You Said, We Did

On this page you will find information and updates on the consultations and engagement work we have carried out. Click on the headline to find out more.

Consultations

The future of the Birmingham and Solihull Clinical Commissioning Groups (CCGs): July to August 2017

During July and August of 2017, NHS Birmingham CrossCity CCG, in partnership with NHS Birmingham South Central CCG and NHS Solihull CCG, ran a consultation on the future of the NHS Birmingham and Solihull Clinical Commissioning Groups.

Overall, the majority of consultation responses were in support of a full merger of the three CCGs. A full merger was progressed with the new CCG to cover Birmingham and Solihull to begin 1 April 2018.

Mental health recovery and employment services: March to May 2017

From March to May 2017, NHS Birmingham CrossCity CCG, in partnership with NHS Birmingham South Central CCG and NHS Sandwell and West Birmingham CCG, we ran a consultation on changes to mental health day services..

We have now considered all of the feedback and would like to share how we have incorporated it into our plans:

  • View the You said, we did presentation
  • The new mental health recovery and employment service is now live and is being delivered by Better Pathways. Find out more here.

Non-emergency patient transport (NEPT): June to August 2015

During the summer of 2015, in partnership with NHS Birmingham South Central CCG, NHS Solihull CCG and NHS Sandwell and West Birmingham CCG, we ran a consultation about creating one universal service for all patients across Birmingham, Solihull and Sandwell.

Following the consultation and the procurement process West Midlands Ambulance Service NHS Foundation Trust will be providing a new non-emergency patient transport service from 1 May 2017.

Engagement

Cheddar Road Surgery closure engagement - 12-30 November 2018

Patients of Summerfield Family Practice and other stakeholders were asked for their views on a proposal to close the Cheddar Road Surgery branch site, which sees around four patients per week. A three-week engagement period was held from 12 November until 30 November 2018.

GPs and practice staff travel daily between the main practice which is based at Summerfield Primary Care Centre, Winson Green Road, Winson Green, Birmingham, B18 7AL, and Cheddar Road Surgery, 55 Cheddar Road, Balsall Heath, Birmingham, B12 9LJ – a distance of around 3.8 miles.

With the majority of its 1,700 patients choosing to book their appointments at the main Summerfield Family Practice, along with the significant investment needed to improve facilities for patients at the branch site which is based inside a terraced house, the practice held a three-week engagement period to discuss proposals for the future. This included a survey (available online and in paper format) as well as two drop-in sessions at the practice.

There are seven alternative practices within one mile of Cheddar Road Surgery, with capacity for a small dispersal of patients.

You can read the engagement report here.

NHS Birmingham and Solihull CCG's Primary Care Commissioning Committee approved the request for the closure of Cheddar Road Surgery. You can read more here.

Non-emergency patient transport (NEPT): October to November 2018

During October and November 2018, representatives from the CCG worked with West Midlands Ambulance Service to visit the renal units across Birmingham and Solihull. We talked to patients about their experiences of non-emergency patient transport and their understanding of the collection times. We are using this feedback to inform future developments, and are planning to do a wider piece of engagement, visiting further hospital sites where non-emergency patient transport is used.

Urgent Treatment Centres: September to October 2018

We have now completed our first wave of stakeholder briefings to update local people about the improvements we are planning to Birmingham and Solihull Urgent Treatment Centres (previously known as walk-in centres).

If you did not manage to attend one of the five stakeholder meetings held during September and October 2018, you can view the presentation which was given here.

Further updates will be given as this project progresses.

Latent Tuberculosis infection (LTBI): September to October 2018

LTBI image 1

Have you heard of TB but not latent TB?

If you have latent TB, the TB bacteria in your body are ‘asleep’. You are not ill and you cannot pass TB on to others. However, the bacteria might ‘wake up’ in the future, making you ill with active TB. Latent Tb can be treated to prevent this happening.

NHS Birmingham and Solihull CCG launched a latent TB awareness and testing campaign on 18 September 2018, targeting communities with a high prevalence of latent TB and encouraging those who met the following three criteria to book a free test with their GP or practice nurse:

A short animation was developed to explain latent TB with a clear call to action for those meeting the criteria; the campaign is being promoted online through our social media channels, alongside a short survey designed to check eligibility for testing.

LTBI image 2 Aston UniAdditionally, between Sept 2018 and March 2019 we are hosting 10 community events to raise awareness, help people identify if they are at risk and encourage them to book a free test with their GP or practice nurse.

Our community events are in high footfall areas such as local community centres, universities and with voluntary organisations.

Details of outreach events held:

  • Tuesday 18 September – Aston University Fresher’s Fair, 10am – 4pm
  • Thursday 20 September– Ashiana Community Project, Sparkbrook, 10am to 4pm
  • Thursday 27September – Lozells Methodist Centre,10am to 3pm
  • Tuesday 9 October – Birmingham City University, 10am to 4pm - Curzon building (canteen area)
  • 17 October - Sparkhill Pool & Fitness Centre,1:30pm – 6:30pm

To remind people of the criteria and testing all campaign materials have a very clear message for example:

  • Our posters promote the community events and any upcoming sessions locally
  • pull up banners
  • bookmarks
  • cotton bags
  • social media – the campaign is promoted both face to face and online using the CCG’s twitter and Facebook
  • further information can be found on the CCG website

Further efforts to engage migrant communities – with the Refugee and Migrant Centre

The Refugee and Migrant Centre (RMC) is a charity committed to changing the lives of some of the most vulnerable members of our community. The RMC assists all members of new and emerging communities regardless of country of origin, ethnicity, legal status, religion, gender, sexual orientation, age or disability.

The CCG has partnered with the Refugee and Migrant Centre in Birmingham; the centre is frequented by a high footfall of migrant communities and offers latent TB testing onsite. A bespoke latent TB poster was designed for the Refugee and Migrant Centre in Amharic, Arabic, Tigrinya and Urdu to encourage non English speakers to get tested.

More information

Commissioning intentions: 26 September 2018

Every year our organisation sets out our Commissioning Intentions. This is in the form of a letter that goes to our partners who provide healthcare services, to inform business plans and contracts. They are intended to drive improved outcomes for patients, and transform the design and delivery of care, within the resources available.

During the development of our intentions we held a workshop on 26 September 2018with our Strategic Patient Partners to test whether our intentions were fit for purpose, as well as understandable and accessible to members of the public.

On the whole our Strategic Patient Partners were happy with our drafted proposals. The main questions were around any patchwork provision. Which in simple terms refers to any gaps where a service may be available in one part of our area but not currently in another. We assured our patient partners that this is of high priority for us and there is currently a review to understand which services may be affected by such a situation.

Granton Medical Centre, and Griffins Brook Medical Centre and Bunbury Road Surgery (BG Health) relocation: August to September 2018

Granton Medical Centre, and Griffins Brook Medical Centre and Bunbury Road Surgery (BG Health), in considering their options to move from three separate surgeries into one single building on the Bournville Village Trust estate by 2020, held a period of engagement with patients and stakeholders which was supported by the CCG from mid-August to 28 September 2018.

The current sites are either not fit for purpose or do not meet the current standards expected for a GP surgery. Moving to a larger site, would allow the practices to offer patients the best possible healthcare, with additional space available for current and future services, in a purpose-built health and wellbeing centre.

The approximate walking distances from the existing surgeries to the new site just off the Bristol Road are:

  • Granton Medical Centre – 1.4 miles
  • Griffins Brook Medical Centre – 0.3 miles
  • Bunbury Road Surgery – 0.9 miles.

Patients and stakeholders were given the opportunity to have their say and ask questions at six drop-in sessions held during September 2018 (two at each practice), as well as through an online survey; which was also available from practice receptions as a paper version.

Find out more:

NHS Birmingham and Solihull CCG launch event and NHS 70th birthday celebrations: July 2018

On Thursday 12 July 2018 NHS Birmingham and Solihull Clinical Commissioning Group engaged with over 250 members of the public, GPs and local organisations at a special launch event which also celebrated the NHS’s 70th birthday.

The CCG, which was formed by the merger of Birmingham CrossCity, Birmingham South Central and Solihull CCGs on 1 April 2018, is the largest clinical commissioning group in England.

As part of the event at The Vox Conference Centre, an afternoon of speakers was arranged for local Patient Participation Groups (PPGs) and GPs, followed by a health fair, with stalls provided by Birmingham City CouncilBirmingham Voluntary Service CouncilGateway Family ServicesHealth Exchange UKLiving Well Taking ControlSolihull TogetherHealthwatch Birmingham and Healthwatch Solihull; as well as the CCG.

The formal launch of the CCG was carried out by Chair Dr Peter Ingham and Chief Executive Paul Jennings, who also paid tribute to some of the many supporters of the local NHS for their personal contribution:

  • Howard Tyers, former Senior Staff Nurse at Heartlands Hospital, for support in raising awareness of local NHS issues on social media;
  • Mark Sanders, and his guide dog Lily, for his continuing support and involvement in a range of CCG meetings and for his instrumental role in the development of a minor eye conditions service;
  • Tony Green, for his work with the Solihull PPG network and involvement with Healthwatch Solihull;
  • Bernie Aucott, a Strategic Patient Partner for the CCG who is heavily involved in CCG meetings, boards, committees, events and workshops;
  • Garry Morris, a local photographer, worked in partnership with the CCG to produce a range of images of Birmingham and Solihull to celebrate NHS70.

Read more about the event in our news release.

Harmonised Treatment Policies: May to June 2018

Following on from new treatment policies published in 2016/17, in July 2017 the Birmingham and Solihull CCGs began working with clinicians and key stakeholders to discuss and assess the evidence and current guidance relating to 22 further treatments and procedures. As a result, draft policies have been created in the areas listed below.

The table shows the treatment or procedure, details of the proposed changes and an opportunity for you to read the full policy as well as a patient-friendly leaflet. 

We have completed an engagement exercise to listen and understand the thoughts and views on the proposed new harmonised treatment policies with members of the public, patients and key stakeholder groups. This was completed by carrying out an online survey and we held a number of engagement events across the local area between 14 May and 22 June 2018.

We would like to thank everyone who has taken the time to share their views. We are currently in the process of evaluating all the feedback and a final report will be published in the near future.

Area/procedure  Definition New draft policy summary Proposed change Rationale for change

Knee arthroscopy for degenerative knee disease

Arthroscopic knee surgery is a treatment which may include:

• Arthroscopic lavage (also called ‘arthroscopic washout’),

• Arthroscopic debridement (in combination with lavage) and

• Arthroscopic partial meniscectomy (APM) which may be performed singly or in combination with debridement and lavage.

Knee arthroscopy for degenerative knee disease is not routinely commissioned

See full policy for more details.

We propose to limit the availability of knee arthroscopy for degenerative knee disease to those conditions and individuals where this intervention is likely to be of benefit, in line with latest evidence. 

The procedure will not be undertaken for diagnostic purposes, for knee “washout”, or for treatment of osteoarthritis, other than for patients with documented history of knee locking.

Clinical evidence strongly demonstrates that knee arthroscopy in degenerative knee disease causes increased damage to the knee and reduces the life of that knee. Any improvement in pain and mobility from arthroscopic knee surgery is often short-lived.

See draft patient leaflet.

 Hip arthroscopy

The three surgical approaches commonly used are:

• Open dislocation surgery involving dislocation of the hip joint

• Arthroscopy (a surgical procedure that allows doctors to view the hip joint without making a large incision (cut) through the skin and other soft tissues) or

• Arthroscopy with a limited open approach.

To limit the availability of this procedure to provider trusts able to:

· Fully support the patient with an experienced Multi-Disciplinary Team.

· Provide genuine choice of more limited surgical incision where clinically appropriate.

See full policy for more details.

Limit the provider trusts performing this procedure to ensure that patients are receiving the best possible care in a supportive multi-disciplinary team environment.

Patient safety and best clinical outcomes.

See draft patient leaflet.

Surgery for carpal tunnel compression

Common condition that causes a tingling sensation, numbness and sometimes pain in the hand and fingers.

Patients must have a definitive diagnosis of carpal tunnel disease and have failed conservative treatment.

See full policyfor more details.

No change from previous policy To be approved by the new Birmingham and Solihull CCG Governing Body

N/A.

See draft patient leaflet.

Dupuytren’s contracture

A condition that affects the hands and fingers, often causes one or more fingers to bend into the palm of the hand.

Treatment options have been broadened to include collagenase injections as well as surgery for patients with moderate disease and joint contracture of at least 30 degrees.

Percutaneous needle fasciotomy (PNF) is no longer routinely commissioned as a treatment option.

See full policyfor more details.

Inclusion of collagenase as a less invasive treatment option for patients.

Percutaneous needle fasciotomy (PNF) is no longer considered an effective treatment for patients by NICE (2017).

NICE TA 459 2017

See draft patient leaflet.

Assisted Conception

Treatment for patients diagnosed with infertility.

One fresh cycle of IVF for patients who meet the eligibility criteria.

See full policy for more details.

For patients who previously fell under the commissioning responsibility of Birmingham CrossCity CCG, the upper eligibility age for women diagnosed with infertility who are clinically suitable for IVF has changed from 42 to under 40 years old. Birmingham South Central and Solihull upper age eligibility for women remains unaltered.

Clinical evidence review demonstrates that a fresh cycle of IVF in the 40-42 year old patient group has a significant reduction in producing a live birth.

See draft patient leaflet.

Gamete retrieval and cryopreservation

Treatment to retrieve and preserve through cryopreservation, gametes (eggs and sperm) for eligible patients at risk of losing their fertility.

Patients must meet the full eligibility criteria set out in the policy in order to have access to treatment.

Patients must be at risk of permanently losing their fertility either through NHS- funded treatment, e.g. chemotherapy or through immediate risk of premature ovarian failure.

See full policy for more details.

To increase the circumstances in which a patient at risk of permanently losing their fertility may access CCG-funded gamete retrieval and cryopreservation in line with new eligibility criteria.

Previously Birmingham CrossCity and Solihull CCGs had no formal policy that had been approved by their respective governing bodies.

To provide those with naturally occurring ovarian failure or NHS-funded treatments other than chemotherapy or radiotherapy with access to gamete retrieval and cryopreservation.

See draft patient leaflet.

Cough assist machines

The mechanical insufflator/exsufflator (MI-E/ Cough Assist machine) is suggested to assist the clearance of bronchopulmonary secretions in those patients with an ineffective cough by the use of both positive and negative pressure.

Use of cough assist machines is not routinely commissioned

See full policy for more details.

No current policy.

Lack of robust clinical evidence to support the cough assist machine as a clinically effective intervention for this cohort of patients.

See draft patient leaflet.

Bunion surgery Surgery to relieve pain and improve the alignment of the patient’s big toe.

A defined group of patients diagnosed with a bunion will be eligible for surgical intervention under the new policy.

See full policy for more details.

No current policy.

To ensure patients are being treated in line with robust clinical evidence.

See draft patient leaflet.

Treatment for snoring Treatment of snoring with uvulopalato, vulopalatopharyngoplasty, palate implants and radiofrequency ablation of soft palate.

The treatments outlined are not routinely commissioned.

See full policy for more details.

No current policy.

Reviewed clinical evidence does not support the long-term effectiveness of these interventions.

See draft patient leaflet.

Treatment for ear wax Ear irrigation should be carried out where possible in primary care by a suitably qualified clinician.

To define a cohort of patients where ear irrigation is an appropriate intervention.

See full policy for more details.

No current policy.

NICE 2017 Hearing Loss. Hearing Loss in Adults: Diagnosis and Management.  (currently in development, final document due for release May 2018).

To deliver evidence-based care to patients in line with NICE guidance in the most appropriate setting.

See draft patient leaflet.

Umbilical; para-umbilical and Incisional hernias Umbilical, para-umbilical and incisional hernias are common abdominal hernias encountered in clinical practice, and involve the protrusion of intra-abdominal tissue through a defect in the abdominal wall.

To define a cohort of patients diagnosed with a hernia where surgical intervention is the most clinically effective course of action.

See full policy for more details.

No current policy. New policy will complement the existing policy on inguinal (groin) hernias.

To ensure patients are treated appropriately in line with up- to-date clinical evidence.

See draft patient leaflet.

Investigation of painless rectal bleeding Rectal bleeding (loss of blood from the anus) is a very common and usually intermittent and self-limiting symptom in people of all ages. 

To define a cohort of patients in which further secondary care investigation is the most clinically evidence based intervention.

See full policy for more details.

Further defines the cohort of patients suitable for referral and investigation in line with NICE guidance.

National Institute for Health and Care Excellence (NICE) 2015 (Updated 2017) Suspected cancer: recognition and referral, NG12.

See draft patient leaflet.

Lithotripsy to treat small asymptomatic renal calculi Extracorporeal shockwave lithotripsy is a non-invasive outpatient treatment that focuses ultrasound shockwaves on renal stones to fragment them and facilitate spontaneous passage.

To define a cohort of patients where lithotripsy is the most clinically effective intervention.

See full policy for more details.

No current policy.

National Institute for Health and Care Excellence, 2017. (Guideline scope) Renal and ureteric stones: assessment and management

See draft patient leaflet.

Breast implant revision surgery Breast implant revision surgery is defined as “any consequence of an implant that would require an operative approach to managing it (e.g. removal)”.

To define two cohorts of patients in whom the most clinically evidence based intervention is a. surgical removal of the breast implants and b. surgical removal and replacement of breast implants.

See full policy for more details.

No current policy.

To ensure patients are being treated in line with up-to-date clinical evidence.

See draft patient leaflet.

Acupuncture for indications other than back pain Acupuncture is a treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.

Acupuncture is commissioned for two defined cohorts of patients, a. patients suffering from tension-type headaches and 2. Patients suffering from migraine headaches.

See full policy for more details.

No current policy.

NICE Low back pain and sciatica in over 16s: assessment and management. NICE guideline [NG59] Published date: November 2016.

NICE CG150 Headaches in over 12s: diagnosis and management (Nov 2015)

See draft patient leaflet.

Treatment of port wine stain A port wine stain is a vascular birthmark caused by abnormal development of blood vessels in the skin. A port wine stain is sometimes referred to as a capillary malformation. Treatment can include camouflage make-up or laser therapy.

Laser therapy is not routinely commissioned.

See full policy for more details.

In line with current policy.

Lack of clinical evidence to support the long-term outcomes of laser therapy as an intervention in this clinical circumstance.

See draft patient leaflet.

Vasectomy

A vasectomy is a surgical procedure performed on males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared) or otherwise interrupted. The semen no longer contains sperm after the tubes are cut, so conception cannot occur. The testicles continue to produce sperm, but they die and are absorbed by the body.

The purpose of this operation is to provide reliable contraception.

To define two cohorts of patients, one to be treated within the community setting and one cohort requiring intervention within a secondary care setting.

See full policy for more details.

To define a cohort of patients where secondary care treatment is clinically appropriate.

To ensure patients receive treatment supported by robust clinical evidence, in the right place the first time.

See draft patient leaflet.

Reversal of male (vasectomy) sterilisation Sterilisation is a procedure by which a person is rendered permanently unable to produce children – made infertile. This is called Vas Occlusion in men (vasectomy): the tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed with heat. Sperm is then prevented from reaching the semen ejaculated from a man's penis during sex. Reversal of sterilisation is a surgical procedure that involves the reconstruction of the vas deferens in men but does not guarantee a return of fertility.

Reversal of male sterilisation is not routinely commissioned.

See full policy for more details.

No change to the current policy.

NICE (2016) deem vasectomy to be a permanent method of contraception and the British Association of Urological Surgeons (2017) state clinicians on gaining consent for a vasectomy, should ensure that it is made clear to the patient that the procedure is irreversible.

See draft patient leaflet.

Reversal of female sterilisation

Sterilisation is a procedure by which a person is rendered permanently unable to produce children – made infertile. In women, it is called operative occlusion of the fallopian tubes: cutting, sealing or blocking the fallopian tubes to prevent eggs from reaching the uterus (womb) where they could become fertilised.

Reversal of sterilisation is a surgical procedure that involves the reconstruction of the fallopian tubes in women but does not guarantee the return of a woman’s fertility.

Reversal of female sterilisation is not routinely commissioned.

See full policy for more details.

No change to the current policy.

In guidance to clinicians the Royal College of Obstetrics and Gynaecologists (2016) state that when gaining consent from a woman for a sterilisation procedure, the patient should be informed that reversal of sterilisation is not available on the NHS.

See draft patient leaflet.

Standing/upright MRI Magnetic resonance imaging (MRI) is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. A standard MRI scanner is a large tube that contains powerful magnets. The patient lies inside the tube during the scan. Positional (upright) MRI has been developed to provide images of the spine under true weight-bearing conditions. This technique relies on a vertically open configuration MRI scanner in which the circular magnets have been turned on end. The patient sits or stands between the magnets during image collection and can adopt various positions such as flexion or extension of the neck or back, allowing imaging of the spine under conditions that occur in daily life.

A defined group of patients will be eligible for access to upright MRI under the new policy.

See full policy for more details.

To define a cohort of patients where upright MRI is clinically appropriate.

Evidence supporting the weight bearing requirement of upright MRIs in certain clinical circumstances.

See draft patient leaflet.

Treatment for chronic fatigue syndrome Chronic fatigue syndrome (CFS) is also referred to as Myalgic encephalomyelitis (ME) or Post viral fatigue syndrome. It is characterised by long-term tiredness that affects everyday life and does not go away with sleep or rest. It can encompass both physical (e.g. fatigue) and psychological difficulties (e.g. muddled thinking).

In patient care or therapy in a residential setting are not routinely commissioned for the treatment of CFS/ME due to the lack of clinical evidence to support this intervention. Patients should be referred for specialist assessment and offered out-patient therapy in the form of a PACE programme comprising of CBT/exercise therapy as appropriate.

See full policy for more details.

No current policy.

NICE (2007). Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management. 

See draft patient leaflet.

Complementary and alternative therapies

Complementary and alternative medicines (CAMs) are treatments that fall outside of mainstream healthcare.

These medicines and treatments range from acupuncture and homeopathy, to aromatherapy, meditation and colonic irrigation.

There is no universally agreed definition of CAMs.

Although ‘complementary and alternative’ is often used as a single category, it can be useful to make a distinction between the two terms.

The US National Center for Complementary and Integrative Health (NCCIH) uses this distinction:

• When a non-mainstream practice is used together with conventional medicine, it’s considered ‘complementary’

• When a non-mainstream practice is used instead of conventional medicine, it’s considered ‘alternative’.

There can be overlap between these two categories. For example, aromatherapy may sometimes be used as a complementary treatment, and in other circumstances is used as an alternative treatment.

Complementary and alternative therapies are not routinely commissioned.

See full policy for more details.

The existing policy in this area is not proposed to change and therefore the following will not be routinely funded by the CCG:

Acupuncture, homeopathy, chiropractic, osteopathy, herbal medicine (including Chinese medicine), Alexander technique, Pilates, flower remedies, meditation, Shiatsu, nutritional medicine, yoga, aromatherapy, bodywork therapy including massage, reflexology, healing, hypnotherapy, anthroposophical medicine, maharishi ayurvedic medicine, traditional Chinese medicine, Eastern medicine, naturopathy, crystal therapy, iridology, dowsing, kinesiology.

Review of the clinical evidence did not support the clinical effectiveness of these interventions.

See draft patient leaflet.

Co-production of health passports for children in care: May 2018

Children in care across Birmingham and Solihull are entitled to have their own NHS health passport to provide a record of a child or young person’s health history and contribute to their emotional and social wellbeing. It is made available for children on school entry and up to the age of 17 years. The passport will stay with them through their care journey and beyond, providing them with very useful information into adulthood.

This document is a hard backed A5 folder containing sections within it for the young person to complete (with support), it covers areas of health including birth history, immunisations, health appointments, wellbeing and health information such as sexual health advice and substance misuse.

Earlier this year the co-production of health passports in Birmingham was featured in the British Association for Community Child Health (BACCH) as an example of good practice.

Why were new health passports required?  

The process was undertaken following a care leavers' forum where young people discuss general experiences of health and their satisfaction of their leaving care summaries -  a statutory document which should be issued to young people who have been in care at the last health assessment before their 18th birthday.

After much debate and discussion, it was noted that whilst the leaving care summary was helpful, it was too late for young people to be receiving information about their own bodies and health history. A solution was required to allow a recorded history to be made, which met young people’s needs to have ownership over information about themselves, and access to basic health information.

The young people at the care leavers' forum suggested a “red-book type document” which would be held by the young person in care, and could be transferred to various placements. We discovered that various similar passport style documents were being used across the UK, and were generally paper bound. To develop a robust health passport, we applied and received funding from NHS England to support the development. Our communications team supported the design, branding, physical production and young people’s engagement sessions.

Who was involved in co-producing health passports?

Over the last 18 months, our designated nurse for children in care, the Rights and Participation team from Birmingham local authority, The Care Leavers forum/Children in Care Council and CCG communications colleagues worked together to create the NHS health passport.

How were young people involved?

Health passport viewsAs part of this engagement process, a debate was led by young people within the council chambers of the city council. 50 young people discussed various topics related to being in care, particularly their thoughts on mental health services, health assessments, stigma of being in care and confidentiality. The thought provoking and enlightening discussions were filmed and video footage is available to view here.

Further development was undertaken to ensure simple and appropriate information was held within the passport e.g. a section was included within the passport for young people to make their own notes at meetings or appointments.

Over a number of sessions young people told us what they liked about these documents and wanted; we concluded what need to be included within the passport to meet their needs and informed the design, contents and inserts of the passport.

Health passportIn May 2018 – the health passport was launched, a full 18 months after the first care leaver’s forum where it was suggested. The process was not rushed, it was thorough, fit for the future and co-designed with young people to meet their needs.

At the launch, some young representatives said that the process left them feeling listened too, and their opinions valued, they felt proud to be making a difference for other young people who would be going through the care system. This reciprocal benefit for service and service user, is the fundamental value of co-production. The process, although challenging and time consuming was empowering and positive for all involved.

Further steps to embed learning for healthcare professionals

Parents, carers, social workers and health professionals have a very important part to play in ensuring that the health passport is explained and offered to the children, taking into account a child/young person’s wishes ability to consent to having it, and that it is taken along to health appointments and to encourage safe storage of the information.

Training videos were developed for professionals to help them understand the rights and needs of young people and their responsibilities around meeting the specific needs of Children in care.

More debate footage is available to view below:

Understanding patient experience of dementia services: 9 May 2018

A dedicated focus group was held with dementia service users and their carers on 9 May 2018at the Alzheimer’s Society office in Solihull in May.

Why was it important to engage with dementia patients and carers?

We are committed to understand the experience of patients so that services are designed and improved based on what is working well.

The engagement exercise was aimed at gaining an understanding of beliefs and attitudes related to dementia and dementia support services; the group shared experiences of the current provision and suggested improvements for future dementia healthcare across Birmingham and Solihull.  Patients commented particularly on equity of access; some people had experiences a very responsive service offering early diagnosis, support and care for those affected whereas others had difficulty in accessing the appropriate level of care in a timely manner.

Our findings and recommendations for future services:

The findings concluded that there were many areas of good practice which should be built on and recommendations to the commissioning manager for future services included but were not limited to - commissioning better service provision, building on what worked well, eliminating any post code lottery and providing equity of access, being more inclusive and co-designing services to meet patient needs which would lead to improved outcomes.

The service should also help those diagnosed with dementia to live more independently by knowing how to access appropriate services in a timely manner. It should also help patients and carers to become more informed so that they are in more control of their dementia support.

Conditions for which over the counter items should not routinely be prescribed in primary care: March 2018

In March 2018 NHS England and NHS clinical commissioners ran a national consultation about a number of health conditions, that have medicines that are available to buy over the counter.

To support this national consultation we did our own outreach work to understand how the proposals could impact on local people.

Birmingham is rated as one of the most deprived cities in the UK, and certain wards within Birmingham such as Ladywood are rated as some of the worst for child poverty. Child poverty – means those in a family living on less than 60% of median household income.

Due to the proposals of this consultation being that individuals would have to purchase rather than be prescribed some medicines, the communications and engagement team, with the medicines management team took a targeted approach to engaging with people within our area: vulnerable, low-income families.

In order to target our most vulnerable individuals we decided to link with local food banks. They were extremely helpful and facilitated us visiting the venues when the food banks were open - and when clients were at the food banks to collect food parcels.

We collated all of what we heard and submitted this into the national consultation run by NHS England.

In conclusion the key points we heard were:

  • It is acceptable for people to pay for very low cost items – probably less than £2/3
  • It shouldn’t be implemented for the most vulnerable e.g. homeless, parents with little-to-no money/income etc
  • There should be information (supported by a campaign) developed to advise people of changes and advise of symptoms and where to buy medicines and rough costs
  • GPs need to be supported to say ‘no’, and also have the discretion to say ‘yes’ to those who really need.

You can read the policy and find out more here.

Modern slavery: 2018

Modern slavery call to actionThere are an estimated 13,000 people living in the UK as slaves. Birmingham alone has seen a 100% increase in recorded instances of modern slavery in the past year.

Modern slavery is occurring every day in our high streets, homes, factories and fields. Our research discovered the general public are not very aware of modern slavery or how to report it.

There is no typical victim of modern slavery; they can be any age, gender, class, nationality or ethnicity. Anyone can be affected and, more often than not, they are hidden in plain sight – working in nail bars, food outlets, car washes, factories or our fields.

In response to the rising incidences in Birmingham, we designed a hard hitting campaign with our partners in Liberate – this involved key agencies and organisations in the West Midlands, including the West Midlands Police, Birmingham City Council, West Midlands Fire Service and the West Midlands Anti-Slavery Network.

Robin Brierley, Chair of the West Midlands Anti-Slavery Network, said: “Human trafficking and modern slavery should not be happening in 2018 in Birmingham, West Midlands or Nationally but the fact is, that it is. Victims must be at the centre of all our work and that it’s the duty of us all, statutory sector, businesses and the public to report suspicions immediately. I don’t believe this is a hidden crime now, we just need to know what to look out for and the signs of trafficking and what to do if we do suspect a person may be a victim. The public should call the modern slavery helpline on 08000 121 700 to get help, report a suspicion or seek advice.”

To achieve maximum impact, the campaign was launched in Birmingham city centre, followed by a programme of smaller events across Birmingham and Solihull.

The campaign needed to grab the public’s attention, therefore we decided to use mock job adverts to highlighting the incredibly poor conditions that modern slaves could experience, whilst they are forced to work in common trades such as nail salons and car washes.

To raise awareness and help to #stopmodernslavery a live theatre performance was staged outside the Bullring and Grand Central East Entrance (opposite the TK Maxx). A van was branded with our ‘job adverts’ and pull up banners worked incredibly well to attract passers-by.

The performance was a powerful immersive experience held inside a transit van, depicting the harsh realities of how many victims are transported and forced into modern slavery.

Detective Superintendent Nick Walton, West Midlands Police said: “It’s really important that we work together with the public to awareness of the signs of modern slavery and urge them to report anything suspicious so we can take action. The Modern Slavery Helpline on 08000 121 700 is there to help but if you feel someone is in immediate danger please call 999.”

Campaign success

Melody BridgesBy designing a campaign that grabbed the public’s attention and a live performance in Birmingham City Centre, the campaign received extensive media coverage and reached more than three million people, thereby raising awareness of modern slavery.

The campaign was featured on ITV News Central, BBC Midlands Today and BBC Radio West Midlands. Media coverage included interviews with a trafficking victim and spokespeople from Liberate and the CCG. Pictured is CCG safeguarding team member Melody Bridges being interviewed by ITV reporters.

Our thunderclap on social media reached over 800,000 people

Informed by the successes of this campaign- West Midlands Police has undertaken a West Midlands wide roll out of the campaign, including an additional 20 community outreach events which are currently being held across the region.

Equality Delivery System 2 - assessment and grading event: October 2017

As part of our Assessment and Grading for EDS2 we held an event to give our partners, patients, and third sector community organisations the opportunity to shape our work on equality, highlighting our strengths and areas where we needed to improve. The engagement event was attended by over 25 delegates and included round table discussion, assessment of evidence, and grading .

The feedback has been used to develop our Equality Objectives and Health Inequalities Strategy 2018-2021 .

Repeat prescription: March 2016

On the 25 February 2016, a survey was launched via Birmingham CrossCity Clinical Commissioning Group’s Survey Monkey account (an online, cloud-based, survey development website) to ascertain how people within our catchment area accessed repeat prescription ordering services.

In order to gather a wide range of opinions, the survey was sent to members of Birmingham CrossCity CCG’s Peoples’ Health Panel. The Peoples’ Health Panel is demographically representative of our population. Members were recruited to ensure that individuals from various protected characteristic groups are able to take part in the CCG’s public engagement activities. In addition, equalities data was requested from respondents as part of the survey.

Following this engagement in March 2016, we created information leaflets to advise patients of the way in which repeat prescriptions would work in the future.

Transforming care for people with a learning disability and autism: March 2016-onwards

Since the Transforming care programme began we have undertaken a number of engagement activities with patients, carers, families and stakeholders. Our first large scale engagement event looked at what was working well and what could be improved for the future. View the event report from March 2016.

Another piece of engagement has been about informing the new service model development. In partnership with The Weaver and Young Foundation we engaged with parents with lived experience of current services. View the engagement report.

Starting in late 2018, the CCG will be working in a partnership with Midland Mencap to undertake a range of engagement activities with patients and families who have experience of accessing services for people with learning disabilities and autism.

We will provide further updates once they are available.

Minor eye conditions service: June 2016

In June 2016, it was recognised that there was a need for a service, which offered patients presenting with non-urgent eye conditions a diagnosis outside of a hospital setting. The results of such a service would see greater management and access of minor eye conditions within the primary care (GP) setting by encouraging self-referral by patients via sign-posting and from GPs.

We developed a project group which included representation from a wide range of departments and background such as finance, contracts, communications and patients.

We were extremely fortunate to have an Expert byexperience, Mark Sanders, who also worked for the Birmingham Sight Loss Council join the project group. Mark was instrumental in the development of the service specification, as well as the evaluation of the tender bids from potential providers of the service.

Mark’s representation of his own, and other members of the visually impaired community's experiences, was integral in commissioning a service that aims to wholeheartedly meet the needs of patients. The service went live in October 2018.

For more information, visit our Eye Health page.

NHS Diabetes Prevention Programme: 2016-onwards

The NHS Diabetes Prevention Programme was launched in 2016 to tackle the growing problem of diabetes in the UK – it seeks to identify patients at high risk of developing Type 2 diabetes and refers them through their General Practice on to a free diabetes prevention programme.

Those referred get help to reduce their risk of Type 2 diabetes including advice on healthy eating and lifestyle, help with weight loss (for overweight participants), and physical exercise programmes, all of which together have been proven to reduce the risk of developing the disease. Adopting a pro-active approach enables patients to take control of their lifestyle factors.

Prevalence of the condition is known to be high amongst Black, Asian, and minority ethnic (BAME) communities, hence the CCG is making specific efforts to encourage people to sign up for and complete the programme.

How are we engaging with Black, Asian, and minority ethnic (BAME) communities?

NHS Birmingham and Solihull Clinical Commissioning Group work collaboratively with organisations such as Diabetes UK to engage with local communities; one of our initiatives is reaching out to various communities through our patient representatives - known as Diabetes Community Champions.

The role of a Diabetes Community Champion?

Community Champions educate and raise awareness of diabetes by organising stalls, talks, presentations and healthy living days at community centres, health fairs and local festivals.

They reach and engage people from ethnic minority groups and other socioeconomically deprived communities.

They explain what Type 2 diabetes is, who is at risk, signs and symptoms, myths and misconceptions, complications, and the NHS services that are available – in a way that is culturally appropriate.

Diabetes Community Inspiration AwardOur Diabetes Community Champion – Tony Kelly

Tony Kelly (pictured right) is a diagnosed Type 2 Diabetic and has been raising awareness of the condition with communities through outreach events across Birmingham, Sandwell and Solihull.

Our NHS DPP board is informed by Tony’s patient experience of living with Type 2 Diabetic. As our Community Champion, Tony hosts dedicated sessions at GP practices with high BAME populations, at faith and community events, as well as regional and national conferences.

Tony is regularly invited to speak on local community radio stations and has received several awards for his dedicated efforts.

Tony’s passion to raise diabetes awareness goes beyond our borders – earlier this year, he was invited abroad (to Dominican Republic, St Lucia, Belize and Jamaica) to share his experience of living with Type 2 Diabetes. Find out more about his visit in the full page spread (page 40) in the Phoenix newspaper.

Is the NHS DPP really making a difference?

A wide range of people with a high risk of developing Type 2 diabetes are currently attending or have completed the NHSDPP programme, delivered by Living Well taking Control.

Our flu campaign - this winter

In partnership with Birmingham Updates, we released a video of local people - including our Community Champion Tony Kelly, explaining why he got the flu jab, in a bid to encourage other diabetics to get theirs too. The video has been shared via our Youtube channel and available on our website. Help us share the video on Facebook and Twitter.

Becoming a community champion

Following the high level of success of this approach the CCG is in the process of recruiting more Community Champions to extend peer support within the heart of our local communities. If you are interested to become a community champion, please email This email address is being protected from spambots. You need JavaScript enabled to view it. and tell us a bit more about yourself and the community you want to help.

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