Bulletin number 19

November 2014

Dear Reader The Healthwatch Brent bulletin is published at the end of each month and has feedback on recent events and information about events coming up as well as news about health and social care issues. Healthwatch Brent also publishes factsheets about issues raised by Healthwatch Brent members and the public. You can find all the back copies of bulletins and factsheets on our website. Healthwatch Brent is a community interest company and we welcome new members to contribute in many different ways. If you are passionate about health and social care issues and would like to help make health and social care in Brent better find out about becoming a member (see contacts below). We have a leaflet that patients can use to let us know what is good and what needs to be better about the health and social care services they use. We need your help to distribute these as widely as possible so that we can hear from as many people as possible. If you can make sure that your local GP displays them (or any other services you know) that would be a great help. Please let our Co-ordinator, Ian Niven, know if you can help by calling 020 8451 5278 or emailing: [email protected] We always welcome your feedback and suggestions about this bulletin and Healthwatch Brent and are pleased to include information about any meetings or groups in the fields of health and social care. If you would like our outreach worker, Elaine Fletcher, to come and talk to your group send an email to: [email protected]

This is how you can contact Healthwatch Brent - email: [email protected] website: www.healthwatchbrent.co.uk or freephone 0800 9961 839 (24 hours) See below details about the next Healthwatch Brent Board meeting. This will be held in public for the first time.

National

NHS England - Five Year Forward View NHS England has published its report about the future of the NHS, called “Five Year Forward View”. NHS England has a new Chief Executive, Simon Stevens, and he has issued the report 1

to set out why the NHS needs to change and what it needs to do in order to meet the needs of patients and make sure everyone has access to good quality care. The report is signalling a big shift in the way the NHS in England is managed and organised. The

summary of the report says:  The NHS has got much better in the past 15 years  Most people agree on what should happen to make the NHS better still in the next 5 years  There is a great need to improve prevention and public health – this will include national action on obesity, smoking, alcohol and other major health risks  People needing health services should have greater control of their own care.  The NHS will work hard to break down the barriers in how care is provided between doctors and hospitals, physical and mental health and abetween health and social care.  There are too many different groups and types of needs for all care to the same everywhere in England, but there must be national leadership which says what is possible  Models of “Multispecialty Community Providers” which involve medical specialists working together to offer out-of-hospital care will be encouraged.  There will be a new option of Primary and Acute care systems which bring together hospital and primary care providers  Urgent and emergency care services will be redesigned to link A&E departments, GP out-of-hours services, urgent care centres, NHS 111 and ambulance services. Smaller hospitals can link with larger hospitals or specialist services so they can survive. Midwives will be able to take charge of the maternity services they offer and the NHS will provide more support for frail older people living in care homes  Primary care is the basis of care for the NHS and there needs to be a new deal for GP’s which involves more funding. There will be a shift in funding so that the GP-led Clinical Commissioning Groups will be able to control more of the budget. The NHS needs to train more GP’s and find ways to make sure they stay in their jobs for longer  The national leaders of the NHS need to work well together and make sure their rules work well for local leaders. Local solutions will be encouraged, rather than more national structural reorganisation. There will be more work to improve how patient’s experience their dealings with the NHS, including new technology  The demands on the NHS will continue to increase and with no changes there will be a shortfall of nearly £30 billion a year by 2020/21. It will be necessary to take action on demand, efficiency and funding.  The NHS has been showing that it can make efficiency savings and does well compared to other countries’ health systems. For this to continue there will have to be more work 2

on prevention, different care models, social care services and system improvements throughout the NHS  Different funding models mean different outcomes for the NHS. This could be the same amount of spending, spending per person or spending as a share of the country’s GDP (gross domestic product)  The government needs to make decisions about the funding gap of nearly £30 billion a year by 2020/21. Whilst there are lots of things in the report that could mean the way patients experience the NHS will change a lot, the most important thing is that the report says the NHS needs more money. In their first response a lot of MP’s have supported the report and said that it is right that there should be more funding for the NHS, but there is not much detail about how this will happen. It will take some time to find out what changes will happen more quickly and this might not be those that seem most important. For example, there has already been agreement that doctors should have an extra payment each time they diagnose someone with dementia, which has taken many health professionals by surprise. One of the more significant things that the report proposes is the development of "Accountable Care Organisations" similar to those in Spain and parts of the United States. This means a single organisation taking responsibility for all of a local population's health needs. For example, a major hospital trust could do everything in its area, including employing GPs and community health staff as well as acute care. To see the full report visit: http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf

Care Quality Commission [CQC]

(http://www.cqc.org.uk/)

The job of the Care Quality Commission (CQC in short) is to check that people get good, safe health and social care in England. They make sure that hospitals, care homes and care services meet the rules set by Government. The CQC publishes what it finds to help people choose care.

CQC’s 5th Annual Report on the state of health and care services in England The CQC has published its 5th Annual Report, “State of Care”, on the state of health and care services in 2013/2014 in England. The CQC covers more than 40,000 health and care services. The report found:    

There is much excellent care but the variation in the quality and safety of care in England is too wide and is unacceptable Safe services occur where effective leadership builds a culture of safety By looking at CQC’s reports on outstanding and good care, other services can learn and improve CQC’s ratings provide transparent information that allows people to make choices 3

The CQC says that although there is rising pressure on care services, including financial pressures, they see many examples of good and outstanding care. However, there are too many poor services where people were not getting the care they should expect. CQC says this variation in the quality and safety of care in England is too wide and unacceptable and has a detrimental impact on people who use health and care services and their families. When the inspections identify poor care, they must lead to improvement by providers, who should learn from the examples of good and outstanding care. The CQC was most worried about the safety of services. Care providers must make the basics of safe care a priority and build a culture of safety in their organisations. The principle of keeping people safe from harm is fundamental. The CQC says these things should be done: 

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The public should be at the heart of good care. People can use CQC ratings to help make choices about their care and become more demanding of those who should be acting in their interests. Providers should accept where there are problems and use the inspections to drive up quality. Some services need help to improve. When the CQC identify failings, the wider health and care system needs to work together to put things right for the safety and wellbeing of people who use services. CQC will use its new approach to regulation to shine a light on poor quality care and highlight good and outstanding care and encourage a learning culture in organisations.

The report gives more detailed findings on the different sectors that the CQC inspects:   

Adult social care Hospitals, mental health care and community health services Primary medical services and integrated care

The report also says how many services were issued with warning notices, as follows:      

Social care organisations – 1149 NHS healthcare organisations – 71 Independent healthcare organisations – 53 Independent ambulance – 3 Primary dental care – 30 Primary medical services - 24

A copy of the full report is available on the CQC website:

http://www.cqc.org.uk/content/state-care-201314

CQC Reviews of different sectors The CQC has been testing the way it carries out its inspections and the way it reports back on its findings. The new systems take account of peoples’ feedback when it has been trying out the new systems. The inspection teams include people who know a lot about the services, 4

both as professionals and service users and their carers – these people are trained and called Experts by Experience.

The inspectors will have 5 key questions about the services when they carry out their reports. They want to know:      

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    

    

    

Are they safe? Are they effective? Are they caring? Are they responsive to people’s needs? Are they well-led?

The reports for each service will say whether the care is outstanding, good, requires improvement or is inadequate. The CQC wants people to know about these ratings and consider them when they are choosing care. The Department of Health has been consulting on plans to ensure that all providers given ratings by CQC display those ratings to help the public see how they are performing and make more informed choices about their care. The CQC thinks this is a good idea. At the moment all the CQC’s ratings are published on its website, but it would be helpful if care homes, hospitals and GPs also made the CQC’s judgements of their services available to the public. The consultation suggested that the rating must be clearly visible, such as in waiting rooms or entrances, and must be published on the provider's website with a link to the inspection report. CQC will test public awareness of the ratings by asking patients if they know the CQC rating of their provider as part of our inspection programme. The CQC has issued new handbooks for people running services to understand how the inspections will be carried out and what the inspectors will be looking for. The CQC has live question and answer sessions and you can sign up as a member to join in these: https://communities.cqc.org.uk/public/

The groups of services the CQC have made new reports about are:

NHS acute hospitals, specialist mental health, and community health services The CQC says all services will be rated from October onwards and the ratings will help people to compare services. The reports will say whether the care is outstanding, good, requires improvement or is inadequate. The handbooks for NHS Acute Hospitals, Community Health Services and Specialist Mental Health Services are available on the CQC website: http://www.cqc.org.uk/content/hospitalcommunity-mental-health-providers#handbooks

Care homes and community adult social care in England. The CQC has been testing how it will inspect and report on these services and has confirmed 5

how it will check these services in England. The CQC has made handbooks to help care providers understand the new system. The services include care homes, with and without nursing and community adult social care which includes services that care for people in their own homes. The teams will visit the services unannounced. The inspectors should think about whether they would be happy for someone they love and care for to use the services. If the services are not good enough the CQC should take tough action so that improvements are made.

The CQC expects to have CQC expects to have rated every adult social care service in England using its new system by March 2016. Further information is available in CQC’s consultation response, which it has published alongside the handbooks. To see the handbooks, visit the following link: www.cqc.org.uk/content/adult-social-care and www.cqc.org.uk/content/what-does-adult-social-carelook-across-cqcs-new-ratings.

The Healthwatch Brent website www.healthwatchbrent.co.uk has a list of local inspections the Care Quality Commission has made in Brent since September 2013. This list shows which standards have been met and which have not. There are links to the full reports.

GP Services The CQC says that the new style inspections of GP practices and out-of-hours services in England will start this month and will lead to the first ever ratings of practices. The intention is that for the first time ever, there will be a clear way for the public and GPs to know which family doctors are providing great care, and which need to improve. The inspection teams include trained inspectors, GPs, nurses, practice managers and trained members of the public.

The Inspections will also look at how well services provide for specific patient groups in the local population. These are met. These groups are: • Older people • People with long term conditions • Families, children and young people • Working age people (including those recently retired and students) • People whose circumstances may make them vulnerable • People experiencing poor mental health (including people with dementia)

There are about 8,000 GP practices across England. The first GP ratings are expected to be available from November and will be published on CQC’s website.

GP out-of-hours services The CQC has finished its first inspections of some NHS GP out-of-hours services in England. These are the services for people who need urgent access to care when their GP practice is closed. The CQC inspected 30 out-of-hour services, run by 24 registered providers. Between them they had responsibility for the care of about a third of people in England. People have been worried about these services and sometimes the care offered has been poor.

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The report shows that the inspections found many examples of excellent practice but also identified variation in the quality of safety and care. Staff and the CQC are keen to share the examples of things that they are doing well and these are in the report. The problem areas will be followed up. The good things were: 

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Out-of-hours providers regularly monitored the quality of care they provided by auditing, putting routine monitoring systems in place and investigating incidents. The providers shared the lessons they had learned and the subsequent actions with all staff. There are some important lessons to learn from the good practice, and GP services, including inhours general practice, can learn from this. There were fewer locum GPs covering shifts than expected in the services. Most of the GPs were sessional GPs from the local community. This meant people were receiving care from GPs who were familiar with the specific needs of the local population and the locally available care services. There were some good examples of GP out-of-hours services reaching out to the local community to raise awareness of services and to make contact with people who may have poor access to primary care. This was done using social media and working with support organisations. Providers had developed innovative and responsive care as a result of feedback from the local population in a number of services. For example, one service provided transport to enable patients to visit in response to feedback that a lack of transport was stopping some patients from attending appointments. Several services had systems in place to predict and manage high levels of activity, such as employing a ‘clinical navigator’ or ‘patient flow co-ordinator’ to ensure that patients were prioritised based on their condition and seen in a timely way.

The things that needed improving were:    

Some providers did not have safe mechanisms for storing and checking the stocks of medicines they held, and for recording the use of controlled drugs. Some providers did not have appropriate recruitment processes in place. Some providers did not have adequate systems for checking and monitoring equipment, including oxygen and emergency medicines. Some providers did not inform patients how they could make complaints about the service.

The CQC thinks all services will make the changes they have been told to make without them having to say that they found serious concerns that required a warning or enforcement notice. There is an overview of the findings in a report called, ‘Findings from the first comprehensive inspections’, by Professor Steve Field (CQC Chief Inspector of General Practice). See: http://www.cqc.org.uk/content/nhs-gp-out-hours-services-findings-first-comprehensiveinspections

Substance misuse services The CQC’s inspections will take account of the government's drug strategy to put people's recovery at the heart of its approach. To help this happen people must be able to access high7

quality services quickly. The inspectors will be aware that people using substance misuse services often have complex and varied needs. Treatment may be short or long term and people often need help from a number of agencies. The plans are set out in the CQC’s guide: 'Developing our new approach for specialist substance misuse services', published 23 September 2014.

Dementia Care The CQC has reviewed dementia care and found that variation in the quality of care means people living with dementia risk receiving poor care, especially if they move between care homes and hospitals. The CQC looked at how people’s care needs were assessed; how care was planned and delivered; how providers worked together and how the quality of care was monitored. The CQC found assessments were not comprehensive in identifying all of a person’s care needs in about a third of care homes and just over half of hospitals. It found when people are admitted to hospital via A&E there is too much focus on a person’s physical health needs. There is also poor sharing of information between health professionals, people living with dementia in care homes and hospitals may not be able to tell staff about their pain and there is a lack of understanding and knowledge of dementia care by staff. The report adds that supporting both the physical health and mental wellbeing of a person – as well as managing known risks such as falls and urinary tract infections– can help reduce avoidable admissions to hospital and unnecessary long stays in hospital. The CQC now intends to appoint a new national specialist adviser for dementia care, train inspectors across all inspecting teams to understand what good dementia care looks like so that their judgements are consistent and include a separate section in hospital inspection reports that shows how well the hospital cares for people living with dementia. The findings of the themed dementia review are available http://www.cqc.org.uk/cracksinthepathway

Access to safe places in health-based settings for people experiencing a mental health crisis The CQC explains that people detained by the police under section 136 of the Mental Health Act must be taken immediately to a safe place where a mental health assessment can be undertaken. This should be a ‘health-based place of safety’, located in a mental health hospital or an emergency department at a general hospital. They should only be taken to a police station in exceptional circumstances.

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The CQC found that too many health-based places of safety are turning people away because they are already full, and some are refusing to help young people, people who are intoxicated or people exhibiting disturbed behaviour. The CQC has said that there must be urgent action to change this and that the places of safety must work better. The CQC has told providers and commissioners what they need to do to make sure these services get better. Click here to find a map where the health-based places of safety in England are: www.cqc.org.uk/hbposmap

Shorter waiting times for mental health services NHS England Chief Executive Simon Stevens and Deputy Prime Minister Nick Clegg announced new waiting time standards for mental health services. £120million investment is going to improve mental health services with shorter waiting times and an introduction of early intervention services. It should help to put mental health on an equal footing with physical health services. People who need talking therapies will begin treatment within six weeks (eighteen weeks as an absolute maximum) while young people hit by psychosis for the first time should be seen within two weeks. The changes will come into force in April 2015.

Care Act guidance If you want to see the revised guidance and regulations for the Care Act click here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/366104/43380_2 3902777_Care_Act_Book.pdf

Social Care assessments Healthwatch England heard that people have difficulties with social care assessments. There are long waiting lists for adult social care assessments. Concerns include long delays in the assessment process, including a further wait for a package to be arranged (the ‘pending list’), resulting in a ‘quantity not quality’ approach. Healthwatch England wants to get a national picture of the issue. Therefore, please let us know if you have difficulties with social care assessments. Contact: [email protected] or telephone: 0800 996 1839 (freephone)

Deprivation of Liberty safeguards (DOLS) Disability Rights UK reports that there has been a big rise in deprivation of liberty safeguard requests. This surge is due to a Supreme Court decision, which considered the criteria for 9

judging whether the living arrangements made for a mentally incapacitated person amount to a deprivation of liberty. The Court decided that there was a deprivation liberty where support arrangements involved continuous supervision and control and where the disabled person was not free to leave whatever arrangements were in place. This applies to a lot of people place in a care or nursing home with no option to leave. Sometimes this is because neither the person nor their family have the knowledge or confidence to object. People who are struggling with capacity to make decisions may want to live in their own home with intensive support – as some people with dementia do, for instance – and placing them in a care or nursing home when it is not where they want to be raises profound questions of human rights. See more at: http://www.disabilityrightsuk.org/news/2014/october/deprivation-liberty-safeguards

Care.data NHS England chose Clinical commissioning groups in four areas of the country to be pathfinders. This means they are going to help develop the care.data programme. They will test different ways of communicating with patients explaining the risks and benefits of the scheme. You can find more details on this website: http://www.england.nhs.uk/2014/10/07/ccgs-care-data-programme/ Under the care.data programme coded medical details held by the GP will be brought together with hospital data at the Health and Social Care Information Centre (HSCIC). Many people still fear that patients’ confidential information will be used by commercial companies. Another concern is that patients have to opt out of the scheme rather than choose to be included.

Patient Data Accredited Safe Havens are accredited organisations which might share patient level data with third party organisations. Healthwatch England (HWE) asked for a single regulatory regime in managing health and care data. HWE wanted the same right to object that the Secretary of State gave to the care.data programme for the accredited safe havens. This will help consumers to understand what they are opting out from and provide much more clarity in the use of their data. A network of regional centres across the country will store this confidential patient information. Critics say it is an attempt to reintroduce the national database of medical records (care.data) which was postponed earlier this year. A recent article in the Guardian explains more: http://www.theguardian.com/technology/2014/oct/07/care-data-patient-information-accreditedsafe-havens?CMP=twt_gu 10

Consultation on proposed Congenital Heart Disease standards and service specifications Deadline: 8th December. You can find more information on: www.youtube.com/user/TheNHSEngland Click here to get to the consultation: www.engage.england.nhs.uk/consultation/congenital-heartdisease-standards

London ‘Better Health for London’ The Mayor of London set up the London Health Commission in September 2013 to review the health of the capital. The Health Commission has now published a report. The report proposes tough measures to combat the threats posed by tobacco, alcohol, obesity, lack of exercise and pollution, which harm millions of people. Together the proposals amount to the biggest public health drive in the world. It contains over 60 recommendations and sets out 10 ambitions for the city with targets. Click here to read the report: http://www.londonhealthcommission.org.uk/wpcontent/uploads/London-Health-Commission_Better-Health-forLondon.pdf?utm_medium=email&utm_source=The+King%27s+Fund+newsletters&utm_campai gn=4844359_HWBB+2014-10-27&dm_i=21A8,2VTXJ,FLWPS6,AH4AB,1 If you want to find out more about the London Health Commission click here: http://www.londonhealthcommission.org.uk/

Report on patient transport Transport for All (TfA) launched a report on patient transport. The report highlights problems in patient transport. It also shows positive solutions of how to make improvements. TfA is asking Trusts to endorse a patient transport charter setting minimum standards in their procurement of patient transport services. Click here to read the report: http://www.transportforall.org.uk/news/just-out-report-into-patient-transport-in-london

Accessibility for all Crossrail stations Transport for All campaigned for over a year so that all Crossrail stations are going to be fully accessible. Thanks to everyone helping with the campaign all of London’s Crossrail stations will now be fully accessible from the day it opens.

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Local Brent CCG Commissioning Intentions 2015/16 Brent Clinical Commissioning Group [CCG] is currently consulting on its plans for commissioning (buying) health services for the years 2015/16. A draft of these plans is on the CCG website. The CCG will also publish an easier to read version soon.

Brent Foodbank is moving From 3 November 2014 Brent Foodbank will be at: St Mary's Church Willesden, Neasden Lane, London NW10 2TS. The opening times will stay the same: Tuesdays and Thursdays between 1pm and 4pm.

Brent and Harrow community mental health services for older people The community mental health services for older people living in Brent and Harrow have moved to a new, single location: Fairfields House, Roe Green, Kingsbury, London NW9 0PS The building has been completely renovated and facilities upgraded. The Central and Northwest London NHS Foundation Trust hopes that bringing the teams together will improve efficiency and provide better integration between the different mental health teams. Community mental health teams for older people provide assessment, care planning and treatment for people who have dementia or other mental health problems that are usually associated with older age. Memory services provide assessment and diagnosis of dementia and provide ongoing support and information to people with memory problems and their carers. Day services run a therapeutic group programme to support people in maintaining their independence in the community.

BAS4IL - Brent Disability Service 4 Independent Lives “Promoting voice, choice and independent living for older and disabled people in Brent.” BAS4IL is a new signposting, information and advice service for people living in Brent who are over 18 years old and disabled and anyone over the age of 65. 12

The service is currently being set up. BAS4IL plans to start in late November. People will be able to access the service through the web site www.bas4il.org.uk, telephone and email. There will also be a drop in service. BAS4IL is a working partnership with Age UK Brent and Brent Mencap for Brent Council.

Feedback from local meetings Northwest London Hospitals merger programme stakeholder meeting Mohamoud Ibrahim, Healthwatch Brent Community Director, attended the meeting in Northwick Park Hospital on 17th September. He writes: It was reported that the merger is on track and the new organisation The London North West Healthcare NHS trust will be created on 1ST October 2014. The new organisation is the merger of the Ealing Hospital NHS Trust, and the North West London Hospitals NHS Trust. The new organisation is going to be one of the largest Integrated Trusts in the country linking hospital and community services across Brent, Ealing, and Harrow. The new organisations are also home to St Marks Hospital, and Central Middlesex Hospital. It was reported that patients will not notice any changes from the merger, and will continue to attend hospital and clinic appointments at the place and time specified in their appointment letter. There will be a new board for the new organisation, and letters will be sent from the merger programme to stakeholders requesting Healthwatch representation on the new board. Brent CCG is the commissioning services to the new Trust. Clinical integration of various teams continue, and discuss what works and what could be improved. Interim senior management will be in place to run the new Trust and many staff line management will remain largely unchanged. There is a detailed plan about the new Trust and first day action and priority areas. Questions were asked if the merger stakeholders meeting will continue and the overall consensus was that there is no need to continue the merger meeting once the new Trust is up and running. But the group agreed to meet in early November 2014 for a final meeting.

Meeting with Councillor Pavey Miranda Wixon, the Chair of Healthwatch Brent, and a Board member from Brent Council for Voluntary Services met with Councillor Michael Pavey on 25th September. 13

Councillor Pavey undertook to ensure that a formal invitation had been sent to Healthwatch Brent to become a member of the Health and Wellbeing Board. He took the opportunity to outline his proposal to have themed Health and Wellbeing boards to involve more members of the community. These would be held around the borough at suitable venues. He asked the question about the future of Healthwatch Brent and undertook to find out what the proposal is in terms of contracting for the future. Councillor Pavey is the Deputy Leader of the Council and Chair of the Health and Wellbeing Board.

Gathering Views Gathering Views Small Grants Health Watch Brent are awarding grants of up to £200 to local organisations and community groups to assist with Gathering Views on key areas for health and social care in Brent. These small awards can be used as a contribution towards the cost of an event or session. This could include funding room hire, printing, or even covering volunteer expenses at drop-in sessions. The objective of Gathering Views is to encourage people to share their views by completion of our Healthwatch survey. Please complete the EOI form to express your interest http://goo.gl/Kq20DM. For any further information, please contact [email protected] / 07825 215 652

EVENTS Healthwatch Brent Board Meeting The next Healthwatch Board Meeting will be held in public. When:

Tuesday 2 December, 10.30 am – 12

A public meeting follows this: When:

Tuesday 2 December, 12.30 – 2 pm

Where:

CVS Brent, 5 Rutherford Way, Wembley, HA9 0BP

Refreshments will be available at 12 noon. To register, visit http://goo.gl/w3SP0H.

Patient Participation Groups (PPG) Many of the GP practices in Brent have patient participation groups which meet regularly to discuss issues important to patients at that practice. Many surgeries also have virtual patient participation groups, so you have the option of contributing electronically as well as attending 14

meetings. From time to time, they run consultations on their proposals. They also publish details of national consultations that may seek your opinion. GP practices in Brent are grouped into 5 localities. The localities are Harness, Kilburn, Kingsbury, Wembley and Willesden. Each locality also has a patient participation group, or PPG, which is open to all patients (or carers of patients) who are registered with a GP practice belonging to that locality. The locality PPGs are very keen to hear from patients and carers who wish to know more about local health services and changes. Meetings take place once every 2 months. Even if you don't want to attend, it is worth joining so you can be sent the patient participation group newsletter. If you would like to join your locality PPG, e-mail: [email protected] or telephone Nan on 07719 635 741. There is a Healthwatch Brent factsheet about PPGs and you will find information at your local GP surgery.

The following meet in November: Kilburn Locality Patient Participation Group (PPG) - please note change of date When:

Wednesday 5th November, 6.30 pm – 8 pm

Where:

St Anne’s Church Hall Rotunda, 125 Salusbury Road, NW6 6RG

The main topic will be the plans for major demolition and rebuilding at St Mary's and Charing Cross and the clinical strategy to go with that. Hopefully there will be a speaker from the Imperial Trust about the big changes they are planning. Members of Willesden PPG are also welcome to come along. Kingsbury Locality Patient Participation Group (PPG) When:

Thursday 6th November, 6.30 pm – 8 pm

Where:

The Sattavis Patidar Centre, Forty Lane, Wembley Park

Brent CCG’s Commissioning Intentions is on the agenda Harness Locality Patient Participation Group (PPG) When:

Tuesday 11th November, 10 am – 12.15 pm

Where:

Wembley Centre for Health and Care, Chaplin Road

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Community Action on Dementia When:

Tuesday 18th November, 1pm – 4 pm

Where:

Patidar House, 22 London Road, Wembley, Middlesex HA9 7EX

The workshop is an opportunity for members of the community to come together to listen to people’s stories and discuss how to tackle the challenge of dementia in Brent. The workshop aims to bring together a range of people to share their experiences of dementia and ideas how help people live better with dementia in Brent. This includes people living with dementia, their families and carers, community and voluntary organisations, local providers, partners in health and housing, members of the Health and Wellbeing Board. If you would like to attend the event please register by 12 pm Friday 7th November. [email protected] or telephone: 020 8937 1306

Brent CCG Health Partners Forum When: Where:

Wednesday 19th November, 6 pm – 8 pm Sattavis Patidar Centre , Forty Avenue, Wembley Park NW10 9PE

The Agenda will cover the following:     

Self Care Diabetes Ophthalmology Musculoskeletal and Gynaecology services update Central Middlesex Hospital

The report from the last Health Partners Forum in September is not yet on the CCG’s website.

Brent Mencap Health Focus Group This session is for people with learning disabilities and their carers When: Where:

Tuesday 25th November, 3.30 pm – 5 pm Brent Mencap, 379-381 High Road, Willesden NW10 2JR

(Refreshments available)

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