PPG Meeting Minutes

May 2022

Meeting Date: Tuesday 3rd May 2022 Start Time: 12.30 pm
Location: Norman Centre, Budleigh Salterton End Time: 1.30pm
Present: Tania Davis (TD); Robert Harland (RH); Sue Lake (SL); Mark McGlade (MM); Deborah Mitchell (DM); Lynette Oram (L); Peter Frean (PF); Chris Kitson (CK); Richard Waller (RW); Judy Wright (JW)
Absent: David Forward (DF); Mike Rice (MR); Jacqui Ruhlig (JR)

Welcome and Apologies

Apologies given by SL

Previous Minutes

Agreed to be true and correct.

Matters Arising

Discussion regarding the Eastern Locality Form. The forum focus is:

  1. Loneliness;
  2. Carers;
  3. Mental Health.

There has been difficulties as local charities all have their own independent constitutions however collaboration is in place.

Young Persons Mental Health Team has expanded and this has been discussed in previous PPG meetings.

PPG are all grateful to SL for her local contacts and for her updates which are “exceptional”.

More about The Eastern Locality Forum

Our vision:
  • We believe that community and neighbourhood approaches are preventative in the first instance, that they generate positive wellbeing, and are relevant to the lives of the people and families in their area.
  • We believe that the existing strengths and assets of individuals and of communities need to be central to these approaches.
  • We will listen to, understand, support and empower local community leadership, collectively offering resources where appropriate.
  • We will encourage and support accessible and inclusive communication with communities and neighbourhoods to identify their aspirations and shape the activity of the local health and care system across Eastern Devon to reflect those.
  • Alongside our local Health and Wellbeing Strategy, we will have in-depth and up to date insight into the assets and challenges of the unique coastal and market towns and the city.
  • We will differentiate our activity to fit where there are specifically place-based approaches or where there are common themes that can be pulled together for a shared purpose or focus
  • We will work to connect the coastal and markets towns and the city through sharing knowledge, insight, data and approaches to build a mutually supportive network
Our values and behaviours:
  • Co-production is at the heart of the ELF as individuals from individual organisations working together. We also apply this ethos as a collective across Eastern Devon and the LCP, working with neighbourhoods, communities and organisations to achieve our vision.
  • We embrace a federal approach with each organisation across the LCP retaining its independence, identity and uniqueness whilst collectively being part of a larger team which collaborates to identify and address shared purposes and aspirations.
  • We will be transparent and honest between ourselves and in our collective role across the LCP.
  • We believe that the most successful and sustainable ways of maintaining wellbeing and staying as healthy as possible for as long as possible are found in and led by communities.
  • We don’t have all the answers or all the questions. We will be inclusive to ensure any individual, community or organisation can participate, contribute and shape in a way that is meaningful for them
How we will work:
  • We will meet four times a year as ELF and invite community leaders from across the market and coastal towns and Exeter to attend and together we will lead this work.
  • These meetings will provide the opportunity to assess progress towards our vision and the determined priorities across Eastern Devon’s market and coastal towns and Exeter.
  • Meetings will be the opportunity for local communities and leaders to share what works and what doesn’t and highlight the things that they are achieving that could work in other communities.
  • We will host an annual conference giving a broader opportunity to a wider range of individuals and communities to contribute and shape our work across Eastern Devon.

Chairperson’s Report 2021/2022

Chairpersons report AGM May 2021

Well, the past year really has been unique with challenges never faced before! However, in spite of that our Budleigh Salterton Medical Centre has worked hard to rise to those challenges and supported an amazing local Covid vaccination programme. It has been a very difficult time for all at the Medical Centre but they have made the necessary changes to working practice in order to keep both staff and patients safe and we know this is much appreciated.

During the pandemic the Patient Participation Group (PPG) meetings have continued with the aid of “Zoom” and “Teams,” and whilst meetings on screen are not the same as meeting in the same room we continue to work together very well. Through these regular meetings with members of the Medical Centre the PPG continues to actively represent patients in the Budleigh area. Although restrictions mean we cannot communicate so easily with those we represent we have received very positive feedback regarding the vaccination clinics and the care provided from the Medical Centre. It is acknowledged that, whilst the service is not the same as usual, face to face consultations are still available. It would be fair to say that e-Consult receives mixed reviews with several people reporting that they find it lengthy and cumbersome to use but many have found it useful.

Dr. Richard Mejzner retired last Autumn but is still to be seen out and about as he helps with the vaccination programme! The PPG are very grateful to Dr Mejzner for his many years of proactive support for the PPG. Dr Tania Davies now regularly joins our meetings and keeps us up to date with the activities of the Medical Centre as well as giving careful thought and response to any concerns we raise.

Our PPG Newsletter is posted online at the Medical Centre website and in addition many people receive it electronically. Please let the Medical Centre know if you would like to be on the list to receive it this way. We hope it will not be too long now before we can place hard copies of the Newsletter at local venues again, such as the Library.

Recently we have taken the decision to withdraw our membership of the National Association for Patient Participation (NAPP). We have found that NAPP has little or no value for the PPG. We have good working relationships with the Primary Care Network, the Clinical Commissioning Group, RD&E plus the Woodbury, Exmouth and Budleigh (WEB) Community Health & Wellbeing Board and so consider that we are sufficiently well armed with up-to-date information which is pertinent to the patients of the Medical Centre.

Looking to the future there are changes ahead in the way that the NHS interacts with local communities and we will keep abreast of that; in particular the organisations that are being established in support of the programme known as the Integrated Care System. This aims to establish closer working between the NHS, local councils together with the private and voluntary sectors.

We would love to have the younger community in the area represented on the PPG so if you know of anyone who might be interested in joining us please let us know. I am aware that membership of such organisations is well received on University applications!

Please don’t forget that the Medical Centre website holds lots of useful information as well as details of the PPG. We plan to hold health information sessions again as soon as Covid restrictions permit and look forward to seeing you then.

Election and Re-Election of Committee Members for 2021/2022

To continue for a further year in view of the current pandemic and the associated restrictions upon open public meetings. It is hoped that in May 2023 there will be an opportunity for re-election and better population representation.

Appointment of Chairman, Vice Chairman and Secretary for 2021/2022

To continue for a further year in view of the current pandemic and the associated restrictions upon open public meetings.

Any other business

RH advised that Covid Vaccinations are not available through a walk-in centre at the Tesco Superstore in Exmouth every other Monday.

LO would like the PPG to reframe the public opinion of general practice locally.

SL has been in communication with the local MP, Devon CCG and Lloyds Pharmacy regarding the lack of opening from the pharmacies and the fact that Lloyds hold the 2 town licences on the understanding that they are separate businesses. The MP is reviewing the rules and regulations regarding licences.

MM asked is the newsletter was easy for young people to access. SL will speak with the college about how they would best like to receive the newsletter. Currently there is a link to the newsletter from the website to Facebook.

PPG agreed that the PPG Newsletter is received positively by the community.

Meeting Closure

The meeting closed at 1.30pm. A date for the next AGM will be set in due course.


Developing a Local Care Partnership across Eastern Devon

The Shadow Integrated Care System (ICS) Board has requested that there is a plan presented from each of the agreed 5 localities setting out the how they will start to develop a Local Care Partnership.


  • The NHS Long-Term Plan set the ambition that every part of the country should be an integrated care system (ICS) by 2021. It encourages all organisations in each health and care system to join forces, so they are better able to improve the health of their populations and offer well-coordinated efficient services to those who need them.
  • NHS England and NHS Improvement (NHSE/I) set out a consistent approach to how systems are designed highlighting three levels at which decisions are made and described the broad functions to be undertaken at each level:
Neighnbourhoods (Pop circ. 30,000 to 50,000) Served by groups of GP Practices working with NHS community services, socal care and other providers to deliver more coordinated and proactive services through primary care networks (PCNs)
Places (pop. circ 250,000 to 500,000) Served by a set of health care providers in a town or district, connecting PCNs to broader services including those provided by local councils, community hospitals or voluntary organisations.
Systems (pop circ. 1 million to 3 million) In which the whole area's health and care partners in different sectors come together to set strategic dircetion and to develop economies of scale. An ICS is not a legal entry and has no authority and powers other than those afforded it by its constituent sovereign organisations that are the NHS and Local authority (LA) organisations in the area.
  • Since early September shadow ICS arrangements have been in place and the following governance and accountability structures are in place.
  • There is a clear commitment across the county that place arrangements need to be suited to the circumstances and priorities of each place and there will be no centrally imposed governance structure. However, it is important that each place is able to demonstrate that it has the capacity and capability to deliver on its objectives before it’s accountability and budgetary responsibility can be increased. Each LCP has a Development Lead who is co-ordinating and supporting this work.

Learning from COVID-19

  • The Devon system response to COVID-19 has been collegiate; partnership working as been a necessity and been done well, individuals, teams and organisations have had a collective and single purpose for 6 months.
  • Relationships have grown across the system and we have demonstrated that collectively we can move at pace together to changes to the delivery health and care services.
  • The delivery of Phase 3 of response to COVID-19 as set out by NHSE/I requires the system to build further on this collaboration and partnership working within the auspices of ICS.

Place leading the development of place

  • LCPs will lead the delivery and development of services at place level. Their constituent organisations will take responsibility for a range of functions, previously assigned to providers and commissioners to ensure that services meet the needs of the local population and population health is improved.
  • The LCP is an arrangement for joint leadership of multifunctional teams, integrated by a shared plan and objectives, common processes and deployment of joint resources.

The King’s Fund has recently set out the emerging functions and purpose of place:

  1. Developing an in-depth understanding of local communities and neighbourhoods
  2. Working in partnership across multiply agencies to coordinate service delivery
  3. Driving service transformation particularly for community-based services
  4. Mobilising the local community and building community leadership capacity
  5. Making use of local assets
  6. Enabling local organisations to use all of their resources to support health, social and economic development
  • It is recognised that the success of LCPs will be dependent on a wide network of relationships within a local area. Culture and the approach to working together will be as important as the formal structures. Therefore, the membership of the LCP leadership team will be based on local circumstances but should include at a minimum:
    • Local Provider Organisations (Health and Care);
    • PCN Clinical Directors;
    • Local Authorities (officers and elected members) to include social care provision, housing, employment and communities;
    • Public Health leadership;
    • Community, Voluntary and Social Enterprise Sector;
    • Independent Sector.
  • LCPs should also be able to demonstrate clearly how they will work with Health and Wellbeing Boards and Scrutiny Committees.

Existing arrangement at place across Devon

  • The development of informal structures for working at place is at early stage with different approaches and levels of progress in each of the 5 LCP areas. One Northern Devon is perhaps the most developed with partnerships established and delivering collectively on local priorities and connected into the community. The following has supported this:
  • OND has grown organically from existing forums with existing assets at the fore
  • Partners have coalesced around a jointly produced plan – starting at a place that was good enough for the present and then evolved
  • The partnership has evolved collectively and established a Northern Devon identity whilst retaining individual partner identity
  • Established a dedicated resource as an engine room to support progress
  • OND is likely to be a central and driving element of the LCP in Northern Devon
  • Across Eastern Devon the Eastern Locality Forum has been the group bringing together strategic system leaders from across health, care and wellbeing. Work has taken place previously to identify priorities across the Eastern locality alongside Public Health and the Health and Wellbeing Strategy and more latterly a focus on population health management and the development of town profiles. Conversations have also t
  • Despite this, action between meetings has been limited and no overarching plan setting out how the collective purpose is to be delivered or what levers it might need in order to deliver. The group has also not benefitted from a dedicated resource to drive developments and act as an ‘engine room’ to facilitate delivery, the recently developed Eastern Locality Delivery Group is well set to play this role.
  • Given the current membership of the Eastern Locality Forum, its work on the health and wellbeing and population health management agenda, it feels like this forum should play a central role in the development and delivery of an Eastern LCP now that shadow system arrangements have been established this September.

Consideration for ELF

  • To consider what architecture needs to be put in place in the first instance (that will no doubt evolve) that enables the functions and delivery of that set out in Section 3, and what role ELF could play and with what membership to ensure senior decision makers from across Eastern Devon are present but it remains nimble. Other considerations include:
  • What other existing infrastructure is appropriate and already established to support commissioning and delivery e.g. local place boards?
  • A ‘place’ must resonate both with the public and across public service agencies
  • What place architecture alongside ELF support buy-in and support delivery?
  • What is the required future membership of ELF?
  • What are the transformational priorities across Eastern Devon? 5.1.6 What are health and wellbeing priorities across Eastern Devon?
  • What is the scope of the LCPs in addressing the wider determinants or health? COVID-19 has had a comparatively mild impact across Devon, but an impact nonetheless that will be felt for a long period; the livelihoods and wellbeing of many are at risk and the challenges and inequalities seen prior to COVID-19 are now magnified.
  • Would a dedicated and collective resource be required acting as support function/secretariat for Eastern Devon LCP – form and function?
  • An Eastern Devon Local Care Partnership Annual Conference to bring together and engage key organisations and individuals and communities.
  • The ask from the Shadow ICS Board is that there is a plan presented from each of the 5 localities setting out the how they will start to develop a Local Care Partnership.