foundation in engagement for health and social care amanda murrell
TRANSCRIPT
Fire exits and facilities
Please silence your Blackberry’s, i-Phones etc during the session
Documentation
Workshop will last 2.5hrs Comfort break halfway through
Housekeeping
Agenda• Purpose of today’s workshop• Background
– Principles/values for good engagement/participation
– Definition of consultation and engagement– Changing landscape/culture– Transforming participation in Health and Care /
NHS Constitution guidance– Duty on NHS to Engage with patients, carers
and the public when redesigning or reconfiguring healthcare services, and demonstrating how this has informed decisions.
– Stakeholder management and the seldom heard– The Ladder of participation– The importance of feedback– Working in collaboration to improve the process
• Breadth not depth
Task 1:
-Thinking about standards or principles for effective participation what
do you think they might consist of?
- What do you think are the most important elements to consider? -What do you think might be potential barriers to effective participation?
Pre-Prep WorkStandards/principles for good engagement/participation
15 Mins
Principles of Participation
Taken from: NHS England - Transforming Participation in Health and Care pg29
• Relationships will be conducted with equality and respect. • Listen/truly hear what is being said. • Proactively seek participation from communities with the greatest health inequalities and poorest health outcomes.• Use all the strengths and talents that people bring to the table.• Respect and encourage different beliefs and opinions.• Recognise, record and reward people’s contributions. • Use plain language, and openly share information. • Understand what’s worked in the past, and consider how to apply it to the present and future. • Have a shared goal and take joint responsibility for the work. • Take time to plan well. • Start involving people as early as possible.• Give feedback on the results of involvement.• Provide support, training and the right kind of leadership to work, learn and improve together
Pre-Prep WorkValuesTask 2:This task is designed to explore the NHS values as set out in The NHS Constitution: the NHS belongs to all of us (pg 5).
1. Think of a time when you were asked for your opinion – what was good about it?
2. Did you feel that your views were valued? -What made you feel valued? -If you did not feel that your views were valued why not?
3. What do you feel are the greatest challenges in ensuring that people feel valued and that their opinions matter?
Discuss within your groups
15 Mins
NHS ValuesPatients, public and staff have helped develop this expression of values that inspire passion in the NHS and that should underpin everything it does. Individual organisations will develop and build upon these values, tailoring them to their local needs. The NHS values provide common ground for co-operation to achieve shared aspirations, at all levels of the NHS.
Taken from: The NHS Constitution p5
1. Working together for patients
2. Respect and dignity
3. Commitment to quality of care
4. Compassion
5. Improving lives
6. Everyone counts
What is the definition of Engagement?
What is the definition of Consultation?
Engagement is the actions and processes taken or undertaken to establish effective relationships with individuals or groups so that more specific interactions can then take place.
Courtesy of The Consultation Institute
Consultation is the dynamic process of dialogue between individuals or groups, based upon a genuine exchange of views, with the objective of influencing decisions, policies or programmes of action Courtesy of The Consultation Institute
https://www.youtube.com/watch?v=8CSp6HsQVtw (6.31)
The following video by The Kings Fund demonstrates the complexity of the NHS
Importance of effective engagement in a changing landscape...
Huge changes in NHS in England since April 2013The abolition of Primary Care Trusts (PCTs) The abolition of Strategic Health Authorities (SHAsThe introduction of Clinical Commissioning Groups (CCGs) The introduction of Healthwatch England
By law NHS organisations must involve patients/public/citizens in the design and development of new initiatives and any substantial development or variation in provision, commissioning (the process of specifying, securing and monitoring services to meet people’s needs at a strategic level) and decommissioning a service.
Engagement activity is a must, not an option, now and for the future.
Commissioners (those that specify, secure and monitor services to meet people’s needs at a strategic level) of services should ensure that contracts for the provision of services should include a requirement to carry out appropriate engagement activity.
Involvement in service decisions benefits patients, the public and staff.
Health and Social Care Act 2012Patients and carers to participate in planning, managing and making decisions about their care and treatment through the services they commission.
The effective participation of the public in the commissioning process itself, so that services reflect the needs of local people.
... which introduces new S. 14Z2 to the NHS Act 2006 - Entitled “Public Involvement & Consultation by Clinical Commissioning Groups”
Duties
Equality Act 2010
Legally protects people from discrimination in the workplace and in wider society. It replaced previous anti-discrimination laws with a single Act, making the law easier to understand and strengthening protection in some situations. It sets out the different ways in which it’s unlawful to treat someone.
Guidance• Transforming Participation in Health and Care• NHS Constitution
The Gunning Principles 1985
When proposals are still at a formative stage
Sufficient reasons for proposals to permit ‘intelligent consideration’
Adequate time for consideration and response...must be conscientiously taken into account(Courtesy of The Consultation institute)
Influencers - Judicial Reviews
- Social Media Instant communications Reaching a wide audience
- Modern relationship management- High relevance to public engagement- Previously done informally- Increasingly professionalised
Key Stakeholders/General Public(What is the difference?)
A new discipline....
Test 1: Who is directly impacted by this decision?
Test 2: Who is indirectly impacted...?
Test 3: Who is potentially impacted...?
Test 4: Whose help is needed to make the decision work?
Test 5: Who knows about the subject?
Test 6: Who will have an interest in the subject?
The Six Tests
…for identifying Key Stakeholders
By kind permission of The Consultation Institute
‘Seldom- heard’ Individuals/Communities...
Human Beings must respect one another in all their diversity of belief, culture and language
• Don’t expect groups to fit in with your needs.
• Target appropriate method for group.
• Innovative approach.
By kind permission of The Consultation Institute
Perception of the NHS
Ten ways to improve patient involvement in the NHS
Guardian Professional article by Bob Hudson –– 1st May 2014 - Hand-out
People should be “not mere consumers of services but genuine and active partners in designing and shaping their care and support”.
1. Coordinate existing forums2. Empower elected foundation trust
governors3. Real public engagement in NHS
commissioning4. A patient congress in every CCG
locality5. Proper support for Patient Reference
Groups6. Deeper understanding of the patient
experience7. Open up the invisible quangos8. Promote and enforce the NHS
constitution9. Strengthen and fund local
Healthwatch10. Reinvigorate local government
interest
infl
uen
ce
low high
high
Plotting Stakeholders – The Stakeholder Matrix...How do you identify stakeholders? What format do you use if any?
By kind permission of The Consultation Institute
interest
infl
uen
ce
lo hi
Manage with care
Need help!
Low priority
Top priority
hi
Managing Stakeholders...
By kind permission of The Consultation Institute
Consider which of your stakeholders sit in each quadrant. You can then identify how to deploy the appropriate resource to manage these. Especially when time, funding and staff are limited.
Group TaskIn your groups decide who the stakeholders might
be for a change in the Diabetes service.
Using the A4 copies of the stakeholder matrix as a
draft working document start to plot them on the
Matrix depending in your opinion of their level of
interest/influence for this change.
Discuss in your groups and come to a consensus as to
where they should be plotted on the A3 matrix.
Then be prepared to feedback to the whole group.
15 Mins
Potential Stakeholders
• Patients• Resident Groups• General Public• Voluntary Sector• Local Authority• Healthwatch• Clinicians• CCG’sWho else?
• NHS Staff;• Clinical Leaders• Chief Officers• Care Trust CE’s• NHS England• Directors of Nursing• Allied Health
Professionals
Who else?
• EmpoweringEmpowering: placing decision-making in the hands of
the community.
• CollaboratingCollaborating: working in partnership with
communities in each aspect of the decision, including
the development of alternatives and the identification of
the preferred solution.
• InvolvingInvolving: working directly with communities to
ensure that concerns and aspirations are consistently
understood and considered. For example, partnership
boards, reference groups and service-users
participating in policy groups.
• ConsultingConsulting: obtaining community feedback on
analysis, alternatives and / or
decisions. For example, surveys, door knocking,
citizens' panels and focus groups.
• InformingInforming: providing communities with balanced and
objective information to assist them in understanding
problems, alternatives, opportunities, solutions. For
example, websites, newsletters and press releases
The Ladder of Citizen Engagement
and Participation
Group TaskThink about what dialogue methods you would use to engage with your stakeholders from the previous exercise.
Using the large A3 examples of the ladder of participation:
1.Transfer your stakeholders from the previous exercise onto post it notes and place them where you think they might be on the ladder of participation.
2.Then write on post it notes the various dialogue methods you might use to engage and place them next to the stakeholders.
Group activity followed by peer challenge and dialogue about gaps.
15 Mins
Ingredients for Effective Engagement...The key ingredient to successful engagement is planning well in advance and preparation
The right people General public, gatekeepers, key stakeholders
Ask the right questionsAppropriate, technical/non technical, jargon, plain English, options, overall coherence
The right methods Range, suitability, flexible, accessible, costs/resources
At the right time Before decision is made, when it will help, avoiding holiday periods
Providing feedback
OutputWho said what?
Two stage process
OutcomeWhat we intend to do with what we’ve heard
‘We must put citizen and patient voice absolutely at the heart of every decision we take in purchasing, commissioning and providing services.’
(Tim Kelsey National Director of Patients and Information, NHS England - Transforming Participation in Health and Care pg27)
Summary
• Providing good quality information
• Offer a range of opportunities to participate
• Work with patients and public from the initial planning stages
• Proactively reaching diverse communities
• Working with each other• Equality and respect
• Listen and truly hear what is being said
• Proactively seeking participation
• Plain language and open sharing of information
• Utilise strengths and talents that people bring
• Working well together• Understand what has worked well and use those approaches
• Have shared goals and take joint responsibility for our work
• Take time to plan well
• Give feedback on the results of involvement
Taken from Transforming Participation in Health and Care pgs. 29, 33, 34
Other PPP workshops Engagement through commissioning cycle
Empowering citizens and patients to participate
Foundation in Engagement for Health and Care
How to measure the impact of engagement on the ground
North West London
Friday 14th November, 0930-1230 Venue tbc.
Thursday 22nd January, 1730-2030 venue tbc.
Thursday 12th March, 1430-1730 Venue tbc.
Thursday 9th October 0930-1230St Paul's Centre, Queen Caroline Street, London, W6 9PJ
North East London
Monday 13th October, 1430-1730Professional Development Centre, 229 Bethnal Green Road, E2 6AB
Thursday 4th December, 1730-2030Venue tbc
Tuesday 20th January,0930-1230 Venue tbc.
Wednesday 18th February, 1430-1730 Venue tbc.
South West London
Thursday 19th February, 1430-1730 Venue tbc.
Wednesday 15th October, 1730-2030, Antoinette Hotel, 249 – 263 The Broadway, WimbledonSW19 1SD
Thursday 20th November, 1430-1730 Venue tbc.
Wednesday 14th January, 0930-1230 Venue tbc.
South East London
Monday 19th January, 0930-1230 Venue tbc.
Tuesday 10th March, 1730-2030 Venue tbc.
Tuesday 23rd September,0930-1230, Xenia, 2 Secker Street, SE1 8UF
Thursday 6th November, 1430-1730 venue tbc.