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Archive for January, 2015

Care Quality Commission GP Inspection and Patient Participation Groups

An Ideal Report of a Meeting With PPG Representatives during A CQC GP Practice Inspection

Prior to the meeting a phone call with the Chair will have taken place to express appreciation for being willing to attend. Also confirmation about who will be there.

On the day:-

Good afternoon everyone. I’m ….. and  you are? Shakes hands with each by name.  I’m sorry for the delay but it’s been difficult to keep to our schedule today. Would you like to follow me – we are going to use one of the GPs consulting room.

Proceed to the room

As I said I am……. I’ve been a CQC inspector for ……. and previous to this present role I was working as…… This is my ….n…th GP Practice inspection.

Tell me a bit about yourselves and how long you have been a part of your PPG

We really do value the time and effort which PPGs put in to enable Medical Centres to reflect the needs of its patients and so I’m glad to have this opportunity to meet with you today. Your participation and comments matter to us in this inspection.

Your practice manager has given me some documentation about your PPG. I have some minutes of some previous meetings and some other documents and I know you have had a short meeting of PPG  members to prepare for our discussion.

Before we chat about the work of your PPG I wondered if you had seen our document ‘A guide for working together’ which sets out the ways in which  PPGs can work with the CQC. It is available on line but its a long document and your Practice Manager would be glad, I know, to photocopy  it for you. We recommend using the guide as you prepare our agendas for action.

Some questions for you:-

It would be good to hear your views about your PPG and how you think things are going.

What progress do you think the Medical Centre has made over the last year?

Does the Practice encourage you to suggest any improvements and changes in its work and how have they responded to what you have suggested?

What work has the PPG planned for this current year? Have you considered including these issues…….?

Are there any special changes which you think the Centre might make this year?

Is there anything else you would like to tell me?

If you wish to add anything else confidentially you can, do so on our web site.

Well thanks for giving me this opportunity to listen to you. We realise that you are volunteers and I know that the Centre really appreciates the time and effort you have given to its work and I know that your responses today will be of value to the inspectors as they make their report.

Shakes hands with all and they are shown out.

What actually happened?

No contact made with the Chair or anyone beforehand.

No apology for keeping us waiting 15 minutes.

No explanation who this inspector was or what qualified him for doing the job.

No knowledge of us or names or used them during the meeting.

Hadn’t seen any documentation about our PPG and asked if we kept minutes etc.

When he was told that it wasn’t clear what CQC documentation he was referring to, we were told we could look on line for it, if we wanted to see it. Actually it emerged later that we did know about the documentation.

Did not sufficiently guide us into dealing with his specific criteria for inspection.

He asked about the worst features of the Centre!

Didn’t express appreciation for what we were doing as volunteers.

LGBTs and Ageing

The Best of Times is Now?

Getting older doesn’t have to be the worst of times and for many it isn’t so, but when we are labelled as being a problem for society, or, at the very least, as an urgent issue to be faced, then we are demeaned and our huge potential ignored.  We are worth more than that. When we view ageing positively and with an accompanying forceful sense of equality there is a chance that we can be viewed not just as a valuable asset but also essential.

Being old is not just a matter of exhibiting the physical changes of longevity, it is also a mindset which can be present in all age groups and can have harmful effects. In his book ‘You’re Looking Very Well  – the surprising nature of getting old’  Lewis Wolpert, suggests that those who are younger, and have a positive attitude towards ageing, actually go on to live longer. Dr Sharon Horesh Berqquist, an assistant professor of medicine at the Emory University School of Medicine, recently suggests that internalising ageist stereotypes is actually harmful to one’s health and that pro-ageing thinking can help you live longer; can reduce disability; can help you practice prevention; can boost your memory; and can help your heart.

Thus what is true for all of us has got to be true for the LGBT community. So away with the stereotypes of ageing found in the LGBT media and with those lists which seem to suggest that it is only the LGBTs of young and middle ages who have the influence, and let’s instead celebrate the graceful maturity of those who are older, with their good looks, their wisdom, their sexiness, their fathomless fund of experience, and, even for many, their significant material resources; and let us do it without being patronising either. Let us take on board the fact that, like straight society, we numerically powerful  and  have the potential to make the world and, especially the LGBT community happier and more dynamic. What might this mean?

We have history on our side. We know in depth just what it means to be ostracised and discriminated against. Indeed we bring into the present a baggage of rejection, and the memory and scars of those experiences have stayed with us. How glorious then, at Pride events hearing people shouting out ‘Thank you’. However our history must not lead to merely creating memorials, it should be a living force for facing the present and a tool for planning the future. Every LGBT organisation should have elders on its management committees, certainly not to instil caution, but to ensure that decisions are made using the widest possible knowledge and thus avoiding mistakes created by an inadequate understanding of our past.

We also have skills to offer which have been attained from a lifetime of activity in a whole variety of occupations and experiences. This does not have to mean that we know it all or that we have nothing to learn, indeed those who offer that kind of approach, whatever their age, are a huge hindrance to real progress. A data base of LGBT seniors with a variety of management and experiences skills would surely be a significant advantage to businesses and organisations which seek to serve the LGBT community and beyond.

One area where such expertise would be valuable to many is that of social care. There are two ways of meeting the social care needs of LGBT people, both young and old. One lies in raising the awareness of all those working in the field about LGBTs and their needs, with a view to ensuring that the care provided is both inclusive and empathic. Another would be to work towards creating discrete and exclusive LGBT services, as in residential care homes or services for the mentally ill, so that there is no danger of discrimination or exclusion and that the care provided is expertly focussed. There are already examples of such projects both in the USA and in mainland Europe. LGBT seniors with experience and training qualifications have a huge amount to offer in meeting both objectives  but it should be a given that where specifically LGBT services are planned there should never be planning without the active and numerically strong involvement of those at the receiving end of such services. Older LGBTs in numbers should be in the forefront of all such groups and organisations where such planning takes place. No decisions about us, without us, and also without a feeling of tokenism. Either way there is a growing understanding that LGBT elders have social care needs which it cannot be assumed will be satisfactorily met by non-LGBT providers and, to avoid facing this issue would be a major failure by the LGBT community.

The existence of social care assumes the presence of a community though we are increasingly living in a world where communities are fragmenting leading to an increase in loneliness, especially amongst the elderly. LGBT Pride events fortunately still reflect feelings amongst us that we are all in it together and surely such feelings should continue to be fostered. The magnificent story of LGBT care for those with AIDS has still to be told in its fullness – it is an inspiring story and shows to the world how we can be galvanised into being a force for caring for those of us in need. Being older for the LGBT person carries with it many of the same experiences of isolation of all elderly people but it could be argued that the loneliness is greater for us being in a relatively small, and often invisible community.  Intergenerational activities and projects already provided by some LGBT organisations show evidence of the benefits  for  the elderly in reducing isolation, giving a renewed sense of belonging, expanding the horizons of LGBT culture, and providing a safe space where LGBT elders can be themselves . The advantages for the young can be similarly huge in providing mentoring, advocacy, training for the creation of sound and stable relationships, and the protection of vulnerable younger people.

Finally it has to be acknowledged that there is still a need to campaign for the rights of LGBT people in all departments of life. Older LGBTs are often skilled and experienced as activists and have much to offer in situations where discrimination occurs, and probably feel more secure about doing it too. Much still needs to done to raise the awareness of organisations, local communities and charities concerning the unique needs of older LGBTs and even, in some situations, of their very existence.  The creation of a national forum for LGBT seniors would do much to ensure that no senior LGBT person would experience discrimination or lack of inclusivity without it being confronted.

So do we matter? You bet your life we do! Will the lives of younger LGBTs be enriched through involvement with us? Absolutely yes! The best of times for our whole LGBT family can be now if we have the will to make it so.

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