oxfordshire pct, for oxfordshire voice · however, satisfaction is not directly correlative with...

Influencing local decisions

Oxfordshire PCT, for Oxfordshire Voice January 2010

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1 © 2010 Ipsos MORI.

Contents Executive summary.........................................................................2

Introduction and Methodology.......................................................3

Background and objectives ........................................................................ 3

Methodology............................................................................................... 4

Interpretation of the data ............................................................................ 4

Structure of the report ................................................................................ 4

Influencing local decisions ............................................................6

The ways in which panellists wish to influence........................................... 7

Opinions on local NHS services ............................................................... 11

Areas where influence is desired ............................................................. 12

Things done to influence decisions .......................................................... 14

Having more influence on decisions made by the local NHS ...15

Participation in public life.............................................................19

Recommendations ........................................................................20

Influencing local decisions - NHS Oxfordshire


Executive summary Only an eighth of Oxfordshire panellists agree that they can influence decisions affecting local NHS services (13%), while three fifths disagree (61%). This finding reflects that of the ICM survey.1

However, satisfaction is not directly correlative with influence. Of those who agree that the local NHS provides a good service (75% of Oxfordshire panellists), three fifths disagree that they can influence decisions affecting local NHS services (59%). The main reason cited by panellists for not being able to influence decisions is lack of knowledge on how to do so.

Two-thirds of Oxfordshire panellists would like to influence decisions affecting local NHS services (68%). A third know how to influence decisions (35%) while over half agree that there are not enough opportunities to feedback (54%). A third agree they can influence decisions about their own care and treatment (36%) although three in ten disagree (29%). However, among the one in eight (12%) of those that feel able to influence decisions, three fifths (62%) feel they can influence their own care and treatment, suggesting that influence over one’s personal care and treatment has a high priority when considering perceptions of influence.

Only 7% of panellists agree that the local NHS listens to feedback about their services. Meanwhile, for four of the five statements relating to the use NHS services make of feedback, a significant proportion do not have an opinion. This perhaps suggests that panellists actually don’t know whether feedback is being used or acted upon. Yet, there remains an expectation on NHS services to clearly communicate the results of feedback (67% of panellists agree that if they gave feedback they would expect to hear what happened as a result).

Half or more of Oxfordshire panellists want greater influence over each of the areas listed in the survey, with greater control over GP surgery’s coming out on top (67%). A quarter of panellists have completed a survey or interview about the NHS (27%) and a similar number have been involved in discussions with a healthcare professional about their care and treatment (26%).

Completing a survey also emerges as the top means by which panellists would like to influence decisions (54%), followed by being involved in decisions which will affect services you receive (46%), and being involved in discussions with a healthcare professional about your care and treatment (43%). Methods of encouraging greater involvement are led by ‘feeling that my feedback makes a difference’ with three quarters of panellists responding to this statement (74%).

When it comes to participation in public life, nearly all panellists have voted in local elections in the last couple of years (90%), while two-thirds have voted in a general election (65%). Seven per cent of panellists have taken part in a consultation about local NHS services.

1 Telephone survey conducted by ICM on behalf of NHS South Central



Introduction and Methodology

Background and objectives

Following the finding of a recent survey that only 12%2 of Oxfordshire residents agree that they can influence decisions affecting their local NHS services, Ipsos MORI conducted two discussion groups on behalf of Oxfordshire PCT with local residents3. The discussion groups focused mainly on influence and explored how residents currently feel they influence decisions made by their local NHS, how they would like to influence decisions and if there were any particular services that they would be more keen to influence. The discussions also looked at how local residents could be encouraged to get more involved.

The key findings of the groups showed that participants were unconvinced that their voices are really heard by the NHS and acted upon. They seemed unaware of the degree to which the NHS is keen to consult with them and a number had a narrow ‘definition’ of influence based upon personal benefit rather than benefit to the system as a whole. In order to feel as if they were able to influence decisions, participants firstly felt they needed to see a link between their input and the decision reached and secondly, they wanted to receive feedback how their input was being used, if at all.

A number of recommendations were made to Oxfordshire PCT following the groups which focused upon making the PCT’s consultation process more accessible and transparent. It was recommended that actions taken as a result of feedback should be communicated clearly demonstrating how peoples’ input feeds into the decisions the PCT makes.

Following the discussion groups, Oxfordshire PCT was keen to quantitatively explore the emerging issues in order to achieve a more robust and representative breadth of opinion.

The key objectives for this survey, then, were to explore using a quantitative methodology (via the Oxfordshire Voice Panel):

How panellists currently influence decisions made by the NHS;

What would encourage panellists to get more involved in decisions affecting local NHS services;

The extent to which panellists want to be involved in decision-making;

How panellists would like to be involved in decision-making;

Panellists’ perceptions of what use NHS services make of their feedback;

Specific services that panellists would like more control over.

2 Survey conducted by ICM on behalf of NHS South Central 3 Fieldwork held in July 2009.



Methodology

In summary, the methodology was as follows:

A postal self-completion methodology.

Questionnaires were mailed out to each of the 2486 members of the Oxfordshire Voice panel. A reminder mailing of the questionnaire was sent out three weeks into fieldwork. By the close of fieldwork, 1492 responses were achieved, representing a 60% response rate.

All questionnaires were distributed – and returned - through the UK Royal Mail postal system.

Fieldwork for the survey took place between 3rd November and 4th December 2009.

Interpretation of the data

It should be remembered that a sample of panellists participated in the survey. Therefore, all results are subject to sampling tolerances, which means that not all differences are statistically significant. Crudely speaking, overall results are accurate to +/- 2 to 3 percentage points at the 95% confidence level, but this assumes a perfect random sample has been achieved (in practice, margins of error may be slightly larger). Further information on this, and a full guide to statistical reliability, is provided in Appendix 2.

Where percentages do not sum to 100, this may be due to computer rounding, the exclusion of “don’t know” categories, or multiple answers. Throughout the report, an asterisk (*) denotes any value less than half a per cent, but greater than zero. Where combined scores are used, these may also differ from the sum of individual codes (answers) by one per cent due to rounding.

In addition, results are shown for key demographic sub-groups, where appropriate. Please note that due to the low number of respondents in the 16-24 age sub-subgroup and BME ethnicity subgroup, we are not able to draw statistical comparisons with other relevant sub-groups and will not be commenting on them in the report. Please refer to the body text for reporting of significance.

Where net figures are discussed this is expressed in plus (+) or minus (-) and this refers to the two most favourable ratings minus the two least favourable ratings.

Structure of the report

The report begins with an executive summary that precedes this introduction, which summarises the key findings and implications of the report. The main body of the report will fall into five chapters:

1. Influencing local decisions - This chapter examines the extent to which panellists feel able to influence decisions, how they feel able/unable to influence decisions and the use NHS services make of panellists’ feedback. The chapter also explores how panellists have previously participated in decision making as well as which services they would like to influence.



2. Having more influence on decisions made by the local NHS - This chapter looks at how panellists would like to influence decisions made by the local NHS and which things would encourage greater involvement.

3. About the NHS - This chapter explores the usage of health services and the extent to which the local NHS is providing a good service generally.

4. Participation in public life – This chapter examines panellists’ engagement in public affairs in a number of different ways.

5. Recommendations - A number of recommendations arising out of the key findings for Oxfordshire PCT to consider.



Influencing local decisions

Following the findings of an ICM survey that only one in eight (12%) of Oxfordshire’s residents felt able to influence decisions affecting local NHS services in their area, this question was again asked to clearly establish a baseline level of perceived influence.

One in eight of Oxfordshire Voice panellists agree that they can influence decisions affecting their local NHS services (13%), while 61% disagree with a quarter disagreeing strongly (25%). Although direct comparisons cannot be made due to methodological differences (telephone versus postal/panel), this finding, therefore, reflects the number that answered ‘agree’ to this question for ICM’s survey for NHS South Central (12%).

1% 11%

17%

36%

25%

9%

Influencing decisions affecting NHS services

Neither/nor

Strongly agreeDon’t know

Tend to disagree

Tend to agree

Strongly disagree

Base: 1492 British adults, fieldwork dates: 3 November – 4 December 2009

Q To what extent do you agree or disagree that you can influence decisions affecting local NHS services in your area?

Looking at demographic sub groups, older panellists feel more able to exert influence with nearly one in five panellists aged 65+ agreeing that they can influence decisions affecting local NHS services (19%, compared with 13% overall). Moreover, non-working panellists are eight percentage points more likely to feel they can influence decisions than those employed in either full or part time work (18% compared with 10%).

It appears that satisfaction with local NHS services is not correlative to the level of influence panellists perceive having. Of those that disagree the local NHS provides a good service, a large majority felt unable to influence decisions (81%). However, a majority of those that agree the NHS provides a good service still do not feel they are able to influence decisions (59%), while only 15% of those agreeing the NHS provides a good service also agree they can exert influence over local NHS decision-making.

Panellists who feel that they are able to influence decisions mention writing or complaining to their local MP (15%), speaking with their GPs or medical staff (10%) as ways to do so. Consultations and panels are also cited by panellists as ways to influence local decisions affecting NHS services (mentioned by eight percent) whilst questionnaires and surveys are mentioned by five percent.



15%

10%

8%

8%

7%

5%

4%

2%

Q2 Reasons for feeling able to influence local decisions affecting NHS services

Base: People who agree that they can influence decisions affecting NHS services, fieldwork dates: 3 November – 4 December 2009

Q Why do you say that?

Top Mentions %Writing/complaining to MPs/key people

Speaking with GPs/medical staff

Consultations/public meetings/panels

If enough people complain we have a voice

Campaigns to save local hospitals

Questionnaires/surveys

Petitions

Public demonstrations

The main reason cited by panellists for feeling unable to influence decisions affecting local NHS services is lack of knowledge about how to do so (14%). Other reasons given include the lack of consultation channels (ten percent), decisions being driven by costs (nine percent), made by national government (nine percent) or by NHS local trust managers (4%).



12%

9%

9%

9%

7%

5%

4%

14%

Q2 Reasons for feeling unable to influence local decisions

Base: People who disagree that they can influence decisions affecting NHS services, fieldwork dates: 3 November – 4 December 2009

Q Why do you say that?

Top Mentions %

Don’t know how to influence

No consultations/channels to influence

Decision are driven by costs

Never been asked for my opinion

Decisions are made by national government

One voice would not make a difference

Decisions are made by PCT/NHS local trust managers

Decisions are made without consultation

The ways in which panellists wish to influence

Panellists were asked to what extent they agree or disagree with a number of statements regarding their desired level of influence over decision-making.

I would like to influence decisions affecting local NHS services

Two thirds of Oxfordshire’s panellists would like to influence decisions affecting their local NHS services (68%), with only 6% disagreeing that they would like to exert some influence;

Fewer older panellists agree that they would like to influence decisions compared with panellists overall (62% compared with 68%);

Yet, on the whole, everyone is keen to exert some sort of influence, reflected in the finding that 69% of panellists agreeing the NHS provides a good service would still like influence over decisions affecting local NHS services.

I only want influence over decisions that will directly have an impact upon me

When asked to what extent they agree or disagree with the statement ‘I only want influence over decisions that directly have an impact on me’ (a finding that emerged from the qualitative work), nearly a third agree (29%) with two fifths disagreeing (41%) and a fifth neither agreeing nor disagreeing (19%);

However, amongst panellists aged 16-34 the percentage agreeing rises to four in ten (38%) compared with those aged 65+ who are the least likely to want influence over decisions only affecting them (24%);



Yet, it is those aged 45-54 who are most likely to disagree with this statement (47% compared with 41% overall);

Panellists who are carers are more likely to disagree than panellists who are not (48% compared with 39%).

I would know how to influence decisions affecting local NHS services, if I wanted to

Two fifths of panellists disagree with the statement, ‘I would know how to influence decisions affecting local NHS services, if I wanted to’, with a third agreeing (40% compared with 35%);

The number agreeing with the statement is similar across all age bands, yet age appears to significantly affect levels of disagreement with half of panellists aged 16-34 disagreeing that they would know how to influence decisions compared with a quarter of those aged 65+ (50% compared with 27%);

Of those panellists that agree the local NHS provides a good service, the same number of people agree as disagree with the above statement (37% compared with 38%), again suggesting that the perception of good service is not currently shaped by panellists’ ability to influence decisions.

20

7

13

17

6

7

47

22

23

37

24

29

19

19

14

21

31

22

4

26

23

6

19

21

2

15

17

2

8

8

8

11

11

16

12

13

Influencing decisions affecting NHS services


I would like to influence decisions affecting local NHS services

Strongly agree % Tend to agree % Neither / nor %Tend to disagree % Strongly disagree % Don't know/not stated/

does not apply %

Q To what extent do you agree or disagree with each of the statements listed below?

I only want influence over decisions that will directly have an impact on me

I would know how to influence decisions affecting local NHS services, if I wanted to

There are not enough opportunities to feedback to the local NHS

I do not have time to be more involved in decisions made by the local NHS

I can influence decisions about my own care and treatment

There are not enough opportunities to feedback to the local NHS

Over half of panellists agree that there are not enough opportunities to feedback to the local NHS, with only one in ten disagreeing (54% compared with 9%);

There are key geographical differences in relation to this statement, with 59% of panellists in West Oxfordshire agreeing compared with 48% of Oxford City panellists;



A majority of those who agree that the local NHS provides a good service still agree that they do not have enough opportunities to feedback (53%).

I do not have time to be more involved in decisions made by the local NHS

A similar number agree as disagree with the statement, ‘I do not have time to be more involved in decisions made by the local NHS’ (30% compared with 27%), and the same amount neither agree nor disagree (31%);

Those between the age of 35-44 are most likely to agree they do not have time, compared with the 65+ panellists who are least likely to agree (37% compared with 21%);

However, there is little variation by age among those who disagree with this statement.

I can influence decisions about my own care and treatment

When asked if they can influence decisions about their own care and treatment, a third of panellists agree they could with three in ten disagreeing (36% compared with 29%);

Again, there are geographical differences, with higher numbers of panellists in South Oxfordshire and West Oxfordshire disagreeing with this statement compared with Oxford City panellists (34% and 33% compared with 23%);

Three fifths of those that feel able to influence decisions affecting their local NHS services agree that they can influence decisions about their own care and treatment (62%), and two fifths of panellists who agree the local NHS provides a good service feel the same (42%), suggesting that influence over one’s personal care and treatment has a high priority when it comes to influencing NHS decision-making.



Opinions on local NHS services

Panellists were also asked the extent to which they agree or disagree with a number of statements about the perceived use that is made of feedback to the local NHS.

With regard to all the statements for this question, with the exception of ‘If I gave feedback to the NHS…’ a large proportion of panellists do not have an opinion. This suggests that panellists actually don’t know whether feedback is being listened to or acted upon.

My local NHS listens to my feedback about NHS services

Only 7% of panellists agree that the local NHS listens to feedback about NHS services, with a quarter disagreeing (24%);

A further quarter neither agree nor disagree (26%);

Those who disagree the local NHS provides a good service are less ambivalent, with 60% disagreeing that the local NHS listens to feedback.

1

1

9

26

2

6

4

21

40

5

26

24

21

10

19

16

15

7

9

14

8

10

3

3

8

43

46

40

12

51

Opinions on local NHS services


My local NHS listens to my feedback about NHS services

Strongly agree % Tend to agree % Neither / nor %Tend to disagree % Strongly disagree % Don't know/not stated/

does not apply %

Q And to what extent do you agree or disagree with each of the statements listed below?

My local NHS acts on my feedback about NHS services

My feedback makes no differences to NHS services

If I gave feedback to the NHS, I would expect to hear what had happened as a result

When I do give feedback to the NHS, I do hear what happens as a result

My local NHS acts on my feedback about NHS services

A similar minority of panellists agree that the local NHS acts on feedback about services (5%), with, again, a quarter disagreeing (25%);

Those unhappy with the service provided by the local NHS are again most unequivocal in their disagreement, compared with panellists overall (67% compared with 25%).



My feedback makes no difference to NHS services

Three in ten agree that feedback makes no difference to NHS services (29%), while a tenth disagree (11%);

A fifth neither agree nor disagree (21%);

Younger respondents are significantly more likely to answer don’t know or not stated (53% compared with 40% overall) suggesting this age group has the least experience of feeding back on local NHS services.

If I gave feedback to the NHS, I would expect to hear what had happened as a result

Two thirds agree that they would expect to hear what had happened as a result of the feedback they had given (67%) compared with a tenth who disagree (11%);

Agreement is highest among those aged 55-64 (73%) and lowest among 16-34 year olds (61%).

When I do give feedback to the NHS, I do hear what happens as a result

Only 7% agree with the statement ‘when I do give feedback to the NHS, I do hear what happens as a result’. A quarter (23%) disagree;

A fifth of panellists neither agree nor disagree (19%);

Groups that are more dependent on support from local NHS services are more disenchanted with how local NHS services communicate what has been made of feedback: panellists with a disability and panellists who are carers are more likely to disagree that they hear what happens as a result of their feedback compared with panellists overall (34% and 29% compared with 23%);

Furthermore, the number disagreeing with this statement doubles among those who disagree that the local NHS provides a good service (50%).

Areas where influence is desired

When asked which areas panellists would like to have more influence over, the highest mention was the ‘service offered by my GP’ (67%) followed by ‘my own personal care and treatment’ (62%). Half or more also mention which services are provided at ‘my local hospital’ (56%) ‘decisions about how NHS services should be delivered in my area’ (53%), and ‘decisions about which services should be provided by the NHS in Oxfordshire’ (50%). 5% of panellists say they do not want any more influence.

Panellists aged 45-54 are more likely to want influence over all of the above areas than panellists overall.



67%

62%

56%

53%

50%

6%

5%

4%

Areas where influence is desired


My own personal care and treatment

Q Looking at the list below, which areas, if any, would you like to have more influence over?

The service offered by my GP surgery, for example, opening times

Decisions about which services should be provided by the NHS in Oxfordshire

Other

I don’t want to influence any decisions

Don’t know

Decisions about how NHS services should be delivered in my area, such as discussion about making more services

available in your local community

Which services are provided at my local hospital



Things done to influence decisions

Of the things panellists have done to influence decisions made by the NHS, a quarter have completed a survey or interview about the NHS (27%) and a similar number have been involved in discussions with a healthcare professional about their treatment (26%). One in eight (13%) have complained about an NHS service and a similar proportion (12%) have written or spoken to a local NHS organisation. Over a third of panellists have done none of the things specified in the survey (37%). As suggested previously, panellists with a disability and panellists who are carers appear more likely to try and influence decisions, with higher than average proportions for both groups answering to all of the things mentioned.

27%26%

13%12%

7%6%6%

4%7%

37%6%

Things done to influence decisions


Written or spoken to your local MP about the NHS

Q Which of the following things, if any, have you done to influence decisions made by the NHS?

Written or spoken to a local NHS Organisation

Completed a survey or interview about the NHS

Been to an event run by the NHS

Been to a community event, where the NHS was present

Complained about an NHS service

Being involved in decisions that affected the services you receive, such as providing services nearer to your home

Been involved in discussions with a healthcare professional about your care and treatment

Other

None of these

Don’t know



Having more influence on decisions made by the local NHS

As well as gauging the extent to which Oxfordshire panellists feel able to influence decisions regarding a range of services, the survey also asked how panellists would like to be more involved and which things might encourage them to become so.

Over half of panellists would like to complete a survey about the NHS (54%) while just under half would like to be involved in decisions which affect the services they receive (46%). Two fifths would like to be involved in discussions with healthcare professionals about their care and treatment (43%), while a further two fifths would like to write or speak to a local NHS organisation (39%). A quarter would like to write or speak to their local MP (24%) and a fifth would like to complain about an NHS service (20%).

For each of the methods of influencing decisions outlined in the question, those that already feel able to influence decisions are proportionally higher than panellists overall. In other words, it is those who are already engaged who are keener to influence decisions in the future.

54%46%

43%39%

24%20%

17%16%

8%5%6%

How to influence decisions


Write to or speak to your local MP

Q How, if at all, would you like to influence decisions made by the NHS?

Write to or speak to a local NHS organisation

Complete a survey or interview about the NHS

Going to an event run by the NHS

Going to a community event where the NHS is present

Complain about an NHS service

Being involved in decisions which will affect services you receive, such as providing services nearer to your home

Being involved in discussions with a healthcare professional about your care and treatment

Other


Don’t know

When asked ‘which of the following, if any, would encourage you to get more involved in decisions affecting local NHS services’ three quarters of panellists mention ‘feeling that my feedback makes a difference’ (74%). Three fifths feel the local NHS telling them what they are doing as a result of feedback would encourage them to get more involved (60%) with a similar number stating that ‘understanding how a decision may affect healthcare services in my area’ would do so (56%). Also, half say the decision directly affecting the care or treatment of their family (50%) or themselves (49%) would encourage them to get more involved. Knowing how to get involved is also mentioned by a third of panellists (30%).



For the first two statements (see following chart), those aged 45-65 are more likely to respond compared with panellists aged 65+, when enthusiasm for these modes of encouragement drops off. For statements relating to ‘understanding how a decision affects health services locally’, ‘decisions directly affecting family care or treatment’, and ‘decisions affecting personal care or treatment’, younger people (16-34) are more likely to be encouraged to get more involved compared with panellists overall.

74%60%

56%50%

49%30%

4%4%

3%

Encouraging greater involvement in decision-making


Feeling that my feedback makes a difference

Q Which of the following, if any, would encourage you to get more involved in decisions affecting local NHS services?

Other


Don’t know

The local NHS telling me what they were doing as a result of my feedback

The decision directly affecting my own care or treatment

The decision directly affecting the care or treatment of my family

Understanding how a decision may affect healthcare services in my area

Knowing how I can get more involved



About the NHS Panellists who use local NHS services more regularly are often more likely to want to be engaged in decision-making as well as often possessing higher expectations of the services they receive. When asked, ‘which of the following health services, if any, have you personally used in the last couple of years or so?’ a vast majority mention having visited an NHS GP (90%). Half have been an outpatient at an NHS hospital (51%) while two fifths have visited a dentist (42%). Around a third of panellists have either contacted their pharmacist for advice (36%), contacted NHS Direct for advice (34%) or attended an A&E department (32%). A quarter have been an inpatient (24%) while a fifth have used the GP out of hours service (21%). 15% have used a Minor Injuries Unit or a First Aid Unit.

90%51%

42%36%34%32%

24%21%

15%3%1%

Health service usage


Been an inpatient at an NHS hospital

Q Which of the following health services, if any, have you personally used in the last couple of years or so?

Been an outpatient at an NHS hospital

Attended an Accident and Emergency Department

Visited an NHS GP

Used a GP out of hours service

Visited an NHS dentist

Used a Minor Injuries Unit or a First Aid Unit

Contacted NHS Direct for adviceContacted your pharmacist for advice

None of theseDon’t know

In order to measure the baseline satisfaction of Oxfordshire panellists with local NHS services, panellists were asked to consider the extent to which they agree or disagree that their local NHS is providing them with a good service. Three quarters of panellists agree that they are being provided with a good service (75%), while only 7% disagree, with 14% neither agreeing nor disagreeing. The implication of this finding is that while people want more influence, the perceived lack of it does not lead directly to dissatisfaction with the overall standard of services the local NHS is providing.

Agreement is highest among young people (83%) and lowest among 45-54 year olds (although 68% still agreed), while geographically, panellists of Oxford City are more likely to agree the local NHS is providing a good service (80%) compared with Vale of White Horse and West Oxfordshire panellists (72% for both).



18%

58%

14%

6%3%

Attitudes towards the standard of local NHS services

Neither/nor

Strongly agree

Don’t knowTend to disagree (2%)

Tend to agree

Strongly disagree


Q To what extent do you agree or disagree that your local NHS is providing you with a good service?



Participation in public life Panellists were asked to indicate whether or not they have participated in public life in a number of different ways. Nearly all panellists have voted in local elections in the last couple of years (90%) and two thirds have voted in a general election (65%). A quarter of panellists have written to their MP or local councillor about an issue (27%), while fewer have take an active part in a local campaign (15%) or have made a speech before an organised group (13%). Seven per cent of panellists have taken part in a consultation about local NHS services.

90%

65%

27%

15%

13%

7%

Participation in public life


Voted in a general election

Q Which of the following things, if any, have you done in the lastcouple of years?

Voted in local elections

Written to your MP or local councillor about an issue

Made a speech before an organised group

Taken an active part in a local campaign

Taken part in a consultation about local NHS services

Women are more likely to say they have voted in a general election (70%) compared with men (60%), as are those aged 35-44 (72% compared with 65% overall). Higher proportions of 45-54 and 55-64 year olds claim to have made a speech before an organised group in the last couple of years (20% and 18% respectively, compared with 13% overall), while residents of Oxford City are ten percentage points more likely than panellists overall to have written to their MP or local councillor about an issue (37% compared with 27%).



Recommendations Emerging from the survey, then, are a number of key findings that can be channelled into a set of recommendations that Oxfordshire PCT may wish to consider. Many of these recommendations reiterate those made following the qualitative work in July 2009, as the themes that came out of the discussion groups appear to have been given greater weight by this survey. The majority of panellists perceive they are unable to influence decisions affecting local NHS services in their area, yet an equally high majority would like to. A significant proportion do not know how to feedback, while a majority feel there are not enough opportunities to feedback. There is, therefore, a willingness to engage on the part of panellists but the findings suggest it is not easy enough for them to do so. Greater and more widespread advertising of consultations or opportunities for public involvement in decision-making, which outline the key role members of the public will be asked to play, is a possible method of stimulating engagement. Further surveys/interviews may wish to be considered, as well as providing opportunities for discussions with healthcare professionals.

There is a wide gap between expectation and experience on the issue of hearing back from the NHS after feedback has been given. Therefore, it may be of some value to advertise the findings of consultations and public engagement using posters and/or easily accessible summary reports, as well as clearly communicating, again through advertising, the important input of the public when decisions have been made, and the influence the input has had.

The report has shown that Oxfordshire Voice panellists more dependent on the local NHS health services, such as panellists with a disability or residents who are carers, are often more eager to be engaged but, equally, are more disenchanted with the use local health services make of their feedback.

Nevertheless, as has been commented on throughout the report, perception of influence is not correlative with satisfaction with services overall, as three quarters (75%) of panellists agree that the local NHS is providing them with a good service.



Appendix 1 – Survey Questionnaire

The first section of this questionnaire asks about your views and experiences with your local health services. We are interested to know how much influence you feel you have locally on the decisions and direction taken by your local health services and how you might want to get more involved, if at all. Q1. To what extent do you agree or disagree that you can influence decisions

affecting local NHS services in your area? Please tick one box only

Strongly agree ............................................ Tend to agree ............................................. Neither agree nor disagree......................... Tend to disagree......................................... Strongly disagree........................................ Don’t know.................................................. Q2. Why do you say that?

PLEASE WRITE IN BELOW

DECISION MAKING IN YOUR LOCAL HEALTH SERVICES



Q3. How, if at all, would you like to influence decisions made by the NHS? Please tick all that apply

Write to or speak to your local MP.............. Write to or speak to a local NHS

organisation ................................................

Complete a survey or interview about the NHS............................................................

Going to an event run by the NHS.............. Going to a community event where the

NHS is present ...........................................

Complain about an NHS service................. Being involved in decisions which will

affect services you receive, such as providing services nearer to your home .....

Being involved in discussions with a healthcare professional about your care and treatment .............................................

Other (please tick the box and write in below).........................................................

I don’t want to influence any decisions ....... Don’t know.................................................. Q4. Which of the following, if any, would encourage you to get more involved in

decisions affecting local NHS services? Please tick all that apply

Feeling that my feedback makes a

difference....................................................

The local NHS telling me what they were doing as a result of my feedback ................

The decision directly affecting my own care or treatment ........................................

The decision directly affecting the care or treatment of my family ................................

Understanding how a decision may affect healthcare services in my area...................

Knowing how I can get more involved ........ Other (please tick the box and write in

below).........................................................

I don’t want to influence any decisions ....... Don’t know..................................................



Q5. To what extent do you agree or disagree with each of the statements listed

below? Please tick one box only for each row

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Don’t know/does not apply

I would like to influence

decisions affecting local NHS services ......................

I only want influence over decisions that will directly have an impact on me .........

I would know how to influence decisions affecting local NHS services, if I wanted to .........

There are not enough opportunities to feedback to the local NHS...................

I do not have time to be more involved in decisions made by the local NHS ........

I can influence decisions about my own care and treatment .............................

Q6. And to what extent do you agree or disagree with each of the statements

listed below? Please tick one box only for each row

Strongly agree

Tend to agree

Neither agree nor disagree

Tend to disagree

Strongly disagree

Don’t know/does not apply

My local NHS listens to my

feedback about NHS services ...............................

My local NHS acts on my feedback about NHS services ...............................

My feedback makes no difference to NHS services ..

If I gave feedback to the NHS, I would expect to



hear what had happened as a result ............................

When I do give feedback to the NHS, I do hear what happens as a result .............

Q7. Looking at the list below, which areas, if any, would you like to have more

influence over? Please tick all that apply

My own personal care and treatment ......... The service offered by my GP surgery, for

example, opening times..............................

Which services are provided at my local hospital

Decisions about which services should be provided by the NHS in Oxfordshire

Decisions about how NHS services should be delivered in my area, such as discussions about making more services available in your local community ...............


I don’t want to have any more influence ..... Don’t know.................................................. Q8. Which of the following things, if any, have you done to influence decisions

made by the NHS? PLEASE TICK ALL THAT APPLY

Written or spoken to your local MP about

the NHS......................................................

Written or spoken to a local NHS organisation ................................................

Completed a survey or interview about the NHS......................................................

Been to an event run by the NHS............... Been to a community event, where the

NHS was present........................................

Complained about an NHS service............. Been involved in decisions that affected

the services you receive, such as providing services nearer to your home .....

Been involved in discussions with a healthcare professional about your care and treatment .............................................




None of these ............................................. Don’t know.................................................. Q9. Which of the following health services, if any, have you personally used in

the last couple of years or so? PLEASE TICK ALL THAT APPLY

Been an inpatient at an NHS hospital......... Been an outpatient at an NHS hospital....... Attended an Accident and Emergency

Department.................................................

Visited an NHS GP ..................................... Used a GP out of hours service.................. Visited an NHS dentist................................ Used a Minor Injuries Unit or a First Aid

Unit .............................................................

Contacted NHS direct for advice ................ Contacted your pharmacist for advice ........ None of these ............................................. Don’t know / can’t remember ...................... Q10. To what extent do you agree or disagree that your local NHS is providing

you with a good service? Please tick one box only

Strongly agree ............................................ Tend to agree ............................................. Neither agree nor disagree......................... Tend to disagree......................................... Strongly disagree........................................ Don’t know..................................................



Q11 Which of the following things, if any, have you done in the last few years?

Please tick all that apply Voted in a general election ......................... Voted in local elections............................... Written to your MP or local councillor

about an issue ............................................

Made a speech before an organised group ..........................................................

Taken an active part in a local campaign ... Taken part in a consultation about local

NHS services..............................................

oxfordshire pct, for oxfordshire voice · however, satisfaction is not directly correlative with...

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