working together towards better participation in health

www.scottishhealthcouncil.org

Working Together Towards Better Participation in Health Services


Emotional Touchpoints

A visual way of helping people share their experience.

Can be used to engage and consult with people as

well as to evaluate/improve service.

Let’s give it a go:

1) Think about your last experience with health

services and select an ‘emotion’ card which best

describes how you feel/felt.

2) Tell the group what card you have chosen and

describe your reason behind choosing that card.


The Scottish Health Council • The NHS Reform (Scotland) Act 2004

created a legal duty on NHS Boards to

involve patients and the public in planning

and developing health services

• The Scottish Health Council was

established in 2005 to promote Patient

Focus and Public Involvement within the

NHS.

• A Committee of Healthcare

Improvement Scotland

• A local office in every NHS Board area and

a National office based in Glasgow.

• Our role is to improve how the NHS involves

people in decisions made about health

services.


What do we do?

Scottish Health Council

Supporting local patient and community

organisations to be involved in the

planning and delivery of health services.

Support Health Boards to

continuously improve their PFPI practices

and methods

Monitor how Health Boards involve patients and the

public in planning and delivering

services

Government guidance on

engaging people in service change and development in the NHS (CEL 4 2010)

Dedicated Service Change team to

support Boards in applying the

guidance


Guidance & Drivers

Informing Engaging Consulting

http://www.nhsaaa.net/pchc/namwm2.aspx


Why Should You Be Interested?


Why Involve People?

What are the benefits of Participation?

Person Centred:

• Promotes patients and public views

• Improves communication and understanding

• Shared decision making and better services.

Equitable:

• Reducing non-attendance for appointments

• Improving patient experience

Timely:

• Involving service users to improve patient pathways to

get the right service at the right time is a key benefit.


Why Involve People?

Safe:

• Improves hand hygiene promotion

• Reducing rates of healthcare associated infections

Effective:

• Empowering patients with greater knowledge

• Improving access and choice

• Improving staff and patient satisfaction

Efficient:

• Getting it right first time by involving patients is sound

business practice and a key measure of efficiency.


Risks of Not Involving People

• Services don’t meet the needs of patients

• Patients cannot access services as don’t

understand them (lack of information)

• Disengagement with services

• Apathy and mistrust

• Protests

• A rise in complaints/campaigns

• Exaggerated media coverage


What reasons might there be to

change services?

• Patient feedback

• Demographic changes

• Workforce

• Patient safety

• Land and buildings

• National policy and standards

• Financial

• Integration etc, etc


Scottish Government Guidance

Informing, Engaging and Consulting-CEL4 (2010)

• Covers all types of service change, including pilots,

contracted services, regional and national arrangements

• Sets out process and general principles for NHS Boards to

follow

• Approach taken should be proportionate to the level of

service change proposed

• Specific requirements for major changes – formal public

consultation, Scottish Health Council report, Cabinet

Secretary approval

• Independent Scrutiny Panel for some major changes


Additional within the CEL 4

• The duty of public involvement covers all

Health Boards

• Equality Impact Assessment of process and

proposal

• Option appraisal

• Governance arrangements

• Focus on evaluation


Key stages in process

Planning Informing Engaging

Consulting Board

meeting Ministerial approval


Scottish Health Council Role

• for all changes: advice and support with:

– developing involvement and communication plan

– involving and supporting people throughout the

process

• for major service changes: all of the above plus:

– quality assuring process as it develops

– assessing process and reporting to Boards

and Ministers


Guidance principles

• Engage people at the outset of service review

• Engagement must be inclusive and

transparent

• Process must be robust

• Approach taken should be proportionate to

the level of service change proposed


Paragraph 37 of CEL 4 (2010)

An inclusive process should encourage and

stimulate discussion and debate.

While it may not result in agreement and support for

a proposal from all individuals and groups, it should

demonstrate that the NHS listens, is supportive and

genuinely takes account of views and suggestions.

Ultimately, Boards should demonstrate that there

has been a wide ranging consultation, which has

taken all reasonable steps to take account of

differences of view.


Recent service changes

• Lightburn Hospital, NHS Greater Glasgow and

Clyde

• Clinical Services Review, NHS Greater Glasgow

and Clyde

• Primary Care Out-of-Hours, NHS Lanarkshire

• Centre for Integrative Care, NHS Lanarkshire

• Old Age Psychiatry, NHS Lanarkshire

• Health and Care Services on Mull and Iona, Argyll

and Bute


Participation Review Function

• Our Participation Review function examines

how NHS Boards are involving people in

services.

• Using the Participation Standard, they collect

systematic, comparable information on how

NHS Boards engage with patients and the

public.

• Supporting NHS Boards to use the

Participation Standard to improve the way

they work with patients and the public.


Participation Network

The Participation Network is based on the

premise that sharing knowledge benefits

everyone.

Key aims include:

• A gateway service for NHS Boards to share

good practice and develop new approaches to

involving people.

• Influencing the development of national policy.

• Producing standards and guidance


Participation Toolkit

A collection of 32 tried and tested

tools for effective public

engagement.

Helps to support the delivery of

PFPI activities.

Local Officers can deliver tailored

training sessions on some of the

tools to support your work.


What do you want to do?

• Leaflets, Exhibitions, Written documents, Focus groups, Public Meetings

Inform - Giving Information

• Questionnaires, Surveys, Emotional Touchpoints, Patient diaries, Users’ panels

Engage – getting information

• Process mapping, Public meetings, World Cafe, Remote Services Future Game

Consult – ongoing engagement and dialogue

• Planning for real, Citizens’ juries, Electronic voting, Ask me 3, Teachback

Empower – partnership working

• After Action Reviews, Patient diaries, Mystery Shopping, Citizens’ juries

Evaluate – review of process


Patient Diaries


What are they?

• Patient diaries are a record of events throughout a

patient’s healthcare experience.

• Patient diaries can include information on:

- events, timings and actions.

- comments about feelings relating to the experience

(what went well/could be better).

- personal emotions about the disease, staff attitudes,

the environment etc.

• Patients or carers can be offered different options for

completing a diary

• It’s a useful technique to look at the detail of the patient

and/or carer's view of a service.


Why use them?

• Information from returned diaries can be used to

identify emerging themes.

• Themes can be shared with a range of services

covering the patient journey and across

organisational boundaries.

• Learning from experience should influence service

improvement and redesign.

PROs

Flexible method which can be adapted.

Useful for recording patient journey through

different services.

People have control over the information they

provide.

But,

The representativeness

of the findings will

depend on the quality of

the recruitment process


Step 1: Purpose and plan

What has prompted the use of patient diaries, how will

patients be selected and how will patient feedback be used?

Draft plan to identify responsibilities, resources and timescales.

Step 2: Design and pilot diary format.

Find the right format and questions

Test out diary

Step 3: Recruit patients to complete diary

If possible, ask people in person, and provide information on the

project, discuss how people want to get involved and how patient

feedback will be used.

Step 4: Running the project

Allow sufficient time and provide support.

Obtain consent and maintain confidentiality.


More Participation Tools

• e-Participation Toolkit

• Evaluating Participation

Toolkit

• Patient Participation

Groups Guides

VOiCE

Analyse

Plan

DO

Review

http://www.scottishhealthcouncil.org/patient__public_participation/e-participation/idoc.ashx?docid=1c6a9577-ae09-4e13-8beb-720f4479d00a&version=-1

http://www.scottishhealthcouncil.org/publications/research/idoc.ashx?docid=3ec535a0-41a7-40f8-bfd7-9162f8ac301b&version=-1


Local examples of our work

• Provide support and assistance to St Vincent's

Hospice to establish a Community Voices Group in

line with their Participation Policy.

• Support Public Involvement Forums to develop and

improve via our PPF Network.

• Gather views from members of the public to ensure

these views influence health services eg, Scottish

Government National Review of GP Out of Hours

Services.

• Provide proactive and tailored support for NHS

Boards using tools developed by SHC and others eg

Specialist Children’s Services.


How Can We Work Together? Here are some ways the Scottish Health Council

can support you:

• Provide a range of approaches for sharing information and

engaging with members of the public.

• Share relevant resources and information including the

Participation Toolkit.

• Assist with communication and evaluation tools to support

development.

• Link to relevant networks and organisations.

• Highlight good practice from colleagues across Scotland.

• Provide practical support with facilitation of focus groups

and meetings, carrying out surveys and evaluating patient

engagement activities.


Future areas of work...

Whole

System

Approach

to

Listening


Further information

Visit our website:


Contact our Greater Glasgow

and Clyde local office:

44 Florence Street

Glasgow

G5 0YZ

Tel: 0141 429 7545

Email: [email protected]

Follow us on Twitter: @SHCGlasgowClyde

http://www.scottishhealthcouncil.org/

mailto:[email protected]


Tell us what you thought!

working together towards better participation in health

Documents