged in Cheshire East to reach out to Eastern European communities through a network of connectors and social media messages in their first language
  • Insight gathered from the work with Eastern Europeans has been used to inform national public health messaging
  • Working with large employers and recruitment agencies to encourage Eastern European workers to take the vaccine
  • Faith sector engaged to address vaccine-hesitant cultural concerns
  • Text messaging and letters to digitally-excluded communities




Marginalised communities


  • Healthwatch working in collaboration with the River Chaplaincy to engage with Cheshire’s boating community. GP Access cards used to support residents of no fixed abode to register with a GP
  • Cheshire’s Gypsy and Traveller Liaison Officers sharing key messages and videos via WhatsApp community groups, undertaking lateral flow tests and engaging with the community to discuss the vaccine. Clinical Directors working with Gypsy and Traveller Liaison Officers and community services teams to vaccinate traveller communities
  • Local Gypsy and Irish Traveller support group commissioned to work with the community to create videos and picture-book style information leaflets for those who find reading a challenge
  • Farming Community influencers identified to support messaging to this community
  • Working in partnership with Reaseheath Agricultural College to engage students from rural communities as local influencers




Learning disabilities or autism


  • National resources tested with people with learning disabilities or autism to determine the most appropriate assets to use
  • Cheshire Disability Access Forum providing information and reasonable adjustment care plan
  • Adjustments made at vaccination hubs to accommodate needs such as quiet spaces and numbing creams for needle phobia. This was supported by a video in simple language to explain what to expect at vaccination centres




Mental illness


  • Staff toolkit developed to support visits and online conversations
  • Messages shared from Clinical Director, lead nurse and pharmacist




Homelessness and rough sleepers


  • Health Protection and homelessness teams providing access to a COVID-19 vaccine for local people experiencing homelessness and rough sleeping – including “couch-surfers” and those in hostels
  • Foodbanks and homeless centres providing vaccination information
  • Community sector organisations helping to identify the most appropriate locations to vaccinate people




Asylum seekers


  • Worked with housing providers to identify additional locations where homeless people live to ensure they were offered a COVID-19 vaccination
  • Worked with the Asylum Seekers and Refugees Partnership Group to ensure key messages were shared about the COVID-19 vaccine




Young People


  • Pathways CIC engaged to recruit young people to develop messages and gather insight from people aged 18-30




Maternity


  • Focus Group held in partnership with Healthwatch to understand concerns of women of childbearing age about pregnancy, fertility and contraception
  • Videos produced by clinicians to address concerns





 

A Year Like No Other

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  • Launch of NHS Cheshire Clinical Commissioning Group

  • Launched virtual Cheshire Chat public engagement sessions 

  • Worked quickly to ensure all meetings in public remained in public - via online platforms

  • Launched NHS is "open for business" campaign

  • Co-ordinated survey of health and care partners to learn lessons from initial COVID-19 response

  • Became first CCG in England to launch its own TikTok channel to help us reach new audiences

  • Engaged with patients in Northwich around a change to the Wound Care Service

  • Marked NHS Birthday

  • Held virtual Maternity Focus Groups involving hospital Heads of Midwifery and Maternity Voice Partnership Chairs to speak to local families about their experiences of maternity services across Cheshire

  • Cheshire Chat event including hints and tips around face coverings

  • Public engagement focused on our Engagement and Communications strategy

  • Worked with partners on digital inclusion and literacy

  • Staged virtual Annual General Meeting including public question and answer session

  • Cheshire Chat event covering Primary Care, a day in the life of a GP and the winter campaign including Flu and NHS 111 First

  • Service design engagement focused on head and neck cancer services for patients referred into East Cheshire NHS Trust

  • Led stakeholder and primary care NHS 111 First webinars

  • Re-established CCG reader’s panel

  • Co-ordinated communications and engagement approach around Cheshire’s COVID-19 Vaccination Programme

  • Supported Local Authority colleagues with communications support following flooding in Northwich

  • Promoted vaccine confidence via unique films for each of Cheshire’s GP-led COVID-19 vaccination centres

  • Held public COVID-19 vaccination programme question and answer session as part on January 2021 Governing Body

  • Raised the profile of the vital role of volunteers in Cheshire’s COVID-19 vaccination programme

  • Supported high-profile #LetsGetVaccinated campaign to help increase vaccine uptake among ethnic and minority communities

  • Supported webinar aimed at creating local care community steering groups in Cheshire West

  • Supported Healthwatch Cheshire at focus group with young women regarding the COVID-19 vaccine and fertility concerns

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You said, we did

It is crucial for us to be open and transparent about how your opinion and feedback helps to inform our work, plans and commissioning decisions.

Our You Said, We Did Framework, developed following a series of public discussions and workshops, simply illustrates the many ways feedback is received and how it helps to inform and influence our work.

 

By working with health and care partners to bring together a ‘network of networks’, the CCG is able to make an even bigger difference to health and care.

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You Said

We Did

You wanted an increased focus on person centred care

More virtual consultations where appropriate. Dedicated social prescribing in place to support carers.

You wanted shorter waits for hospital appointments

Implemented NHS 111 First, enabling access to timed appointments in A&E. Temporary blood testing community hub models implemented from October 2020 to March 2021. Established ophthalmology services in the community.

You wanted to reduce the reliance on emergency and urgent care

Set up a dedicated Care Home Practice in Chester, providing consistent support to 927 residents in 15 care homes.

Worked with providers to develop integrated hubs to help coordinate sourcing of care. Development of NHS First services to support sign posting to the most appropriate service.

You would like to see more promotion of  self-care to manage the health needs of the local population

Continued to progress the roll out of  the Self Care Awards across schools, colleges and workplaces in Cheshire

You would like to see more to support carers, particularly young carers

Worked with local authorities to develop an integrated All-Age Carers Strategy to ensure joined-up support from health, social care and community sector providers.

You wanted continued focus on stopping smoking

Commissioned a joint provider (Brio and One You) across Cheshire to improve access to services. Changed delivery of Stop Smoking Services to telephone and online.

You would like to see improved support for people living with serious mental illness care in the community

24/7 mental health crisis helpline introduced in April 2020. Supported more people with severe mental illness to receive regular health checks.

You wanted to ensure there was access to support for children and younger people who need help

Mental Health Support Teams established in selected schools across Crewe and Ellesmere Port.

You wanted to see an increase in Breastfeeding rates

Connections with infant breastfeeding leads are in place.

You want to see better health outcomes for people with learning disabilities and / or autism 

National target for health checks for Cheshire CCGs (75%) achieved.

You wanted end of life care to be better supported

Online education programme delivered to Cheshire workforce around end of life care. Additional bereavement support commissioned in response to COVID-19.

You would like to see improved quality of life for those with long term conditions

Increased access to structured education and self-management tools for patients with diabetes. Rolled out Blood Pressure monitors to support GPs with early detection.

That Maternity Voices Partnerships were key to supporting maternity services in Cheshire

Funding secured to continue the three successful and vibrant Cheshire Maternity Voice Partnerships.

You wanted to ensure the needs of children and young people with SEND are met 

Continued a Support and Training Working Group. Established a Cheshire Autism Clinical Network group.

You want to see Autism Awareness training to support care home staff

Enhanced training in place across the health and care workforce, with particular focus on GP practices.

You want an increased focus on person centred care for individuals and their carers

We have a Care and Accommodation Board that proactively plans for the care and accommodation needs for those with learning disabilities and/or mental health issues.

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Looking ahead

In 2021-22 we will build on our strong relationships and engagement links with health and care system partners to connect with more community groups and forums. This is initially about getting in touch, listening, understanding what they do and how we can help each other with engagement.

This is not about developing additional forums or groups but reinforcing our strengths in managing a ‘network of networks’.

Harnessing digital engagement 

The move to online platforms necessitated by COVID-19 has brought many benefits in terms of public engagement. We plan to develop further options that support engagement to run alongside Cheshire Chat.

Working alongside health and care partners and commissioning colleagues, we will ensure we engage on meaningful topics that support our priorities and commissioning intentions.

Supporting our two “places” – Cheshire East and Cheshire West 

We will continue to support the two “places” in Cheshire and be a driving forcing in ensuring that all partners are working to a common purpose. Through collaborative communications and engagement we can continue to involve residents in shaping the future of health and care.

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