FOUNDATION IN ENGAGEMENT FOR HEALTH AND SOCIAL CAREAmanda Murrell

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

• Your name

• Your role and organisation

• Why you came along today

Introduction

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

Different Aspirations...

17

How are you perceived?...It is important if we want people to engage with us.

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

Thank you and Feedback Forms

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.