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Dundee Health & Social Care Partnership
Participation and
Engagement Strategy
Ensuring that the voices of the citizens of Dundee are heard and recognised and listened to, to improve the quality and delivery of health
and social care services.
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Table of Contents
Page No
1.0 Introduction 3
1.1 Principles 6
1.2 Landscape 7
2.0 Section 1 – Supporting Participation & Engagement 9
3.0 Section 2 - Learning from Each Other 12
4.0 Section 3 - Hearing Stories 13
5.0 Section 4 – Governance 14
6.0 Implementation Plan 15
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Introduction
This strategy outlines how Dundee Health and Social Care Partnership (the
Partnership or “we”) will ensure that the those who use health and social care
services in Dundee, their families and carers (”you”), will remain at the centre of
participation and engagement relating to the work of the Integration Joint Board
(the IJB).
We committed to understanding the needs of the different communities in
Dundee. This strategy recognises that meaningful engagement and participation
with you requires us to take into account your individual and collective
characteristics in particular the protected characteristics of age, disability status,
ethnicity, gender/sex, religion/belief, sexual orientation and transgender
identity. In Dundee we are committed to reducing inequalities which arise
because of socio-economic status. In Dundee we will aspire to embrace the spirit
of co-production, which has the following ambition:
“No one is more equal than anyone else” Scottish Co-Production Network
We recognise that you are key partners in improving your own health and
wellbeing, and reducing health inequalities. We support the vision of Integration
described by “Our Voice” where:
“People who use health and care services, carers and the public will be enabled to
engage purposefully with health and social care providers to continuously improve
and transform services”.
To do this, we will create genuine opportunities for engagement which build on
existing practice and structures as well actively seeking opportunities for
innovation and change. This will contribute to a partnership with you that
supports the following:
• We will work with you, supporting you to feel that you are at the centre
and have ownership of services that you access;
• We will work with you to co-produce efficient and effective services that
meet individual and locality need;
• We will work with you to create opportunities that build on and
contribute to the assets of local communities;
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• We will work with you to ensure you are involved and contributing to key
strategic decision making structures, making your voices part of our
governance arrangements.
Everyone who is involved in the delivery of health and social care, regardless of
who employs them, and whether they are paid or unpaid, has a key role to play in
ensuring full participation and engagement. This will be embedded into
everyday practice and is not an “add-on” to the work that we do.
Participation and engagement is not achieved by stand alone pieces of work such
as surveys, one off consultations, or attendance at meetings. It is an ongoing
process that demonstrates the commitment to hearing and listening, recognising
and acting on the voices, stories, contributions and ideas of people to improve
pathways and outcomes for the health and wellbeing of communities in Dundee.
It is fundamentally about creating the conditions for an open and honest
dialogue that leads to and supports trust, confidence and respect.
Our strategic priorities are set out in the Strategic and Commissioning Plan,
which will be agreed after consultation, in March 2016. These priorities are as
follows:
1. Health Inequalities
2. Early Intervention/Prevention
3. Person Centred Care and Support
4. Carers
5. Localities and Engaging with Communities
6. Building Capacity
7. Models of Support/Pathways of Care
8. Managing our Resources Effectively
How we listen to and include you as equal partners will be key to achieving these
priorities. Putting your voices at the heart of decision making will ensure that
outcomes improve over time.
We will work closely with you to identify the ways that you want to be involved
in, and contribute to, decision making. This will include engagement at all stages
of the Commissioning Cycle i.e.:
• Planning
• Doing
• Reviewing
• Analysing
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We are committed to building on successes whilst remaining an exemplar of
good practice and innovation; using new and emerging tools, techniques and
approaches that support excellent and meaningful participation and
engagement. Dundee will remain cutting edge.
We will work with communities and organisations, including those with whom
we commission, in order that a shared understanding of the principles of
participation and engagement is reached. Partner organisations will be
supported to show commitment to these principles which is evident in the way
that their services are delivered.
We recognise the ongoing good work already in place and look forward to
opportunities for increased learning from each other.
This is an ongoing and evolving document and will be reviewed to be concurrent
with the Strategic and Commissioning Plan.
Progress made and milestones achieved will be reported back to the IJB through
the Integrated Strategic Planning Group.
An implementation plan accompanies this strategy. This sets out actions to be
taken forward over the period of the Strategic and Commissioning Plan (2016 –
2021). It will be this implementation plan which will form the basis of future
reporting to the IJB and our broader participation and engagement partners.
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1.1 Principles
These are based on those contained within the National Community Engagement
Standards and have been adapted after local consultation. The principles:
• Give a clear message of our intentions
• Set expectations and guide our practice
• Set a mutual context and understanding of our approach to participation
and engagement
• Support embedding of principles of engagement in the way we do things
Dundee Health and Social Care Partnership – Principles of Engagement
1. We will use a variety of ways to engage to make sure that everyone is involved
2. We will make sure that those who provide services and support to people in
Dundee are involved. This will include all staff including those from the third
sector, the private sector and unpaid carers and volunteers.
3. We will build on what we already know works.
4. We will let people know what difference their involvement has made as soon as
possible.
5. We will develop ways to measure the differences engagement and participation
has made, linking these to what we have already said we will do and what
people have told us is important to them.
6. We will make sure that staff are confident, well trained and are able to engage
with communities, service users and their carers.
7. We will make sure that local communities, carers and service users are
supported to feel confident and able to engage with us.
8. We will make sure that the IJB can measure the difference that engagement is
making and keep improving, by evaluating our activities to improve our
practice and outcomes.
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1.2 The landscape of participation and engagement
National legislative and policy context includes:
Public Bodies Joint Working (Scotland) Act
Community Empowerment (Scotland) Act
Patient Rights (Scotland) Act 2011
NHS Reform Act (Scotland) 2004
Chief Executive Letter (CEL) 4 (2010) Informing, Engaging and Consulting people
in developing health and community care services
Chief Executive Letter (CEL) 8 (2012) - Guidance on Handling and Learning from
Feedback, Comments, Concerns and Complaints about NHS Health
Our Voice –
Listen, Learn Act, (National Education for Scotland)
Public Sector Reform Act
Carers Strategy
The Participation Standard for the NHS in Scotland
Ways this happens locally include:
Community Learning and Development Strategy
Pan Tayside Communications and Engagement Framework (April 2015-April
2016)
Local Community Planning Partnerships Plans & Structure
Dundee Partnership Community Engagement Model
Voluntary Sector Networks & Forums
Private Providers Forum
NHS Tayside Public Partners
Public Reference Group
Care Group Strategic Planning Group Engagement plans and mechanisms
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What does this mean for the Strategy?
This strategy sits within, and contributes to, the implementation of a well
developed local and national framework. It does not replace any of these but will
add value to existing methods of participation and engagement, and support
seamless connections between these.
As much of the local guidance is still emerging, the strategy will be sufficiently
flexible to respond appropriately to this continually evolving landscape.
Areas for further development
As a result of a review of the above landscape and the existing work, the
following sections have been identified as priorities to support our maturing
participation and engagement. These sections have been identified as being key
to adding strength and depth to existing relationships. It is recognised that this
work is not exclusive and that other activities will be taking place; the strategy is
not intended to constrain innovation.
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2.0 Section 1 - Supporting Participation and Engagement
You have a unique contribution to make in shaping, improving and developing
health and social care service. You are the “experts” by experience, bringing
skills, qualities, knowledge and life experience. You live in families and
communities, and have common or shared experiences and as such know the
strengths of your communities and where the assets and opportunities lie.
How will we support meaningful participation and engagement?
Co-Production at the Centre
A continuum of participation and engagement exists. This strategy recognises
that different types of engagement are appropriate depending on the individual
situation. However the integration of health and social care services gives us the
opportunity to shift the balance more towards co-production and to allow
services and communities to develop tests of change which help us make co-
production “the norm”.
Co-production is at the centre of integration. Co-production is about engaging
people (patients, service users, citizens and staff) in the planning and design of
services, in assessing their own needs, and deciding which supports would best
meet those needs.
Co-delivering is about the way that services are undertaken and delivered so that
they enable you to make the best use of, and further develop, your own strengths
and assets, and those of your local communities, to improve the health and
wellbeing of yourself and others.
Implementing co-production and co-delivery requires a genuinely different and
creative change in perspective. This change is one that moves from a “narrow”
health and social care technical fix, to one that puts co-production or outcomes at
the centre of the integration agenda. It requires people and communities to be
treated as equal co-producers of outcomes, and the rethink of the use of
organisational resources so that they complement and support the development
and use of individual and community assets.
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The ladder of participation has become a well recognised model to describe the
journey towards co-production. It sets out the stages of participation moving
from a stage of ‘doing to’ to ‘doing with’. While the practice currently varies
across the different agencies our current practice for the integrated partnership
would indicate that we are generally currently sitting within the ‘doing for’ area
of the ladder.
Information:
We will provide Dundee citizens with the information they need to:
• Maintain and improve their own health;
• Make the best use of available services;
• Contribute to service development and improvement.
This will be supported by the Pan Tayside Communication and Engagement
framework and by the work of the Communication and Engagement Sub Group
Dundee.
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Involvement at all levels:
We will involve you throughout your journey of care and all stages of planning.
This will include involvement in relation to planning for your own care, how
services and supports are delivered in your local communities, and how services
and supports are commissioned for the whole City. You will be supported to be
involved. We will ensure that people from all backgrounds are involved and that
everyone has an equal opportunity to participate.
We will ensure that you are involved as equal partners in your own care. We will
actively seek to hear feedback about your care and services in order to make
improvements and learn from your experiences. This will be done within
existing legislative and policy frameworks.
Services will involve and include you at a local level, by linking with existing
locality and engagement structures. You will be supported to choose what the
best mechanism for you is. By strengthening the links with and helping to build
the capacity of these engagement groups the IJB will ensure that the full range of
different voices are heard.
We will ensure that you are fully involved in developing, monitoring and
reviewing Commissioning Strategies by ensuring that each of the Strategic
Planning Groups has its own Engagement Framework.
This practice will contribute to and inform developments across Tayside and at a
national level, with Dundee continuing to be noted as an exemplar of best
practice.
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3.0 Section 2 – Learning From Each Other Together
We aspire to embody a learning organisation which continuously transforms
itself by expanding its capacity to change and evolve and “where people are
continually learning to see the whole together”. (Peter Senge 1990)
We will create the conditions where the following areas become the “learning
norm” across the organisation.
Tests of Change – Experimentation
We will continue to use tests of change to produce incremental gains in
knowledge. We will support the development of a culture where it is
acknowledged that there is permission to create innovative ways to include and
involve you. We will seek to capture the learning from these tests of change in
order to learn from these as widely as possible.
Learning from Past Experience
We will make best use of feedback received by ensuring that learning is shared
across the organisation and beyond. We will learn from what has worked well
and from what could have been done better and will share this learning with
others.
Learning from others
We will continue to widen the range of those with whom we engage, making sure
that we actively seek contribution and involvement from those whose voices are
less likely to be heard. Engagement will be purposeful and will contribute to
achieving the wider outcomes of the Integration body. This will mean that we
develop learning from:
• engagement with individuals
• engagement with communities
• examples of best practice across the City
• practice and developments outwith Dundee
Sharing knowledge and learning
We will ensure that the broad range of methods, tools, models and examples of
participation and engagement, and the learning from this, are captured in what
will emerge as a “virtual” Toolkit. You will be encouraged to contribute to this
and to make active use of the resources captured. As well as using existing
methods of communication such as e-mail, newsletters, e-briefings etc, we will
explore the use of social media such as Facebook and Twitter to create a
platform for engagement and participation. We will build on the existing shared
approach to learning and development that ensures formal and informal
opportunities to learn from each other are accessible to all.
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4.0 Section 3 – Hearing Stories
Stories are an incredibly rich, powerful but underused source of information.
They bring to life issues that really matter to people, in their own words.
“There is evidence that, when they are properly gathered and used, personal stories
empower storytellers. People who share their experience, and know how the
learning from their stories has been applied, feel that they have been positively
involved in service development and improvement. Organisations that use stories to
improve services develop a culture of participation and a reputation for listening
and acting upon what they learn.” (NES – Listen Learn Act)
How are we going to hear stories and how will we act on them?
We will support people to tell their stories. We will set expectations for how
they will be heard. Staff, citizens, their families and carers will have a common
understanding of these expectations. We will create a safe and supportive
environment in which people can have their stories heard.
We will create a range of opportunities for more people to tell us their stories
including making better and safe use of social media such as Facebook and
Twitter (via the on-line toolkit referred to above). We will also use these
platforms to share information.
Before we share stories we will ensure that the story teller and the story sharer
have a joint understanding of what that story is telling us and how it can
contribute to service redesign.
We will be clear about how we are going to use the information people give us in
their stories ensuring that the principles of confidentiality, consent, dignity and
respect are core to this.
We will have a clear route by which stories can be fed into existing planning and
improvement mechanisms.
We will ensure that support is available to story tellers and those listening to
their stories – particularly where those stories may cause potential distress or
emotional concern.
We will continue to develop “Tom’s Story”, which will incorporate the learning
from stories which we hear, making it more and more relevant to people in
Dundee, to ensure that it reflects their lived experiences. We will use the
developing story to inform:
• Citizens about emerging changes to health and social care services
• Evaluation of service improvement
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5.0 Section 4 – Governance
We have overall strategic responsibility for ensuring that the principles of this
strategy are adhered to across Dundee. The IJB itself has wide representation
from across Partner agencies, the voluntary sector, staff, patient and carer
representatives.
Progress on and review of this strategy will be reported regularly to the IJB as
per the agreed implementation plan, and reporting arrangements will be in line
with those of the agreed Strategic and Commissioning Plan.
The ISPG will retain responsibility for overseeing progress of this strategy and
are responsible for ensuring that links across the broader partnership in Dundee
are developed and sustained, in line with the agreed principles of participation
and engagement.
At an operational level, integration managers will be responsible for:
• Ensuring that operational and strategic managers engage and evidence
co-production
• Supporting the development and embedding of participation and
engagement activities across services areas in accordance with the
principles and outcomes in this strategy
• Monitoring progress on the intended outcomes set out in this strategy
• Evaluating the quality of participation and engagement across the
Divisions
Evaluation and Service Improvement:
Citizen Role
We will evaluate our engagement activity to ensure that you have been given the
opportunity to provide feedback on what worked well and where improvements
are needed.
Planning and decision making
We will evaluate how our engagement has impacted on our service planning and
delivery and identify areas for improvement.
What else?
We will evaluate the impact of this strategy to identify successes and areas for
improvement.
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Implementation Plan
2016 – 2021
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Theme: Supporting Participation and Engagement
Outcome: You will be involved throughout your journey of care and in all stages of planning
Outcomes for people who
use services, their
families and carers.
Key Actions
Timescales
Who?
You will know how to get
involved
Your involvement will be
welcomed and encouraged
Your involvement will lead
to better outcomes for
communities and
individuals
You will have the
information you need to
be engaged and involved
You will be supported to be
involved
Your involvement will feel
good and will contribute
positively to your health
and wellbeing.
Map communication routes and opportunities for involvement across
the 3 levels (Strategic, Community and Individual)
Identify and engage with key partners in order to produce information
in a range of formats that inspire a desire to be part of the work of the
Health and Social Care Partnership.
Review existing available formats and identify gaps and areas for
improvement.
To produce a suite of information materials eg leaflets, in alternative
audio / visual / formats and media.
Establish and build on existing links to and between Care Group SPGs
and other groups such as Local Community Planning Partners, third
and independent sector networks and forums.
Continue to create and take advantage of opportunities to work in co-
productive ways.
Create opportunities to support staff and volunteers to increase
confidence in the use of participative and co-produced approaches to
the delivery of services.
October 2016
October 2016.
March 2017.
October 2016
Ongoing,
reviewed in line
with governance
arrangements
Ongoing,
reviewed in line
with governance
arrangements
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Outcomes for people who
use services, their
families and carers.
Key Actions
Timescales
Who?
You will be confident that
staff know how to create
opportunities for your
participation and
engagement.
Make use of Our Voice to support local participation and engagement
processes and developments.
Ongoing,
reviewed in line
with governance
arrangements
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Theme: Learning From Each Other
Outcome: You will know how the learning from participation and engagement supports service improvements.
Outcomes for people who
use services, their
families and carers.
Key Actions
Timescales
Who?
Your individual needs will
be taken into account
allowing you to become
involved in a way that best
suits you.
You will know that the
learning from tests of
change will be used to
make improvements to
services.
Learning opportunities will
be open to and shared by
all, where appropriate.
You will be confident that
staff are continually
developing their skills and
that they have access to the
tools required to
encourage participation
and engagement.
Identify existing learning opportunities relating to participation and
engagement methods across Dundee, from our neighbouring partners,
and best practice at national and international level.
Identify how what is known from other consultations in communities
across Dundee contribute to improvements to health and social care
services – this will include existing community engagement work
undertaken by our community planning partners and others.
Co-produce and design key learning for staff that has a focus on
Participation and Engagement.
Support the development of learning networks across the city that
involve users of services, their families and carers.
Development of a virtual Toolkit that is the gateway to the best learning
resources that support meaningful participation and engagement.
Continue to invest in co-production skills development.
October 2016
October 2016
March 2017
March 2017
March 2017
Ongoing, reviewed
in line with
governance
arrangements and
the life of the
Strategic and
Commissioning
Plan
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Theme: Hearing Stories
Outcome: Health and social care delivery will be shaped by stories shared by people with lived experience of using services, receiving care
and / or treatment, and their unpaid carers.
Outcomes for people
who use services, their
families and carers.
Key Actions
Timescales
Who?
You will have safe and
appropriate
opportunities to share
your story.
You will have support to
share your story.
You will have support to
interpret the meaning of
shared stories with those
who choose to share
them and those who are
required to act on their
lessons.
The meaning of your
story for you personally,
for communities, and for
future service delivery
will be received and
understood by those
concerned in your care.
Map where sharing stories is having a positive influence on helping to
improve people’s outcomes, to include gathering examples of local story
sharing which have helped to reshape services and led to better
outcomes for individuals and communities.
Identify a range of opportunities within communities and services for
people to share their stories.
Identify planning and improvement mechanisms which would be
enriched by the sharing of individual stories.
Define the support available to people who share their stories.
Create innovative ways for the IJB to directly hear people’s stories that
include the celebration and acknowledgement of when things went well.
Develop alternative ways to share and hear stories including digital
stories, animations, and other audio or visual methods.
Create opportunities for people to tell their stories directly to the IJB
where appropriate.
December 2016
December 2016
December 2016
Ongoing, reviewed
in line with
governance
arrangements
Ongoing
throughout 2016 -
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Outcomes for people
who use services, their
families and carers.
Key Actions
Timescales
Who?
You will know what
difference sharing your
story has made.
The insight your story
communicates will be
used by all concerned in
your support and care to
positive effect.
Identify or establish mechanisms for providing feedback to people who
share their stories.
Produce or adapt guidance to inform the process of story sharing, based
on the information gathered.
Examine alternatives to a “complaints” based process that acknowledges
the opportunity for improvements through stories.
Support staff through appropriate staff development, to hear stories and
to know and demonstrate how to use these to improve outcomes.
March 2017
March 2017
From April 2017
onwards
From April 2017
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Theme: Governance
Outcome: You will know that decisions taken by the IJB have been informed by meaningful participation and engagement
Outcomes for people who
use services, their
families and carers.
Key Actions
Timescales
Who?
You will have access to
information relating to key
decisions to be taken by
the IJB.
You will know how you can
get involved in helping to
shape these decisions.
You will be confident that
the IJB is taking its
governance role seriously
and that there are
measures in place for this.
Examine and contribute to best practice across other Health and Social
Care Partnership that ensures governance arrangements are supported
by participation and engagement.
Further develop transparent processes relating to IJB decisions, to
include the range of formats information is presented in and how that is
made available.
Develop a participation and engagement protocol for key decision
making processes which also takes cognisance of statutory
requirements.
Audit public and community attendance at the IJB with consideration of
venue, location, accessibility and how the information is
shared/disseminated.
Report on the IJBs adherence to the National Engagement Standards.
Develop a “plain English” protocol for reports and other documents
being presented to the IJB.
Develop a monitoring and evaluation framework.
April 2017
April 2017
October 2016
October 2017
Annually in line
with the Strategic
and Commissioning
Plan Reporting
Requirements
April 2017
October 2017