Patient and publicengagement

Annual report2018-19

Working together to improve health and wellbeing

Involving the public inour workOur vision is simple. We want people to live healthy andindependent lives, supported by thriving and connectedcommunities with timely and easy access to high quality andefficient public services when they need them. We can only dothis if we work together with our partners in the health andcare system and with our patients and public. We know that in the past we haven’t been very good atlistening to the people who live or work in Somerset. To helpus change this we are developing new ways of working tomake sure the voices of our people are heard. We arecommitted to making sure that the patient and public voice isat the heart of everything we do as move forward together.

We will:make sure that patient and public voices shape what we domake decisions based on people's needsvalue, support and develop our staffwork together with our partners as one system to driveimprovementbe open, honest and transparentdo what we say we will and explain what is and is notpossible.

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Our duty to involve

We have a legal obligation to involve the public both in howwe plan services and in any changes to current services.  The rights of patients and individuals to be involved in theplanning and development of health services are also set out inthe NHS constitution. But we want to do more than this. Involving people is not justsomething we have to do, it's what we want to do. We want tomake sure that the patient and public voice is at the heart ofeverything we do. We are using the NHS improvement framework for patient andpublic involvement to identify our weaknesses and establish acohesive process to make sure our core principles and strongfoundation link all he required elements. By listening to people and talking to them about the thingsthat are important to them, we can improve the quality of theservices we commission. We want our engagement to be realand meaningful with patients and the public being empoweredto really influence the outcome. This will help us make sure that the right services are availablein the right place at the right time for everyone. 

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Somerset people

580,000

1 in 4

600,000

18%18.8%

our population projected population by 2031

over the ageof 65

under the ageof 18

living with adisability or life-limiting illness

1,700

80 years 84 years

12%

average life expectancyat birth for males

average life expectancyat birth for females

1 in 5

1 in 8alcohol related hospitaladmissions per year

of the populationsmoke

4-5 year olds classifiedas overweight or obese

adults diagnosedwith depression oranxiety

2 in 3adult classified asoverweight or obese

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Who we involve

people who use health services across Somersetpeople who use specific services or health and care servicesin generalpatient groups and representativespeople who care for those using health and care serviceslocal voluntary and community sector organisationslocal people, as individuals or groupspeople who have an interest in health and care servicesspecial interest groups

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We involve people in a proportionateand appropriate way

regular meetingsspecial consultation eventssocial medialay members as patient voicesdrop in sessionsengagement eventspatient storiesGoverning Body meetingsGP practice patient participation groupsengagement bulletins

How we involve

Working in partnership

Patient Participation Groups (PPGs)Healthwatch (Somerset)Health, Overview and Scrutiny Committees in SomersetPatient groupsCommunity and voluntary sector organisations such as SparkSomerset, the Parent Carer ForumSpecial interest groups

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We want to work with our public,patients, carers, partners and staff in acollaborative and positive way

We invite our local partners to inspect, review, comment andconsult on our commissioning proposals. These partnersinclude:

Our people

66

60

140patient participation groups - one in each GPpractice in Somerset

members of Somerset Engagement and AdvisoryGroup (SEAG)

5,019 Twitter followers and growing . . .

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lay members providing a patient perspective

Representing local interestsActing as critical friends to our proposals, ideas anddiscussionsTalking to people and helping us to hear your voices

All who are:

We are also taking our conversations online to reach more ofour people and give them the opportunity to have their say

What we asked

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Fit for my Future is our strategy for how we will support thehealth and wellbeing of all the people of Somerset bychanging the way we commission and deliver health and careservices. It is being delivered through a partnership betweenSomerset County Council and ourselves, supported by ourmajor NHS providers. In 2018 we published our case for change on our dedicatedwebsite: www.fitformyfuture.org.uk. Based on the case for change, key proposals have beendeveloped to transform services – some will require full publicconsultation because of their scale and others can be changedmore rapidly as part of ongoing improvement andtransformation. The case for change and proposed changes for change weresubject to a major public engagement exercise in 2018/19.  This included 18 specifically arranged drop-in sessions acrossSomerset, over 150 events and workshops, a newsletter drop to232,000 homes.  We also used digital channels to reach moreand different audiences with almost 2,000 people watching ourground-breaking Facebook Live events.

What people told us

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The responses show:    We are using the feedback to inform the further developmentof our plans and also to help us involve more people in co-designing new care models and new ways of working.  Next year, 2019/20, will be a significant year for health andcare partners and our populations as we progress withplanning and delivering change in Somerset.

the majority of proposals are supported, especially carecloser to home and self-careconcerns about centralisation of services, travel / transport,staff shortages, reduced community servicesoverwhelmingly positive support for people with acuteconditions to go home as soon as possible providing there is adequate care and support availablerecurring theme of early help, joined up and coordinated;people want to see person-centred approach to servicesacross the countysupport for equal priority in service provision and for aholistic approach to treat physical and mental healthillnesses/conditions together

What people told us

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Our patients, Patient Participation Group Chairs, members ofSomerset Engagement and Advisory Group, partners andmembers of the public have also told us that they haveconcerns about the following:

the 111 service and out of hours careavailability of GP appointments and access to primary carepatient transportaccess to dermatology servicesavailability of rheumatology servicesrecruitment and retention of GPs and nursessupport for young carers

We awarded a five year contract to Devon Doctors Ltd todeliver a new Integrated Urgent Care Service for the countyfrom February 2019. This provides integrated 24/7 urgent careaccess, clinical advice and treatment service by bringingtogether the NHS 111 service in Somerset and GP out-of-hoursservice with the introduction of a new Clinical AssessmentService. Since Devon Doctors in partnership with Care UK took over thecontract, the Somerset service has become one of the topperforming 111 service provisions in the country.

How else people havehelped

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Our Somerset Engagement and Advisory Group (SEAG) has amembership of 140 people across the county – it includesindividual patients, charities, community groups, voluntaryorganisations, village councils, disability groups and equalitygroups. Approximately a third of the membership attendquarterly meetings.  Following feedback we changed how themeetings work and we are moving the meetings out to differentcommunities across Somerset. We have also acknowledged, following feedback from ourengagement activities, that is was not the right decision todismantle the health forums.  Somerset communities are uniqueand health issues differ in each neighbourhood. We areexploring how we can establish effective links in communitiesand work more closely with existing networks There are Patient Participation Groups (PPG) in 66 GP practices.We support PPG Chairs by facilitating quarterly networkmeetings. PPG Chairs discuss issues in their GP practice andreport any commissioning concerns raised by patient voices. Weplan to assist the network further by providing support andtraining on membership recruitment, meeting skills, practiceliaison and being heard.

How else people havehelped

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We are improving our governance for recruiting and supportinglay members. We have 60 active lay members representativesinvolved in different commissioning work streams. We arerevising our policy and matching process to include morecomprehensive training for all new lay members and include anew welcome pack. We provide portable hearing loops for allmeetings. We developed an NHS jargon directory to support laymembers who get involved in different aspects of our work andfor meetings. Demographic monitoring has identified where we are under-represented in our involvement and engagement activities. Wehave reached out to seldom heard groups and sought theiradvice. Feedback has indicated that many are not interested injoining our established forums so we are exploring new inclusiveapproaches to engage in ways which meet their needs. We have undertaken targeted outreach work with seldom heardgroups; such as Maternity Voices, set up social media, parentbaby/toddler groups, 2BU – transgender commissioning, CAMHsteenagers service feedback, Special Educational Needs andDisability work stream, running stalls with parent/carer forums. 

What we've done

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revised our constitution to provide a detailed explanation ofour principles and arrangements for public involvementreintroduced patient stories to our Governing Body meetingsand established a patient engagement dashboard presentedby the Chair as part of his report at every meetingtrained our Governing Body on patient and publicengagementdeveloped our website content to improve information aboutengagement and how people can get involved in our workrun our Annual General Meeting as a health marketplace -offering free health checks and promoting the work of ourhealth partners and voluntary groupsimproved our Quality of Leadership compliance for patientand community engagement indicatorsimproved the effectiveness of our SEAG meetings to makethem more consultativeput in place recruitment and governance systems for laymembersset up a lay members forum to support and celebrate thecontribution of our lay membersheld equality and health inequality monthly workshops forour staff, hospital trusts, and other organisations provided free training to GP practices across Somerset to raiseawareness of equality and diversity issues in health.

Our plans for 2019-20

We have spent some of the last year taking stock and lookingat developing a new approach to public involvement, buildinga stronger foundation to our work.  

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Next year we will:

develop our new Communications and Engagement strategydevelop a new website which is more accessible andengaging, with clearer information and purposedevelop a virtual focus group to support those who areunable to attend events, meetings and drop-ins to have theirsay and be heardset up a lay members forum to provide better support,project matching, coordination and governance of laymembers involvement

Create

Builddevelop our existing groups (SEAG and PPG Chairs) tosupport effective changebuild public engagement early into our planning cyclebroaden our presence on social media as part of ourdeveloping social media strategy

Explorepursue opportunities to partner with existing neighbouroodnetworkslook at new models and methods to engage with andinvolve patients and the public in our work

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acknowledge and celebrate contributions from patient andpublic participation and say how involvement andengagement has influenced changeevidence our public involvement in our annual reportsregularly share patient and public stories with our staff at alllevels to make sure that the voices of our patients and thepublic are at the heart of everything we docontinue to improve the visibility of engagement atGoverning Body meetings

Traintrain the Governing Body and our leadership onengagement best practiceprovide training to our staff to make sure pathways andservices are designed to include patient and publicengagement from the start and that public voices are able toinfluence developments at meaningful stagesimprove accessibility and hold staff training on producingEasyread documents, co-produced with local people withlearning disabilities.

Share

Encouragepromote and encourage members of the public to askquestions at Governing Body and remind them of their rightto make a statement at the public part of the meetingsprovide effective support and involvement opportunities forpatients and the public to hold us and our providers toaccount on our engagement and consultation dutiesimprove the way we listen and talk with patients and thepublic to make sure we are coming to them, where they liveand work, to have the conversations that matter to themhold meetings that are fully accessible and reach seldomheard groups

If you would like to find out more about our work and howyou can get involved contact us: NHS Somerset CCGWynford HouseLufton WayYeovilSomersetBA22 8HR Telephone: 01935 384000Email: somccg.engagement@nhs.net @somersetccg