Report on National Association on Patient Participation (NAPP)
34th Annual Conference & AGM
“Empowering Patients Supporting Practices”
Manchester 26th May 2012
This was a well supported meeting with around 120 delegates and some
excellent speakers; I was the only delegate from Bristol and one of three
doctors present.
In the absence of Dr Niall Dickson , the Chief Executive and Registrar of the
General Medical Council (GMC) Professor Rajan Madhook , a Council Member
of the GMC stood in and gave a very good account of the role of the GMC and
what sort of standards were expected of doctors today and in the future
regarding education and behaviour. His main theme however was, as far as
patients were concerned that there should be ‘No decisions about me without
me’ He drew attention to a new booklet entitled ”What makes a good doctor”
and even suggested that patients should be involved in doctor’s educationpossibly a step too far! He reckoned that there should be more bottom-up
than top-down management in practices. He was concerned that practice
managers were not being regulated-it was not quite clear what he meant! In
fact the introduction of registration with the CQC covers registered managers.
He noted that there had been 44000 letters of complaint against doctors in the
year 2009-10 and of the million doctors on the register 3500 were under
investigation, 1 in 10 had a hearing and 1 in 4 were struck off but he felt that
the GMC monitoring and appraisal of doctors was satisfactory. He jokingly
indicated that most doctors’ ability to do some good outweighed their
predilection to do harm! He suggested that PPGs should make themselves
known to the local GMC Liaison Representative.
This session was followed by the workshops:
A. PPG Commissioning Champions.’ Biting the Bullet’
B. PPGs and Care Quality Commission (CQC): ‘Working Together’.
C. Empowering patients. Harnessing potential of PPGs to support self-care
for minor ailments.
D. Striking a new deal with patients. Building partnerships for the future.
Each delegate was allowed to attend only two of the workshops and I went to
B and D.
The A Workshop (see above) looked at PPGs getting involved in commissioning
so that local strategic groups would respond to patients’ needs. The NAPP is
pioneering a national pilot project funded by the Department of Health (DoH).
It also suggested that PPGs should get involved with other local health groups.
I got the impression there were far too many groups and let us hope they are
all largely in agreement!
The B Workshop (see above) outlined the role of the CQC and the standards
required for care providers. We were told how the CQC were going to monitor
Primary Care Services and how the PPGs might work with CQC in the future
and help feed into CQC’s pilot inspections. The whole process was pretty
complicated but to put it simply. GP practices have to start registering with the
CQC this summer and this should be complete by April 2013. Registration
requires that the practice is compliant with a list of regulated activities ie
general medical care and fulfils certain essential standards of safety, Criminal
Bureau Records screening, suitability of premises and cleanliness and infection
control. The problem is that the document applies to all forms of health care
i.e. hospitals, care homes GP surgeries etc. and some of the requirements do
not apply to the latter e.g. ‘meeting nutritional needs’. Pilot inspections of
practices may start this summer and concentrate on outcomes which really
means patients views and satisfaction therefore we will be involved but
initially the inspectors are concentrating the pilots on the SW London region.
The practice staff will have to collect relevant data about waiting times, out of
hours services etc. and this has to be documented for appraisal by the CQC
inspectors. It was thought that unannounced visits would be impractical. All
this information is available on line-www.cqc.org.uk or in the CQC document
“An overview of registration with CQC. There are a confusing number of other
groups other than NAPP and the individual PPGs with an interest in outcomes
including the Patients Association, LINk health ( Local Involvement Networks)
and Provider Reference Groups which I am still learning about.
The C Workshop (see above) NAPP is the patient champion for the national
Self-care Forum which encourages a patient-led bottom-up approach so that
patients look after themselves when they have a minor ailment or everyday
illness (sort of DIY medicine). This has the support of the Care Minister Paul
Burstow and this has been launched in the NHS North West in parallel with the
Choose Well Campaign (see attached)
The D Workshop(see above) looked at getting members of the PPG more
involved in the work of the practice, the Direct Enhanced Service (DESwhatever that is) and collaborating with the Practice Management Network.
Ideally there should be a PPG member representative at practice
management meetings. It also explored the use of tele-health and the use of
social media e.g. Facebook. Twitter, Linkedin etc.
Following the workshops there was a very entertaining Soapbox or Speakers’
Corner session when 10 delegates raised a subject that was dear to their
hearts. There was a bit of doctor bashing about - doctors don’t strike, lazy and
greedy, clock-watching, no longer a vocation but a job. What was interesting
was that rural doctors seem to give 24/7 service probably because there are no
paramedics/ambulances/hospitals nearby. Apart from these negative
comments some looked at group dietician sessions for diabetics and obesity,
exercise sessions, web-sites, fund raising, having a patient information-cum
reading room in the surgery, awareness weeks for specific diseases and
spreading word about the PPG in the media, schools etc.
Finally the Corkhill Award for the best PPG was won by the Wilsden Practice, a
small rural practice who looked at several areas mainly the efficiency of the
practice telephone system, how long it took to get an appointment etc.
Finally the Chairman of NAPP Professor Sir Dennis Pereira Gray, a Exeter GP,
summed up and the main theme was for us all to go back to our practices and
make a difference! However he warned that rationing of health services
would occur and it was important for PPGs to have a say in that matter. He
said that this next year was going to be crucial to the survival of the NHS and
hoped that the hand over from the Primary Care Trusts and Strategic bodies
would go smoothly and that market forces would not destroy the altruistic
aims of the NHS.
Campbell Mackenzie June 2012