Peer review reports
The aim of a Peer Review Visit is to increase the learning for the host PCT to enable them to progress their work on access to primary care.
2010 Peer Review Visits
NHS Bristol ‘Deep Dive’ pilot review, 26th November 2010
NHS Bristol hosted a rapid ‘deep dive’ review of its Diabetes Care Pathway from a race equality perspective on the 26th November 2010.
The review was action focused, interrogative but supportive, with the aims of:
- Identifying what is working in the care pathway
- Identifying gaps in the care pathway
- Providing key action points in how to strengthen and clarify the care pathway to influence the way Diabetes support services are provided and commissioned in Bristol for the benefit of BME service uses.
The review team comprised a Shared Intelligence facilitator, a Race for Health Thinking Partner and an external peer with an in-depth knowledge of the Diabetes Care Pathway.
The methodology included background research, a mapping session – to map race equality within the patient pathway, and a day on site to interview key staff, clinicians and service users. The review will culminate in a summary report and action plan which will be published once agreed by NHS Bristol.
Liverpool PCT RfH Peer Review, 19th – 20th October 2010
Liverpool PCT’s RfH peer review took place on the 19/20 October 2010. Liverpool PCT agreed to focus the peer review on the overarching research question: ‘How can Liverpool PCT encourage and support services across the city to improve oral (and wider) health outcomes for BME communities?’ This was the first RfH review with a focus on oral health. We brought together a mixed and experienced review team for the review, who worked together well. The peer team was able to take away lessons for themselves and their own organisations as well as contributing to the findings and recommendations for the PCT. The report is now with the PCT for comment.
Kent and Medway RfH Peer Review, 30th June - 2nd July 2010
Kent and Medway NHS and Social Care Partnership Trust hosted a Race for Health peer review in June/July 2010 – the first for a Mental Health Trust. The review was chaired by Melba Wilson, National Programme Lead - Mental Health Equalities for the National Mental Health Development Unit (NMHDU). We brought together a highly experienced and diverse review team for this review which also included service users. It was the largest team that we have brought together and we used a slightly extended review timescale to adapt to the extensive geographical coverage of the Trust.
The focus of the review was partnership working across Kent and Medway with the key themes of commissioning/partnerships, community engagement, membership and communication. It was a very interesting, enjoyable and intensive review for all involved. The outcome paper has been sent to KMPT and Sue, Melba and Helen held a conference call with the Chief Executive of the Trust to discuss the key findings. The paper is due to go to KMPT’s E&D Committee at the end of November and will be available on the Race for Health website once it has been agreed by the Trust.
The pilot mental health peer review was very well received from peers. Analysis of the results of the online evaluation revealed that peers felt the length of the review, the content and the size of the team was right. We have received some very useful suggestions for improvements, which we will take on board in future planning. Comments left by peers included:
“Thank you all, it was a very rich experience. It has informed my thinking and inspired me”
“As a peer reviewer I found it a valuable exercise”
“Just to say thanks for letting me join in what I think is a really helpful exercise for both the reviewed and the reviewers”
“I would persuade any eligible organisation that I work for in the future to join the programme. I think it was a really useful chance to reflect on my own practice.”
24-25 February 2010 - NHS Bristol
NHS Bristol hosted a Peer Review in February. The theme was to explore:
How can NHS Bristol ensure that local BME-led voluntary, community and social enterprise organisations have the opportunity and ability to participate in its tendering processes?
2-3 February 2010 - NHS Leeds
The theme of NHS Leeds’ peer review , hosted on 2-3 February 2010 was
The Peer Review team was split into three working groups during the Review and was asked to explore the research questions through three focus areas of work. Two groups explored different commissioning models and how Race Equality has been taken into account within these models. The third group explored with Commissioners their understanding of the systems that the PCT has in place to embed equality and diversity in commissioning practices.
2009 Peer Review Visits
21-22 January 2009 - NHS Westminster
NHS Westminster hosted a Race for Health (RfH) Peer Review on 21st and 22nd of January 2009. Peer reviews are used within the Race for Health programme to share learning and good practice between PCTs, and support the host PCT to identify areas of improvement and subsequent actions in order to make those improvements. The review focused on ensuring health services address the complexities of a diverse and changing population.
Westminster faces a number of unique challenges:
It has a very challenging population. The borough’s daytime population can quadruple due to visitor numbers. The borough has a very diverse and transient population;
NHS Westminster has large secondary and tertiary providers where change leverage can be challenging;
The PCT is part of strategic alliances. This offers additional challenges around delivering on equalities, due to the different equality challenges faced by partner PCTs;
The PCT is required to deliver equalities in the context of its commissioning relationship with Imperial College Academic Health Science Centre (AHSC);
- The PCT has not in the past given the equalities agenda the priority it has now.
10-11 March 2009 - Hastings and Rother PCT
NHS Hastings and Rother hosted a Race for Health (RfH) Peer Review on 10th and 11th of March 2009. Peer reviews are used within the Race for Health programme to share learning and good practice between PCTs, and support the host PCT to identify areas of improvement and subsequent actions in order to make those improvements.
This review focused on ensuring health services address the complexities of a diverse and changing population. As a relatively new member of Race for Health, NHS Hastings and Rother PCT wished to ensure that its approach to World Class Commissioning would deepen and embed its approach to improving the health and well being of BME communities in the district.
The PCT asked the Peer Review Team to focus on the support Commissioners can give Providers in both General Practice and Community Services to identify BME groups and address their needs - a central part of the PCT’s approach to World Class Commissioning.
The PCT also wished to consider further accountability mechanisms to ensure that Providers are delivering best practice and that Commissioners have the appropriate mechanisms in place to promote their statutory duties on equalities as part of the WCC process.
15-16 October 2009 - NHS Norfolk
NHS Norfolk hosted a Race for Health (RfH) Peer Review on 15th and 16th October 2009. Peer Reviews are used within the Race for Health programme to share learning and good practice between PCTs, and support the host PCT to identify areas of improvement and subsequent actions in order to make those improvements. NHS Norfolk’s Peer Review focused on ensuring that the Equality and Diversity agenda is an integral part of NHS Norfolk’s organisational culture.
2008 Peer Review Visits
22nd January 2008 - Liverpool PCT
Having joined the RfH programme in 2007, this will be Liverpool PCT’s first review. It will focus on the needs of BME service users with Severe Mental Illness (SMI). In particular, we will be looking at three specific conditions: schizophrenia, bipolar and psychosis, as well as the process the PCT has gone through to assess the needs of these patients and how this has been used to inform the decisions of mental health commissioners.
9th April 2008 - Leicester City PCT
Leicester City PCT hosted a Peer Review visit on the evening of 9th April and all day on April 10th 2008. The aim of the visit was to increase the learning for the host PCT to enable them to progress their work. The theme of the Peer Review was Targeted Interventions.
15th May 2008 - Ealing PCT
Ealing PCT hosted a Peer Review visit entitled 'Race Equality and Cardiovascular Health' on the evening of 15th May and all day on May 16th 2008. The aim of the visit was to increase the learning for the host PCT to enable them to progress their work.
8th September 2008 - Luton Teaching PCT
Luton Teaching PCT hosted a Peer Review visit on the evening of 8th September and all day on 9th September 2008. The theme of the Luton PCT’s peer review was resident engagement, both in accessing local health provision and contributing to the way the PCT commissions and delivers health services.
The Race for Health programme aims to be flexible and adaptable to meet the needs of individual Pacts, especially for new joiners to the Race for Health programme. As such, the focus of Luton PCT’s peer review was on providing developmental guidance and support, with less of a focus on actual reviewing of its systems.
10-11 December 2008 - Suffolk PCT
NHS Suffolk hosted a Race for Health (RfH) Peer Review on 10th and 11th of December 2008. Peer reviews are used within the Race for Health programme to share learning and good practice between PCTs, and support the host PCT to identify areas of improvement and subsequent actions in order to make those improvements.
The theme of NHS Suffolk’s review was developing cultural competencies of staff in order for the PCT to build and sustain effective relationships with BME communities and community leaders.
The purpose of this outcome paper is to highlight the issues that were covered during the course of the review, and present the main finidngs and recommendations from the peer review team.
2007 Peer Review Visits
24th January 2007 - Bristol PCT
The review will focus on the customer service experience of Black and Minority Ethnic people, looking at how existing services/process currently respond to patient concerns and also to comment and advise on a proposed new service currently being designed. The review team will be asked to address the following questions; using the ‘patient journey’
28th February 2007 - South Birmingham PCT
South Birmingham PCT has focused its Race for Health work on developing the curriculum and learning access routes to deliver a new kind of support worker (para-professional) to operate in the NHS. Working initially with children and family services only, but now with older people services too, the aim of these workers is to enable the PCT to offer more culturally appropriate support services to BME families, by confronting the difficulties they experience when accessing and utilising health services.
South Birmingham PCT aims to use the learning obtained from the development of para-professionals to inform the development of practice based commissioning, an approach which is being piloted in the Selly Oak area of Birmingham with a group of GPs. The PCT also hopes to improve the application of evidence to allow the targeting of individuals, groups and communities where access and utilisation is poor.
30th April 2007 - East Berkshire PCT
Health Activists are a mechanism that have been employed by two of the former PCTs (Slough and Windsor, Ascot and Maidenhead) to increase access to health services among BME communities and other disadvantaged groups. Having worked in partnership with Berkshire College and Thames Valley University to develop the role, the Health activists were originally funded in 2000. Since then,
their role has grown significantly, and the review will examine what progress has been made in this area, particularly in the area of older people’s services.
20th September 2007 - Wolverhampton City PCT
In line with the performance indicators for the programme, the key questions for the peer review team were around:
- how well is the PCT tackling equality gaps in service outcomes?
- is there parity in public confidence levels and service satisfaction
- has the PCT’s work resulted in measurable improvements in
- are BME communities adequately represented in all levels of the PCT’s workforce?
- is there parity in employee satisfaction levels and experiences?
In addition, the PCT asked for specific support from peers around their diabetes work, and asked the team to consider the following questions:
- How do individuals from BME Groups who are diagnosed with diabetes receive culturally appropriate education?
- How reflective of the population is the take up of supportive services for diabetes from BME groups?
- How does ongoing diabetic care, support and education contribute to:
- the health and wellbeing of BME groups?
- the diabetic stability of BME groups?
- What data/information do commissioners have access to and use to inform the needs of BME groups in relation to diabetes?
- What evidence base supports the care pathways for diabetic care and BME groups?
19th November 2007 - Haringey Teaching PCT
The review will focus on two key areas – workforce issues, including progression and satisfaction among BME staff, and the use of Equality Impact Assessments on the PCT’s new 10 year Primary Care Strategy, which have been used to identify whether its implementation would limit access to primary care services for particular population groups and consider how these effects could be mitigated.
2006 Peer Review Visits
7th February 2006 - Lambeth PCT
The focus for the review was on how successful Lambeth Primary Care Trust is at collecting, recording, analysing and using ethnicity monitoring information (EM).
22nd February 2006 - Wandsworth Teaching PCT
The theme for the Peer Review was: how successfully is Wandsworth PCT communicating its race equality agenda to its staff, partners and the communities it serves, and is this being translated into more effective service commissioning? Are the ‘messages sent’ the ‘messages received’, and are people aware of progress made on the ground?
21st March 2006 - Shropshire County PCT
The theme for the Peer Review was: how effectively is Shropshire County PCT (SCPCT) collaborating with its local partners around race equality, particularly through the mechanism of the LSP and the new Equalities Forum? Is the partnership-working on race equality perceived to be adding value by those involved, and by BME communities themselves? What has been achieved to date?
13th September 2006 - Central Manchester PCT
The thematic focus for the Review consisted of three interlinked aspects:
- Is CMPCT designing a commissioning strategy that will meet the needs of all communities in Manchester?
- How effectively is CMPCT engaging with Black and Minority Ethnic (BME) communities in the development of the strategy?
- Is CMPCT effectively using the information sources that it has to inform its commissioning strategies?
6th November 2006 - Bradford and Airedale Teaching PCT
The theme for the Peer Review was: how can the newly formed Bradford and Airedale Teaching PCT enhance Black and Minority Ethnic patient engagement with diabetes care, as it interfaces with both Primary Care and the family?
2005 Peer Review Visits
12th July 2005 - Ealing PCT
The aim of the visit was evaluate how well the PCT provides access to primary care for Black and Minority Ethnic Communities; and to provide practical suggestions on areas for development and how future services should be structured, such as the proposed new walk-in centre.
14th September 2005 - Eastern Leicester PCT
The focus of the visit was on Commissioning using Mental Health Services as a case study. The visit encouraged the PCT to have an open discussion with their stakeholders about how they progress their services. Peer reviewers were asked to speak to stakeholders and to draw up a basic guide or framework to assist them in the future. An outcome paper is available below.
7th December 2005 - Westminster PCT
The thematic focus for the Review consisted of two interlinked aspects:
- The effectiveness of community engagement, with a specific focus on mental health services; and
- How feedback from community engagement can inform commissioning strategies within the PCT, and support promotion of race equality through ‘managing the market’.