patient and public engagement committee

Patient and Public Engagement Committee

Date: Tuesday 13 April 2021 Time: 14:00 - 16:00 Venue: MS Teams

No Agenda Item Lead Purpose

1 Welcome, Introductions and Apologies Chair Discussion

2 Declarations of Interest Chair Requirement

3 Minutes of previous Patient and Public Engagement Joint Committee

Chair Approval

4 Action tracker Chair Discussion

5 Matters arising All Discussion

6 Chair update (verbal) Chair Note

7 Update on Covid and vaccination programme (verbal)

MS Note

8 Update on service redesign work (verbal) SF Note

9 Communications and Engagement Strategy 2021-2024

JM / MS Note

10 Work programme 2021/2022 and developing the PPEC

JM Discussion

11 Any other business - Future standing items

Chair Discussion

12 Date of next meeting Tuesday 15 June 2021

Chair Note

Author: Anona Hoyle, Senior Engagement Officer

Contact Information: [email protected]

Lead Executive: Jane Meggitt, Director of Communications and Engagement

Which activity does this paper relate to?

The purpose of this paper is to receive any declarations of interest or declarations relating to matters on the Agenda.

How? Members are asked to confirm any declarations at the start of the meeting to be recorded in the minutes.

What are the members being asked to do?

Members will be asked to complete a declaration of interest form which will be emailed to them by the secretariat. These will be recorded on BLMK CCG’s Register of Interests.

What are the financial implications?

None identified

Set out the key risks and risk ratings

None identified

Date to which the information this paper is based on was accurate

31 March 3021


Agenda item 2 – Declarations of Interest

Information

mailto:[email protected]

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Type Description Financial Interests

This is where an individual may get direct financial benefits from the consequences of a commissioning decision.

Non-Financial Professional Interests

This is where an individual may obtain a non-financial professional benefit from the consequences of a commissioning decision, such as increasing their professional reputation or status or promoting their professional career.

Non-Financial Personal Interests

This is where an individual may benefit personally in ways which are not directly linked to their professional career and do not give rise to a direct financial benefit.

Indirect Interests

This is where an individual has a close association with an individual who has a financial interest, a non-financial professional interest or a nonfinancial personal interest in a commissioning decision.





Patient and Public Engagement Joint Committee (PPEJC) minutes for approval

How? N/A


To review and approve the minutes of the following meetings:

- Ratify the minutes from the PPEJC meeting held on 20 October 2020

- Review and approve the minutes from the PPEJC meeting held on 15 December 2020


N/A


N/A


31 March 3021


Agenda item 3 - Draft minutes from previous meeting

Information


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Background

The following minutes are presented to the Patient and Public Engagement Committee for approval:

• Patient and Public Engagement Joint Committee – 15 December 2020 • Patient and Public Engagement Joint Committee – 20 October 2020

As the NHS was in a state of emergency and prioritising and pausing work, the minutes from the meeting on 20 October were not approved when the PPEJC met on 15 December. It was agreed for the draft minutes to be approved by the PPEJC Chair and Director of Communications, and circulated on 16 December 2020 to members of the PPEJC for comment and ratification by the committee at the following meeting. Proposals and next steps

N/A

Executive Summary

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Minutes of the PPEJC Meeting Held on Tuesday 20th October 2020

Held over Microsoft teams

Patient and Organisational Representatives Effie Assan Patient and public representative BLMK EA Steve Black Patient and public representative BLMK SB Diana Blackmun Healthwatch Central Bedfordshire Bedfordshire DB Cheryl Green Patient and Public Representative BLMK CGr Alan Hancock Patient and Public Representative BLMK AHa Tracy Keech Healthwatch Milton Keynes Milton Keynes TK Lucy Nicholson Healthwatch Luton Luton LN Josan Race Community Action Milton Keynes BLMK JR Martin Trinder Community Voluntary Services (CVS)

Bedfordshire BLMK MTr

Phil Turner Patient and public representative BLMK PT John Wright Healthwatch Bedford Borough Bedfordshire JW

Members Present: Richard Alsop Director of Commissioning and Contracting BLMK RA Alison Borrett Chair of PPEJC / Lay Member Bedfordshire AB Dr Nessan Carson GP Member Milton Keynes NC Lloyd Denny Lay Member Luton LD Dr Christopher Longstaff

GP Member Bedfordshire CL

Jane Meggitt Director of Communications and Engagement BLMK JM Nicky Poulain Director of Primary Care BLMK NP Mike Rowlands Lay Member Milton Keynes MR

CCG Staff and Presenters Present Jackie Bowry Communications and Engagement Manager BLMK JB Jennis Cain Secretariat for PPEJC and Mental Health PA BLMK JC Sanhita Chakrabarti Assistant Director of Public Health BLMK SC Mark Cox Head of Commissioning Transformation BLMK MC Sarah Frisby Senior Communications and Engagement

Manager BLMK SF

Christina Gleeson Public Health across Bedford Borough, Central Beds and Milton Keynes Council

BLMK CGl

Anona Hoyle Senior Communications and Engagement Officer

BLMK AHo

Michelle Summers Head of Communications and Engagement BLMK MS

Apologies: Lisa Wright Advocate for Children and Young People

(CYP) across BLMK BLMK LW

1. Welcome, Housekeeping and Introductions The Chair welcomed all members and attendees to the meeting. The Chair advised that the meeting was quorate.

Action

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Apologies for absence Apologies were received and noted as above.

2. Declarations of Interest The Chair asked for any declarations of interest with regards to items on the agenda. There were no declarations of interest.

3. Chair’s Update The Chair gave an introduction and verbal update. The application for one BLMK CCG was submitted to NHSE at the end of September; the next stage is for NHSE to review the application. System working and Covid-19 The Communications and Engagement Team will be looking to work with Communications and Engagement partners across the ICS system, helping to develop system-side communications over the next 6 months. This will form part of the communications and engagement strategy.

4. Minutes of last meeting The minutes of the meeting held on 18 August 2020 were approved as an accurate record subject to the following amendment:

• Amend initials ‘CG’ to either CGr or CGl as appropriate

5. ACTION Log The following were outstanding: Action 22: NHS 111 collateral available in different languages Update: In progress as still awaiting for the national team to respond - once received it will be localised. Action 23: Nicky to catch up with Tracy re comments made on Facebook. Update: Mix messages are now fixed. This action can be closed. All other actions were closed.

6 & 7. Communications and Engagement pipeline – our approach, and Communications and Engagement Strategy 2021. To enable a fuller dialogue, the two agenda items were discussed at the same time. JM gave an overview of the strategy document and explained as part of the application to become one organisation the communications team has been asked to review the Communications and Engagement Strategy. The document is high level which will set out principles e.g. what does co-design, engagement and consultation look like. JM explained that people use the same terminology but have a different level of understandings of what it means. The document will include the patient voice and have a clear plan and clarification on ‘what good looks like, which should help manage expectations. CGr stated it was quite ‘wordy’, high level and did not include much actual content. The paragraph ‘everyone should have a voice’ should be changed to ‘everyone should have an opportunity’. CGr said she has

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listened to the Bedford Borough Overview and Scrutiny Committee and felt that the strategy needed to be more prescriptive. The phrase ‘The CCG is required by law to involve the public and decision-making’ should include an explanation as to why there is a need to consult as well as an explanation on the difference between engagement and consultation. CGr asked how are we going to hear patients voices actively and suggested having new channels of how to do things virtually and online such as ‘talking heads’ with patients, clinicians and the local authority. PT mentioned that collectively it is a 2-way process of us listening to the public feedback, and listening to the public on what they would like to know about the CCG and the work taking place to improve local health services. He suggested that information about what is happening and what has been done is publicly available. He said he would like the information to be easily accessible, for example around Luton Town. CL felt that the line ‘how do we measure our success’ in the strategy was measuring the success on the relationship with practice members. He suggested that the paragraph be amended to reflect that the patient is central and that success is measured by the level of public understanding. AHa stated the document is very general and mentioned a stakeholder map state which was not included in the document. SB responded to CL point on ‘how do we measure success of a communications and engagement plan’ he stated it is about measuring the activity but felt there was little included about whether the communication was effective, and suggested that this be incorporated. NC mentioned that he found the ‘bottom-up’ approach, involving both patients and professionals at the start of the pathway design process was an effective way of designing a service to meet the needs of patients. MT commented on timing, he said he cannot see any reference regarding timeframes for engagement or consultation. He said it was important to be asking questions at the right time. DB noticed on page 12 ‘You asked we did‘, (patients stories), felt that the way to share their experiences and to feedback on changes to services is to show them stories of people who has had success and has enabled change. DB asked is there a way of widening the coverage of publications/communications as not everyone has access to the internet or attends governing meetings etc. This may encourage people to come forward. JR suggested having pop-up banners in colleges, secondary schools, pharmacies and food banks as part of external communication, which would include the digitally disadvantaged. CGr asked how the CCG will measure engagement conducted by providers and whether the need to engage is included in the contract. RA commented on NC comment about extending engagement to local people at Integrated Care Partnership (ICP) level in the patch, and the importance of engaging and delivering at place.

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JW suggested reducing inequalities under the mission was over ambitious, suggesting it be changed to reducing health inequality. He also pointed that Central Bedfordshire is not the only area to have rural communities as Bedford Borough has a large rural community area too. CGr commented on page 20 - Commission and Engage with services users and asked how is this measured? On p.26 Re: The Complaints team: CG asked who analyses the complaints to determine common themes. What is done with the data and how do the public know what has changed as a result? JM responded to CGr comment about engagement and consultation; the engagement is about listening and ensuring patients voices are taken on board. JM responded to AHa point on measuring success as part of the Covid work, advising that the CCG has accepted offer from a psychologist to develop messaging so that the messages land better. MS responded to AHa comment re: stakeholder map, MS explained that it is an organic document and the feedback will be incorporated into the document and then shared with the public for further comment. The CCG will work with partners on what co-production means and agree some principles. TK stated that similar conversations about the aspirations had taken place previously and little had changed as a result. She suggested that the organisation had been working in silos and that a review takes place on what has been said and done in response, what is working and what further actions need to be taken. PT advised that some programmes and projects that he had been involved with had stopped such as the ICS Priority 1-5 work streams. He would like to know where we are with this work and what the progress has been made. RA advised that Mark Cox from his directorate is working closely with both commissioners and the Communications Team to help streamline work. MS responding to the ICS query – Emma Richards is now the lead for the ‘Priority 1-5 work streams following Peter Hewitt’s departure in March. We will add this to a future PPEJC agenda. CL wanted to respond to the viewpoint PT made about priority 1-5; he stated that from a GP and practice perspective the CCG does a good job at resolving problems, issues and prioritising work, however he feels the CCG is not good at keep sharing its successes and progress with stakeholders. Suggestion was made that there needed to be more support for PPGs ay network level PT agreed the CCG needs to articulate the successes stories and communicate it to the public so they know what’s happening.

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JM stated it’s about getting the balance right and will add in the strategy the cycle of review on a six month basis. The committee assured feedback mechanisms are in place and pointed out the right questions are being asked like the what, who and why, for our patients to understand what we doing then that should deliver the why. ACTION: To include ICS Priority 1-5 work streams as future agenda item. MS to update the Communications and Engagement Strategy to include feedback from committee Members to send any additional feedback to [email protected] or [email protected]

8. BLMK Flu Campaign update Sanhita Chakrabarti (CCG), Jackie Bowry (CCG) and Christina Gleeson from the Public Health Team introduced this item. SC updated the committee that is has been a good collaborative project across BLMK, professionals and communities have helped shape and deliver the communication around the programme and provided a targeted approach in low take-up areas. The programme has commenced with collaboration including practices, primary care networks, community pharmacists, care homes and local authorities to ensure vulnerable patients are vaccinated. The majority of front line staff and social care workers are to be vaccinated. Organisations are working collaboratively e.g. a Shefford GP practice is collaborating with the fire service and local authority. CGl explained that the ‘Trusted Voice’ campaign photo session with local clinicians and community leaders is taking place Thursday 22nd October 2020. She also mentioned that there has been feedback from the Covid champions that there needs to be a focus on carers as the campaign progresses. JB informed the committee that there is a flu page on the BLMK website which includes videos, posters and leaflets in various languages such as Bengali, Gujarati, Hindi, Polish, Punjabi, Romanian and Urdu. The Flu steering group works with colleagues from Public Health, Healthwatch and other organisations to help share the key messages. The Local authorities are promoting via Facebook advertising to key groups’ i.e. pregnant ladies, women with children 2-3 years and people with long term health conditions. Clinicians have agreed to talk on various local radio shows such as Romanian radio, Luton Urban Radio, hospital radio, community and on-going slots with Inspire FM to promote the flu campaign.



https://www.blmkccg.nhs.uk/your-health/seasonal-flu/

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Also engaged at the older people’s festival which was organised by Healthwatch Central Bedfordshire, and will be attending the Carers, Older person and Dementia Partnership Boards which are facilitated by Healthwatch Milton Keynes. LD requested that the CCG capture race and ward, age to help understand which wards or communities where take-up is low and to review messaging. MR commented that there are different types of carers - unpaid family carers and paid for professional carers.

9. Updates and Reports

• NHS 111 First - MS advised that the paper provided an update following the presentation and discussion around Communications and Engagement in August 2020.

• Report - BLMK One Team Public Engagement JM advised that findings from the One BLMK public survey formed part of the final submission to NHS England and Improvement to become one CCG by April 2021.

10. Regular reports and papers relating to action log • BLMK Recovery plan

Paper has been updated to reflect contributions made in June 2020

• Glossary of Terms This was produced following requests in June 2020 meeting.

• Social Media Log Report for period 10 August to 4th October 2020

11. Any Other Business PT suggested having a section at the start of meetings to update the committee on what’s happened since the previous meeting. AB suggested that ideas are ‘deposited’ in an ‘idea’s bank’ to reduce the risk of ideas being forgotten. EA complimented the glossary of terms. CGr gave reference to a local press report they have indicated there could be an issue with regular blood tests, but had not seen an official response from the hospital or CCG regarding this. NP responded to CGr stating there has been a national supply chain issue that has impacted both Bedford and the Luton and Dunstable Hospital but not Milton Keynes.

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MS advised that the CCG had been liaising with the Head of Communications at the local hospitals. The hospitals have been working with the national team to develop messaging for sharing with patients. CG said she is part of the Covid champions group so will bring up the blood tests comment in that meeting. CL commented (via message box) that the CCG and partners can learn from the blood test situation to ensure that information is shared and cascaded appropriately in the future. EA expressed that she enjoyed reading the engagement strategy document and it was clear that we wanted to listen to what patients and public had to say, this does not however come across in day to day life. The CCG should publicise how people can get involved; communicating to the members of the public, ways to make their voices heard such as groups they can join or ways they can comment ACTIONS: Include an ‘update element’ on the agenda for future meetings Develop an ‘PPEJC Idea Bank’

12. Date of next meeting Tuesday 15th December 2020 at 10:00 a.m. Via Microsoft Teams

The Meeting Closed at 11.58

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Draft Minutes of the PPEJC Meeting Held on Tuesday 15 December 2020

Held over Microsoft teams

Patient and Organisational Representatives and Meeting Presenters Present Effie Assan Patient and public representative BLMK EA Steve Black Patient and public representative BLMK SB Diana Blackmun Healthwatch Central Bedfordshire Bedfordshire DB Cheryl Green Patient and Public Representative BLMK CG Alan Hancock Patient and Public Representative BLMK AHa Tracy Keech Healthwatch Milton Keynes Milton Keynes TK Lucy Nicholson Healthwatch Luton Luton LN Josan Race Community Action Milton Keynes BLMK JR Martin Trinder Community Voluntary Services (CVS)

Bedfordshire BLMK MTr

Phil Turner Patient and public representative BLMK PT John Wright Healthwatch Bedford Borough Bedfordshire JW Lisa Wright Advocate for Children and Young People

(CYP) across BLMK BLMK LW

Members present: Alison Borrett Chair of PPEJC / Lay Member Bedfordshire AB Dr Nessan Carson GP Member BLMK NC Lloyd Denny Lay Member Luton LD Dr Christopher Longstaff

GP Member BLMK CL

Jane Meggitt Director of Communications and Engagement

BLMK JM

Nicky Poulain Director of Primary Care BLMK NP Mike Rowlands Lay Member Milton Keynes MR

CCG Committee Members: Jennis Cain Mental Health & LD PA Luton JC Sarah Frisby Senior Communications and Engagement

Manager BLMK SF

Anona Hoyle Senior Communications and Engagement Officer

BLMK AHo

Guest presenters: Elisabeth Fitzgerald Engagement and Communications Manager BLMK EF Mark Meekins Head of Organisational Resilience BLMK MM Kathy Nelson Senior Commissioning Manager – Planned

Care/Cancer BLMK KN

Apologies: Richard Alsop Director of Commissioning and Contracting BLMK RA Michelle Summers Head of Communications and Engagement BLMK MS

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1. Welcome, Housekeeping and Introductions The Chair welcomed all members and attendees to the meeting. The Chair advised that the meeting was quorate.

Action

2. Apologies for absence Apologies were received and noted as above.

3. Declarations of Interest There were no declarations of interest with regards to items on the agenda.

4. Chair’s Update There was no update

5. Minutes of last meeting The minutes of the meeting held on 20 October 20 were not circulated due to the NHS being placed in its highest state of emergency, level 4 and the need to prioritise and pause work. AB advised that the draft minutes had been approved by JM and herself and would be circulated for comments and will be ratified at the February 2021 meeting.

6. ACTION Log The following actions were agreed as closed: Action 37 Update: To include the update element – can now be closed. The following updates were given: Action 22 Update: NHS 111 still in progress – went on1st December 2020. Action 35 Update: A new SRO to start February 2021 – to ask her how to respond to the ICS Action 36 Update: x Action 38 Update: – to be updated in February 2021

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Update on CCG Work-streams Mental Health inpatient beds (RA) AB advised that RA would provide an update for the committee for circulation. SF added that that she has been working with the Bedfordshire provider East London Foundation Trust (ELFT); they have started having conversations with the Overview and Scrutiny Committee and are due to go back to the committee with further information. ACTION: RA circulate update to members of PPEJC

7b Mount Vernon (KN) Background: Services at Mount Vernon Cancer Centre are being reviewed by EoE Spcialised Commissioning Team as part of its ambition to provide high quality and safe services. The cancer centre serves the population in Luton and Bedfordshire along with many other Integrated Care Systems (ICS’s) including Hertfordshire, Buckinghamshire and London.

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The team will be looking at understanding the factors that influence patients and any current issues that affect patients accessing radiotherapy and specialist chemotherapy. They are holding a series of workshops and focus groups which patients from across BLMK are being encouraged to join. In addition there is also a similar review of radiotherapy provision for the Milton Keynes population linked to Oxford. The Milton Keynes work will focus on reprovision of radiotherapy on the Milton Keynes hospital site following a contract change in 2019. If anyone has any ideas or is interested to get involved please contact Kathy Nelson – email: [email protected] SF explained she attended a meeting regarding Mount Vernon and was expecting a new website and information to materialize however this has not yet been received; once received this will be circulated to committee members. ACTION: Circulate details of Mount Vernon website

SF to fwd details

7c Improving Access to General Practice (including Same Day Access) NP gave an update stating this is linked to ‘Think 111 First’ this is for people who are asking for same day access. It is a range of GP and Primary Care Services currently available for patient 24 hours a day 7 days a week. This is to have a seamless service to patients. The following areas were discussed.

• Direct Booking from 111 to GP/ Primary Care Services • Improving Information and Access to GP and Primary Care Services • Improving Access to GP Services –2021/22 • Additional Workforce (increased Access to Appointments)

TK stated it is one of the best things to improve GP and primary care services are to allow people register at their practice. Registration is not a multi factorial issue - it is a policy/ quality issue. Practices need to follow national guidance and policy. SB raised a ‘conflict of interest’ as he stated he provides analysis to NHS England and to GPs about online access for particular service providers. SB commented that the 24/7 access to primary care services seems confusing as a mix of services and felt there was a lot of emphasis on NHS 111 and felt it add another layer of complexity of how patients will get access to services. NP welcomed as off-line conversation with SB and members of her team NP explained NHS 111 is an alternative if you can’t get through to your own GP practice.

Npo/PL to discuss with SB

7d ICS Future direction (JM) It was noted that Felicity Cox has been appointed as the BLMK ICS Executive Lead. There are proposed legislative changes regarding ICS’s, the CCG together with other ICS partners are reviewing these and a discussion paper that has been issued.


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8 Covid Mass Vaccination Communications Plan Mark Meekins (MM) is the Emergency Planning Lead for BLMK CCGs, his role is to ensure the CCGs are prepared for dealing with emergencies in the Command and Control situation. MM gave a verbal update. Key points of discussion:-

• Working better with our local authority colleagues and other statutory partners across Luton, Bedfordshire and Thames Valley

• Supported by military planners • Multi-agency training and exercising response • Working with LAs reacting to PPE provision and Covid testing

managed by the control centre. • ‘Out of hospital’ where patients are moved from acute into the

community • Working closely with Bedfordshire Local Emergency Volunteers

Executive Committee (BLEVEC) and the voluntary sector • Health and social care - established a Strategic and Tactical command

and control structure reporting through the Recovery and ongoing Covid management for the BLMK System.

• Currently in wave 2, level 4; MT stated there was a good volunteer network in place, the Community Voluntary Services (CVS) has been engaged with the recruitment of volunteers and was joined-up with the work of the resilience forum. LD requested that an assessment on the planning be undertaken to assess how well BLMK did, and any learning. TK commented that the Vaccine rollout through-out the hospital has been spectacular. Some patients had told Healthwatch that they had their vaccine and are going very well. CL asked where the Milton Keynes Hospital number for the over 80s had been advertised and the number of appointments available. JM and NP will be meeting to discuss the vaccination rollout across the PCNs to be able to direct people to the appropriate telephone numbers. SB asked what is the current rate of vaccination and is it expected to change over time. JM updated the committee There are 3 delivery models

1. The Hub went live in Milton Keynes for over 80’s, care home staff and vulnerable NHS workers.

2. Primary Care Networks (PCN) – 4 sites due to go live in December. 3. Community Hubs supported by our community services provider in

Hertfordshire working across the BLMK system. The CCG is working with the local authorities to identify suitable sites (to ensure logistics including vehicular access, parking etc)

TK stated that Healthwatch Milton Keynes has received feedback from patients that they’re worried that they miss a telephone call from their surgery (particularly if they hard of hearing) inviting them for their vaccination. Also

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concern regarding finding a carer to look after a vulnerable person whilst the carer is having their vaccination. JM replied that the engagement team will ensure they work with GP practices to support them with their messaging. JW wanted to know when the vaccine would be available in Bedford Borough. JM advised that arrangements are in place and different Primary Care Networks (PCNs) would start delivering at different times. The CCG is meeting with colleagues at Bedford Borough Council to discuss arrangements, information will then he shared with residents. JW suggested that the CCG should be proactive with the messaging as residents in Bedford Borough can see that the residents in Central Bedfordshire, Luton and Milton Keynes are starting to receive theirs. CL commented that he is a GP from Central Bedfordshire and his practice’s PCN is not included the first wave. He advised that there are many logistical challenges that need to be overcome and decisions to be made by the surgeries. The PCNs need to be able to put plan and put their plans into place to be able to deliver effectively whilst delivering sustainable GP services. JW – asked if Bedford Borough patients could attend a PCN clinic in Central Bedfordshire or Milton Keynes. JM responded that practices / PCNs will contact patients to invite them for a vaccination. Patients should wait to be contacted by their practice/PCN and should not attend another PCN. Other points raised by members of the committee included:

• How can we encourage everyone to have the vaccine? • How would they know if someone is asymptomatic for Covid? • Some people are concerned going to a hospital, would they be at risk

catching the virus if attending hospital. • How far so people have to travel to get the vaccine? • Are people being asked for identity when they have their test (could

here be a black market and people letting others have their slot). • If a couple is attending (i.e. a partner driving, can they both be

vaccinated at the same time? JM stated that the team are developing some frequently asked questions (FAQ) which will answer the above questions. The communication plan that the team are following forms part of the national plan, it is not a public facing document. The national plan includes useful collateral for using on social media and website content and FAQs TK commented that a member of Healthwatch Milton Keynes’ staff has a PHD related to vaccinations. They are holding an event for their members ‘Myth Busters – vaccinate yourself against misinformation’ – the event will be recorded. There will be questions and answers a poster will be created then will be shared. TK advised that Healthwatch Milton Keynes had heard that the receptionists from some GP practices are telling patients not to attend the hospital hubs, but to wait until their GP practice invites them for the vaccination.

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The chair thanked everyone for their contributions and encouraged members of the committee members to continue to share feedback / things they’re being told to Anona Hoyle [email protected]

9 Health inequalities LD gave a brief update on Inequalities Review which was being undertaken. The first programme board meeting was held on 30 November 2020. The board reviewed the Terms of Reference and the Specification for the Health Inequalities Review; the review was due to be completed by April 2021. The Board recommended that the deadline to be extended to enable a more detailed review take place and to work with the community to co-design the review.

10 Any Other Business There was no any other business

11 Date of next meeting: Tuesday 16 February 2021,10:00am via Microsoft Teams

The Chair thanked all attendees and the meeting was closed at 11.50


Author: Anona Hoyle, Senior Engagment Officer




The tracker shows the outstanding actions of the BLMK Patient and Public Engagement Joint Committee (PPEJC) that have been carried over to the BLMK Patient and Public Engagement Committee (PPEC).

How?


To discuss and provide updates for the trackers including new action deadlines/reassigning action owners where appropriate.


N/A


N/A


31 March 3021


Agenda item 4 – Action tracker

Information


06/04/2021 PPEJC Action Log

Page 1 of 1

PPEJC

EscalatedOutstandingIn ProgressNot Yet DueCOMPLETE:

Propose closure at next meetingCLOSED

(dd/mm/yyyy)

Action No.

Meeting Date CCG Item Title Action Responsible Manager (Enter full name)

Delegated to (Enter full name)

Can hide this column when sending out

papers

Past deadlines

(Since Revised)

Current Deadline Current Position RAG(Add date action is agreed closed)

22 18.08.20 BLMK NHS111 First NHS 111 collateral available in different languages Jackie Bowry Update: In progress as still awaiting for the national team to respond - once received it will be localised.16.04.21Due to operational reasons promotion of the 111 first campaign locally were put on hold however we are looking to restart the promotion of the service in the coming month.

In progress

35 20.10.20 BLMK Communications and Engagement Strategy

MS to update the Communications and Engagement Strategy to include feedback from committee

Michelle Summers Michelle Summers 15.12.20 15.12.20 - deferred 13.04.21 Updated strategy taken to Governing Body on 6 April 2021. 13.04.21 Recommendation to close

COMPLETE: Propose closure

13/04/21

36 20.10.20 BLMK Communications and Engagement Strategy 2021.

Include ICS Priority 1-5 work streams as future agenda item for discussion

Anona Hoyle 15.12.20 15.12.20 - deferred 13.04.21 This will become part of standard CCG business with updates provided on a regular basis 13.04.21 Recommendation to close

COMPLETE: Propose closure 13/04/21

38 20.10.20 BLMK AOB

Develop an ‘PPEJC Idea Bank’

Anona Hoyle 15.12.2015.12.20 - the 'idea's bank is in progressLog produced - to be reviewed as future agenda item as part of learning process 13.04.21 - Recommendation to close


39 15.12.20 BLMK Mental Health inpatient beds

Provide update on mental health inpatient beds in Bedfordshire

Richard Allsop 16.02.21Update included on agenda 13.04.2113.04.21 - Recommendation to close


40 15.12.20 BLMK Mount Vernon Review Share details of Mount Vernon website Sarah Frisby 16.02.21 13.04.21 Focus groups and webinars promoted via website and social media. New website is https://mvccreview.nhs.uk/ 13.04.21 - Recommendation to close


41 15.12.20 BLMK Improving access to General practice

Primary Care Team to have off-line conversation with Steve Black regarding process in BLMK for patients to access primary care services

Nicky Poulain 16.02.21

RAG KEY Escalated - items flagged RED for 3 subsequent meetings - BLACKOutstanding - no actions made to progress OR actions made but not on track to deliver due date - REDIn Progress. Outstanding - actions made to progress & on track to deliver due date - AMBERNot Yet DueCOMPLETE - GREEN

CLOSED



Lead Executive: Jane Meggitt, Director Communications and Engagement


The verbal update covers the period from when the PPEJC last met in December 2020 to April 2021.

How? An update by the Lay member for Patient and Public Engagement, and Chair of the Patient and Public Engagement Committee, Alison Borrett


To note the update.


N/A


N/A


N/A


Agenda item 6 – Chair update

Information


Page | 2

Background

The purpose of the Chair’s brief is to provide the Patient and Public Engagement Committee with an update since they last convened. The update will include:

1. Governance changes following the establishment of the new organisation NHS Bedfordshire, Luton and Milton Keynes Clinical Commissioning Group’ on 1 April 2021 (including Terms of Reference) – Terms of Reference van be found on page 14 of the BLMK CCG Governance Handbook, page 412 of Governing Body papers 6 April 2021)

2. Inclusive values of the NHS and following best practice on how we name and group together

people when discussing issues such as health inequalities. Moving forward the CCG will use the ‘ethnic minorities’ which is considered more inclusive term to BAME. https://www.ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity

3. Format for future meetings

Executive Summary

https://www.blmkccg.nhs.uk/documents/governing-body-meeting-in-public/

https://www.blmkccg.nhs.uk/documents/governing-body-meeting-in-public/

https://www.ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity

https://www.ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity

Author: Michelle Summers, Associate Director of Communications and Engagement




The verbal update provides an update on the Covid and the vaccination programme

How? An update by Michelle Summers, Associate Director of Communications and Engagement


To note the programme of activities being undertaken to roll out and deliver the vaccination programme to all communities across BLMK


N/A


N/A


31 March 2021

The purpose of the update is to provide the Patient and Public Engagement Committee with information regarding Covid and the vaccination programme across BLMK.


Agenda item 7 – Update on Covid and Vaccination Programme

Information

Executive Summary


Author: Sarah Frisby, Head of System Engagement.




The verbal update provides an update on the reset and restoration phase of BLMK CCG

How? An update by Sarah Frisby, Head of System Engagement.


To note the progress that is being made during the reset and restoration phase


N/A


N/A


31 March 2021

The purpose of the update is to provide the Patient and Public Engagement Committee with updates relating to mental health inpatient bed provision and alignment of policies.


Agenda item 8 – Update on service redesign work

Information

Executive Summary


Author: Michelle Summers, Associate Director Communications and Engagement




The Communications and Engagement Strategy 2021-2024

How?


To note the Communications and Engagement Strategy 2021-2024 which was taken to the Governing Body for approval on 6 April 2021


N/A


N/A


31 March 2021

This document sets out the communications and engagement strategy for BLMK CCG which has been co-developed with system partners. It broadly covers a period of three years, with a particular focus on transition year priorities during 2021/22.


Agenda item 9 – Communications and Engagement Strategy 2021-2024

Information

Executive Summary


1 BLMK Communications and Engagement Strategy April 2021

Our Communications and Engagement Strategy Final Draft 26 March 2021

This strategy details how we will communicate and engage with all our audiences, as a new, single clinical commissioning group.


Reader information Version control Final draft (v4.0)

Publication date Final draft to be taken to the CCG Governing Body on 6

April 2021

What does this document replace?

Communications and Engagement Strategy 2016-18 Three separate documents for three individual CCGs

Lead Jane Meggitt, Director of Communications and Engagement

Description This document sets out the draft communications and engagement strategy for BLMK CCG. It is a working draft and will continue to be co-developed with system partners between now and April 2021. It broadly covers a period of three years, with a particular focus on transition year priorities during 2021/22.


Contents BLMK CCG: summary communications and engagement strategy ........................... 4

1 Why we need this strategy ............................................................................... 5

2 Introduction ...................................................................................................... 5

Looking ahead – change is the continuity ........................................................ 8

3 CCG’s strategic priorities 2021-24 ................................................................... 9

Clinical commissioning areas of focus for 2021-22 .......................................... 9

4 Scope of this strategy .................................................................................... 11

5 COVID-19 context – a blueprint for the future ................................................ 11

6 Principles of our approach ............................................................................. 14

7 Our aims ........................................................................................................ 15

Communications and engagement aims in the new organisation .................. 16

8 Objectives ...................................................................................................... 17

9 Audiences and insights .................................................................................. 19

10 Narrative and key messages ......................................................................... 20

11 Activity/key components ................................................................................ 20

Delivery channels .......................................................................................... 20

Supporting materials ...................................................................................... 21

12 Communications and engagement in the new organisation .......................... 21

Priority areas for communications and engagement activity .......................... 22

Channels for the new CCG ............................................................................ 24

13 Insights, engagement and experience ........................................................... 25

14 Implementation .............................................................................................. 28

15 Risks and mitigation ....................................................................................... 29

16 Evaluation ...................................................................................................... 32

17 Appendix 1: ‘Think, feel, do’ aims for each audience group ........................... 33

18 Appendix 2: Stakeholder mapping grid .......................................................... 36

19 Appendix 3: draft delivery plan ...................................................................... 39

20 Appendix 4: Narrative and key messages for the new organisation .............. 42

21 Appendix 5: Patient and Public Engagement Committee .............................. 46

22 Appendix 6: Team structure ........................................................................... 46

23 Appendix 7: Glossary ..................................................................................... 47


BLMK CCG: summary communications and engagement strategy

Aims and objectives

Generate understanding of

the benefits of change

Build confidence in support

plans

Facilitate meaningful insight

and engagement

Encourage actions for

delivery

Specific SMART OBJECTIVES identified

Audience

Staff GP Members Health and care system partners

Local stakeholders and the public

Regulators

Strategic principles

One #TeamBLMK, one clinical

commissioning strategy and

contribution is valued.

You are our trusted voices – work with us to influence and

improve health outcomes in your

area.

Collaboration is key to improving health

outcomes and reducing health

inequality

We are restoring our services but we need

to change. We will be transparent and co-produce services

locally.

We are focused on continuous

engagement that is honest and open.

Delivery Channels

Internal Engagement

Briefings and updates

Briefings and updates

Updates for patients and the public

Face to face briefings

Briefings and events

Members Forums, events

Programme of stakeholder engagement

BLMK Community meetings

Local Engagement report published to

our website

Supporting documents

Narrative, key

messages and FAQs

Engagement

materials

Peer to peer engagement

Patient stories

IAF / PPE Evaluation

Evaluation Inputs: development of plans and

materials Outputs: volume of activity delivered and people reached

Outcomes: support for clinical commissioning strategy, change in awareness, knowledge and behaviours

1 Why we need this strategy

How and why we talk to people and involve them in our plans is very important. We need to work collaboratively across Bedfordshire, Luton and Milton Keynes with our partners and residents to make the right decisions about local services.

Since publication of our last Communications and Engagement Strategy in 2016, the landscape has shifted significantly. Covid-19 has completely changed how we work and our priorities. This, together with the establishment of the BLMK CCG and further planned legislative changes, which includes a new NHS Act, which will be introduced later this year, means that this strategy will be a transition document setting out two clear stages of focus over the next two years, explaining why this is important and what we expect to achieve within these timescales. The first stage is about cementing the benefits of a single CCG while demonstrating we are listening to local voices and issues. Stage two will see an additional focus of the move towards operating as a single ICS organisation – supporting greater primary and secondary care integration – but again with a local flavour.

By delivering this strategy and plan, we will:

- Involve residents from Bedfordshire, Luton and Milton Keynes in improving local services

- Help all patients understand local services and how to access them, making information accessible in different formats to help reduce health inequality

- Help staff, partners and patients feel confident that the CCG is focused on delivering high quality local services

- Deliver joined up communications and engagement with partners through the BLMK ICS, setting out the benefits of partnership working for local people

- Help the Clinical Commissioning Group (CCG) to deliver its corporate objectives, meet its legal duties and manage its reputation

2 Introduction

Since 2018, the three CCGs of Bedfordshire, Luton and Milton Keynes (BLMK) have been on a journey towards joint working and joint management arrangements, when they established the BLMK Commissioning Collaborative. The Collaborative brought systems and processes together to achieve greater economies of scale and deliver better patient care and value to patients and residents, while building on relationships with members, staff and local communities.

In 2019, we agreed to take the opportunity to formalise these arrangements by applying to NHS England to join together the three CCGs into one statutory organisation, which would reduce duplication and deliver greater economies of scale, in line with guidance from NHSE.


From April 2020, we introduced transitional ‘shadow working’ arrangements to align our governance and help us to work more as one organisation. The outbreak of Covid-19 helped us to solidify these arrangements, as working as one organisation during the pandemic enabled us to deliver a more agile and stronger clinical response to an unfolding crisis, which would not have been possible, if we were working as three sovereign organisations.

On 1 April 2021 the three CCGs will join together to form one organisation, called the NHS Bedfordshire, Luton and Milton Keynes Clinical Commissioning Group.

Since 2019, in line with the direction set out in the NHS Long Term Plan (published January 2019), we have been engaging with the public, our members, staff and stakeholders, to explore the benefits of creating a single CCG for BLMK.

During this period, we have identified that by working as one CCG we can make better use of our resources such as clinical leadership, workforce, technology, money, and buildings to more effectively:

Integrate health and social care to personalise care – we will play a pivotal role in facilitating the right environment for a new way of working that is designed to provide seamless care between different parts of our system depending on each person’s needs, improve health outcomes, reduce inequalities and deliver sustainable health and care services for our population. We will work with our Integrated Care System (ICS) partners to re-frame the way NHS commissioning works to be more strategic and less transactional, focusing more on population health and outcomes than we have before

Develop primary care networks – by joining together we will undertake some functions of the CCG once, not three times, releasing additional capacity to work together with local authorities and primary care networks to address local health inequalities with greater pace and purpose

Achieve organisational efficiencies – operational efficiencies will come from moving three separate organisations to one. These efficiencies will be cash releasing (rationalisation of estate and a single staffing structure and governing body) and non-cash releasing (submitting one set of statutory returns instead of three, and greater stability in the leadership to help build stronger relationships in the health and care system). These changes, and others, will achieve at least a 20% reduction in running costs and help release more resources for frontline services.

While significant progress has been made in aligning and collaborating as three CCGs, especially as we work together to address the challenges of Covid with our health and care partners, becoming one organisation will enable us to build on and further accelerate this joint working to address our key challenges. By becoming one

November 2018BLMK Commissioning

Collaborative

April 2020Shadow working as a

single CCG

April 2021Formal establishment

of BLMK CCG


organisation, and being more strategic in the way we commission services, we aim to achieve our mission and vision.

Our mission is to optimise health and wellbeing for our population, advance health equality in our communities and make the best use of NHS resources.

Our vision aligns with and supports delivery of the BLMK ICS’s vision and underpins

the delivery of this strategy.

As a strategic commissioner, we will optimise health and wellbeing for our population by:

Enabling effective collaborations of providers and primary care

networks, supporting an evidence-based approach to the design of health and care services

Enabling local place-based partnerships to support more people to manage and improve their own physical and mental health and wellbeing, and tackle the wider factors that impact people’s health

Promoting clinical best practice and quality improvement across the system

We have had rich conversations and engagement with all our stakeholders, with key themes emerging around ensuring strong clinical leadership, a strong local focus for services and funding, and partnership working to ensure the best health outcomes for local people. This has helped us to mitigate many of the concerns our members, partners and wider stakeholders have, including ensuring clinical leadership is embedded in our governance and we retain our strong local focus and connections, for example. However, it is important to acknowledge that there is still work to do with some partners, to ensure we fully understand their concerns and put appropriate and effective mitigations in place. Importantly we will need to demonstrate through our daily work and behaviours that we have effectively addressed their concerns.

The Covid-19 pandemic has helped to overcome some of these concerns, with a strong collaboration emerging between the communications and engagement functions in across all health and social care agencies, which has allowed for greater use of resources, improved transparency and trust and a stronger focus at place to tackle issues at source using local insights and feedback.

The strengthening of partnerships between Healthwatch, the Voluntary Sector, Covid Champions and Community and Faith Leaders has also provided an effective best practice model, which will serve the CCG well in the future, enabling us to break down barriers, better reach seldom heard groups, tackle digital exclusion and engage across the health inequality divide to improve social inclusion in our area.


Looking ahead – change is the continuity

In the last five years, changes in health policy has been the continuity, as government has worked to tackle how we manage a diverse, growing and ageing population that is living longer with long term conditions. As we move forward, the NHS needs to change the way it delivers its services, providing more care closer to home, more personalised care, hospitals providing specialist care that can’t be

delivered in community settings and continuing to invest and develop primary care. We also need to consider the developing national ‘reset’ strategy.

On the back of the merger of the three CCGs, legislative proposals for change to the health and care system have been set out by the Government in its White Paper, which was published in February 2021.

The model being been put forward will see a line being drawn under the Lansley reforms and CCGs being incorporated into the new statutory ICS model1.

The NHS and local authorities will be given a duty to collaborate with each other. Measures for statutory Integrated Care Systems (ICSs) will be brought forward. These will be comprised of an ICS Health and Care Partnership, bringing together the NHS, local government and partners, and an ICS NHS body. The ICS NHS body will be responsible for the day to day running of the ICS, while the ICS Health and Care Partnership will bring together systems to support integration and develop a plan to address the systems' health, public health, and social care needs. Both bodies will need to draw on the experience and expertise of front-line staff across health and social care. The legislation will aim to avoid a one-size-fits all approach but enable flexibility for local areas to determine the best system arrangements for them. A key responsibility for these systems will be to support place-based joint working between the NHS, local government, community health services, and other partners such as the voluntary and community sector.

As ICSs are formally established and evolve, the intention is to further strengthen partnership working between the NHS, local government, public health, and social care. This will benefit local residents and communities as partnership working is truly embedded and matured and accelerates place-based arrangements for local decision making and use of resources.

This proposed legislative change is the next step of the journey towards integrating services to improve outcomes for residents and will build on the benchmarks that have been established during the Covid-19 pandemic.

1 Integration and innovation: working together to improve health and social care for all https://www.gov.uk/government/publications/working-together-to-improve-health-and-social-care-for-all/integration-and-innovation-working-together-to-improve-health-and-social-care-for-all-html-version

https://www.gov.uk/government/publications/working-together-to-improve-health-and-social-care-for-all/integration-and-innovation-working-together-to-improve-health-and-social-care-for-all-html-version

https://www.gov.uk/government/publications/working-together-to-improve-health-and-social-care-for-all/integration-and-innovation-working-together-to-improve-health-and-social-care-for-all-html-version


3 CCG’s strategic priorities 2021-24

In line with national policy direction the CCG and ICS will be brought closer together over the coming months, and this would continue under either of the proposed legislative changes put forward. This includes:

The CCG and ICS speaking with one voice A single Accountable Officer for the CCG and ICS, Felicity Cox, to support

a system-wide approach and further integration A continued focus on partnership working.

The development of ICS/CCG strategic priorities with ICS partners and wider stakeholders started in March 2021 and our Clinical Commissioning Strategy has adopted the draft ICS strategic priorities as our strategic priorities. This communications and engagement strategy takes account of these draft priorities. As outlined earlier in the document, this is a two stage transition strategy and will be reviewed and updated to reflect the CCG/ICS’s new strategic priorities once they have been developed.

The BLMK ICS and CCG’s draft strategic priorities as set out in our Clinical Commissioning Strategy for the period 2021-24 are:

1. Every child has a strong, healthy start in life: from maternal health, through the first thousand days to reaching adulthood

2. People are supported to engage with and manage their health and wellbeing

3. People age well, with proactive interventions to stay healthy, independent and active as long as possible

4. We work together to build the economy and support sustainable growth 5. In everything we do promote equalities in the health and wellbeing of our

population

Clinical commissioning areas of focus for 2021-22

Area one - To recover from the impact of Covid-19, optimise people’s health

and wellbeing, advance health equality and make the best use of NHS resources2 including:

COVID-19 incident response, recovery, and transformation Primary care development – working with local authorities and providers to

continue to improve access and reduce waiting times Working with local authorities and supporting Care Alliance and PCN

development to transform out of hospital care Working with local authorities and providers to:

2 BLMK Draft Clinical Commissioning Strategy, Appendix A


o deliver more personalised care o improve care for people with learning disabilities and autism o improve children and young people’s care o improve maternity care o improve care for people with diabetes o improve respiratory care o improve cardiovascular care o improve stroke care o improve cancer survival o improve mental health care o optimise medicines and prescribing o improve screening and immunisation

Area 2 - strategic commissioning transformation

We have worked with our ICS partners and staff to co-design a Target Operating Model (TOM) for BLMK CCG as a Strategic Commissioner. This shared understanding of strategic commissioning will enable us to move forwards together to implement the transition to a statutory ICS and new ways of working in BLMK that align with the direction of travel set out in Integrating Care (November 2020 and Jan 2021). Further developing our plans to implement this TOM will be a key focus of the CCG during 2021/22, with the ambition to operate new ways of working in shadow form during this year in readiness for ‘go live’ in April 2022. To deliver improved outcomes for our population, commissioning will become more strategic, with a clearer focus on population-level health outcomes and a marked reduction in transactional and contractual exchanges within a system. The activities, capacity and resources for commissioning will change in three significant ways:

1. Ensuring a single, system-wide approach to undertake strategic

commissioning including: Assessing population health needs Planning how to address those needs Ensuring that these priorities are funded to provide good value and health

outcomes. 2. Service transformation and pathway redesign will led by providers through

place and provider alliances, with CCG staff enabling and resourcing this work

3. Greater focus on population health and outcomes in contracts.


4 Scope of this strategy

This strategy’s focus is to describe the communications and engagement required from April 2021 for BLMK CCG. It will support the new CCG to meet its organisational goals (set out above) and build on previous strategies which have focused on communicating, engaging and involving our governing bodies, member practices, staff and key partners, stakeholders and the public about the proposed merger. It also builds on the significant best practice co-production work around Local Maternity Services and the collaboration across the health and care system to respond to the Covid-19 pandemic, which provided a blueprint for social inclusion and has enabled us to work closer with seldom heard groups within our communities.

The strategy is an important moment to set the tone and direction for the new organisation going forward. The strategy covers the time period 2021-24 but with a specific focus on priorities for 2021/22, recognising changes to the organisation that could result from the proposed legislative changes described above and commitment to partnership working and (service) user involvement.

The draft strategy has been shared with the Patient and Public Engagement Joint Committee, CCG Executive, Shadow Working Group and One BLMK CCG Programme Board before going forward for approval by the new CCG Governing Body in April 2021. Implementation of this strategy will be overseen by Jane Meggitt, Director of Communications and Engagement on behalf of BLMK CCG. In line with our two stage approach, this strategy will evolve into an ICS strategy and further socialisation with system partners will be undertaken to gather further input at the appropriate time.

5 COVID-19 context – a blueprint for the future

The strategic principles of the communications and engagement strategy requires us to work closer than ever before with system partners and especially our seldom heard communities on a continuous basis. Central to achieving this will be having an engaged workforce of staff, who are committed to delivering positive change and a mobilised GP membership who are the trusted voices of our community and who will work to advocate for the CCG and ultimately the ICS.

The Covid-19 Pandemic has helped to sketch out a blueprint from which we aim to build upon through the lifespan of this strategy. At the start of the pandemic, a communications and engagement unit was established as part of the Local Resilience Forum, to manage the unfolding crisis and provide specialist support to the partners in sharing public health messaging and encouraging compliance.

As the partnership developed, a ‘strategic communications and inclusion cell’ has

been formed between health partners and Local Authorities to provide a system wide approach to communications planning and engagement to support the ICS response


to the pandemic and the vaccination programme. This has led to the sharing of population health information, allowed for better understanding and targeting of our public and increased inclusion, as we have developed closer contact with seldom heard groups – using the most appropriate organisation, or trusted voices to engage where it is better to do so.

Our engagement with Healthwatch and the voluntary sector, as strategic partners has also helped to improve our engagement and regular two way ‘sharing

conversations’ among equal partners has helped to re-frame how we operate, to maximise the impact of our work and build the foundations for more integrated working with our diverse communities and local residents.

This approach has started to deliver returns, with more clinicians, staff, elected representatives, community and faith leaders actively willing to get involved with the communications and engagement effort to make a difference to people in the communities they live and work.

It is clear that this approach and new way of working will be beneficial when applied to other areas of our commissioning strategy, and ICS priorities including regular discussions with a ‘Health and Social Care Community’ around wider determinants of health, early years, maternity services, mental health, cancer care, strokes, primary care commissioning and the annual flu and Covid campaigns.

This approach would negate the need for set pieces of consultation around service changes, which is often criticised by Health Overview and Scrutiny Committees and moves us more towards a co-production approach, where communities are empowered to design the services they want in their area.

Team BLMK - our NHS people

Team BLMK - our NHS People are central to delivering this strategy. Building on the NHS People Plan, it is essential that our staff have a sense of belonging to the NHS brand, feel empowered to make a difference and advocate new ways of working and collaboration that will deliver outstanding patient care, improve outcomes and reduce health inequality in Bedfordshire, Luton and Milton Keynes.

This approach has been successfully applied in Milton Keynes, through the MK Way strategy from Milton Keynes University Hospital and this should be used as the foundation for the system wide approach to staff engagement and advocacy.

All staff engagement and involvement work will be aligned to the developing our People Strategy, to ensure that we are mindful that our people have been responding to an ongoing crisis for over 12-months, while also managing organisational change around the merger of the three CCGs. Further change arising from a new NHS Act has the potential to deplete resilience and create a drain of talent and corporate knowledge, which has the potential to hamper progress against achieving our overall strategy.


Lessons from the public

Public confidence is an issue with many people feeling hesitant about resuming some activities (when guidelines allow). Research from Ipsos MORI found that significant numbers of Britons remain anxious about many aspects of life returning to normal, particularly where these are in enclosed spaces or with large groups of other people3. While attitudes may change over time, we should recognise that for some groups, engagement preferences may have permanently changed. How we best reach people at home continues to be a primary consideration for our planning.

There are lessons that can be learned from the pandemic, with some discussion amongst influencers and opinion leaders about patient and public participation during the crisis. Commentary from The King’s Fund and National Voices refocuses our

attention on the importance of listening and responding to the views and experiences of patients and the public, whatever the circumstances: ‘Too often efforts to

understand what goes on for people and to respond to their needs and aspirations

can feel like a nice to have rather than a key part of how to deliver health and care

services effectively. It is tempting for services to extend this view into crisis periods

by saying ‘We don’t have time to do it’, but now, more than ever, health and care

services need to base their decisions on the reality people experience.’4 There is a body of evidence that shows how user involvement leads to better services and outcomes

The NHS occupies a prominent place in the public’s consciousness and because of COVID-19, the profile of our health service has never been higher. The pandemic has seen an unprecedented outpouring of affection and interest in the NHS, with public shows of appreciation and fundraising efforts making headlines and fostering a new sense of interest and loyalty. As a result, people are more likely to engage on the future of their local health services. Research from Healthwatch showed that two-thirds of people in England say they are more likely to act to improve health and social care services since the outbreak of COVID-195. We believe that this may positively impact our engagement activity as people who previously might not have wanted to talk about the NHS have a new interest in getting involved.

Although public affection and interest is positive, we will also need to be sensitive to those who have been adversely impacted by COVID-19. Voluntary and charity sector groups are key partners, helping information exchange and fostering discussions with patients and families who might otherwise be difficult to reach. In an article ‘Time to unmute the patient voice’ published on 16 July 2020, Health Service Journal

3 ‘How comfortable are Britons with returning to normal, as coronavirus concern rises again?’ 2 July 2020

https://www.ipsos.com/ipsos-mori/en-uk/how-comfortable-are-britons-returning-normal-coronavirus-concern-rises-again

4 Shielded Voices: hearing from those most in need, The King’s Fund – 26 May 2020 https://www.kingsfund.org.uk/blog/2020/05/shielded-voices-covid-19

5 Healthwatch ‘Because we all care’ – 8 July 2020 https://www.healthwatch.co.uk/news/2020-07-08/help-health-and-social-care-services-recover-covid-19-becauseweallcare



https://www.kingsfund.org.uk/blog/2020/05/shielded-voices-covid-19

https://www.healthwatch.co.uk/news/2020-07-08/help-health-and-social-care-services-recover-covid-19-becauseweallcare

https://www.healthwatch.co.uk/news/2020-07-08/help-health-and-social-care-services-recover-covid-19-becauseweallcare


correspondent Sharon Brennan concluded that ‘patients may be more distrustful,

charities have less time to campaign or engage and services already have rapidly

changed, but if the NHS is to reduce health inequalities in its Covid reset, patients

must be both heard and listened to.’6 Reviewing and strengthening our relationships and partnerships with the voluntary, community and charity sector will be an important next step in developing and delivering our plans.

We recognise these challenges and opportunities require a different mindset for communications and engagement and we have built on learnings through the coronavirus period, reviewed our proposed activities, channels, and materials to ensure they adapt in this uncertain context.

6 Principles of our approach

Our communications and engagement activities will be guided by the following strategic principles. They are intended to ensure alignment and consistency of our approach with our overall aims, objectives, and audience insights:

• One #TeamBLMK, one BLMK Clinical Commissioning Strategy 2021-24 This work sets out the new CCG’s plan to develop and improve health and wellbeing services for our population over the next three years. Optimising the health and wellbeing of our population, advancing health equality in our communities and making the best use of NHS resources. Our communications should enable staff to coalesce around one strategy, one purpose and help them to feel connected to the Team BLMK brand. Linking into the People Strategy, this work will demonstrate to all staff that they can make a difference to improving health outcomes for the residents and communities in which they live and serve. Our trusted voices Engaging with our clinical leadership is central to our communications and engagement approach. Using trusted leaders should be a key component of our communications and engagement activities. Our approach will be to develop a multi-professional clinical voice focused on the breadth of clinical roles including doctors, nurses, pharmacists, AHPs etc and give them the opportunity to influence commissioning and improve outcomes in their area.

• Collaboration is key

6 ‘Time to unmute the patient voice’ https://www.hsj.co.uk/expert-briefings/the-integrator-time-to-unmute-the-patient-voice/7028054.article?mkt_tok=eyJpIjoiTXpGbU5URXlOV0prWlROayIsInQiOiJFNlgwdHdiZkc3cnVPTlJxR2tQb3NscXU1MmkwXC9Ha0J5WDVVeklRU21DdmQ0WUVDXC9nQ1lkYmRQVVY5a1FSeEZRN0FMT1Q0K21FZWRcL2Z6blJHXC9PaCtLTjN0NkNFZ3I1RFwvK0Y1TW4wQWx2U0NqUU1XUmQxbWtxQ0xuODF5Zk1uIn0%3D

https://www.hsj.co.uk/expert-briefings/the-integrator-time-to-unmute-the-patient-voice/7028054.article?mkt_tok=eyJpIjoiTXpGbU5URXlOV0prWlROayIsInQiOiJFNlgwdHdiZkc3cnVPTlJxR2tQb3NscXU1MmkwXC9Ha0J5WDVVeklRU21DdmQ0WUVDXC9nQ1lkYmRQVVY5a1FSeEZRN0FMT1Q0K21FZWRcL2Z6blJHXC9PaCtLTjN0NkNFZ3I1RFwvK0Y1TW4wQWx2U0NqUU1XUmQxbWtxQ0xuODF5Zk1uIn0%3D






Interconnectivity between ICS partners is central to delivering the communications and engagement strategy and achieving the desired outcomes to improve health and reduce inequalities. Working collaboratively will enable us to engage in a more authentic way with partners and deliver greater results. Using patient stories and focusing on people, instead of pathways will be one way to bring our work to life and gain traction with residents/

• We are restoring our services but we need to change Open and honest conversations with the public about the health services is essential as part of re-framing the NHS in a post Covid, ‘new NHS Act’ world.

Continuous two way conversations with our BLMK Community will be required to bring people on the journey with us, and ensure that their views are reflected in how services will be delivered in the ‘new normal’.

• Meaningful engagement, that is open, honest, timely and responsive We should always also seek to co-produce service changes with residents, staff, clinicians and partners. This will ensure that services are delivered that meet the needs of local people. We will be open, honest, and transparent in our engagement about new ways of working and any changes we are proposing, including where they may impact on individuals and/or organisations, as we implement our Clinical Commissioning Strategy and functional area strategies, co-produced with our staff, partners and stakeholders. We will ensure the impact of any changes are fully understood and we will provide opportunities to ask questions and provide feedback. We will also be clear about the aspects of our proposals that can be influenced, and what particularly we are seeking views on. Our engagement will also be meaningful. The process will be genuinely two way - we will actively listen to feedback and, where appropriate, adapt our proposals in response. We will ensure our audiences are aware of how they have informed this work through regular ‘you said, we did’ communications. It

will also build on the previous engagement undertaken which informed Living

longer in good health, Bedfordshire, Luton and Milton Keynes Longer Term

Plan (2019-2024) for improving health and care (our local response to deliver the commitments set out in the NHS Long Term Plan).

7 Our aims

Our overall aim is to provide and share clear information about the CCG’s plans and to develop, support and facilitate targeted and meaningful engagement with key stakeholders to help us deliver them. We will use this insight to inform discussion and planning and shape the CCG’s work programmes.


We have developed audience-specific aims based on what we want each of our audience groups to ‘think, feel and do’, which are outlined in appendix 1. They are based on the following overarching aims:

a) to generate understanding of the need to change and benefits it brings

b) to build confidence in, and support for, a new organisation and its priorities and work programmes

c) to facilitate meaningful insight and continuous engagement with the governing body, GP members, staff, stakeholders, patients, carers , the public and seldom heard groups to demonstrate that plans/work programmes have been co-developed with them and/or their concerns are heard and acted on in ongoing discussion and planning

d) to encourage all audiences to take the necessary actions to support the delivery of the Clinical Commissioning Strategy and the development of the new BLMK CCG.

Communications and engagement aims in the new organisation Our detailed aims of the communications and engagement activity for the single CCG for BLMK are to:

help set the tone, style and behaviours of the new organisation from the very start, including making staff and members feel valued, through appropriately marking the launch of the new organisation and recognising their place in it, in a focused and memorable way

support the CCG leadership, working with HR colleagues around the emerging new People Strategy to maintain and deepen a supportive and dynamic culture where we live our values and develop our people

support the CCG leadership to develop and deepen relationships with our partners, our members, provider alliances and PCNs, with stakeholders, and with the population of BLMK (patients, carers and the public in different communities) building on the strong relationships and local knowledge of our predecessor CCGs and local commissioning teams and the foundations established during the Covid response

further develop and regularly evaluate the CCG’s communications and engagement products and channels to share and receive information and maximise our reach by ensuring we have strong, effective and trusted two-way channels, including our use of established stakeholder and partner channels where appropriate

ensure that the trusted voices of staff, clinicians, GP members, stakeholders, patients, carers, community and faith leaders and seldom heard communities are clearly heard within the CCG so we are aware of local opportunities, issues, views and concerns, and have mechanisms for acting on them as well as establishing the CCG as a ‘people’ organisation


work with local authorities and other key partners including voluntary organisations to challenge ourselves in terms of who we work with and how we work more inclusively, reflecting our priorities and the diversity of our population

support service reviews led by the CCG, undertaking pre-consultation engagement, involvement and co-design, and formal public consultation where necessary, ensuring we engage with those impacted by change, as well as the seldom heard, digitally excluded and those with protected characteristics

build confidence and trust with seldom heard communities, stakeholders, staff and other stakeholders as an effective, collaborative and responsive organisation supporting and working with other health and care services in BLMK to improve health and wellbeing for local people.

8 Objectives

SMART communications and engagement objectives have been established and progress will be assessed and evaluated quarterly. This will measure the effectiveness of our communications and engagement, and ensure any learnings can inform the design of future communications and engagement activity.

Objectives can be measured by inputs (e.g. development of core narrative, collateral produced, etc), outputs (e.g. volume of uptake of communications and engagement activities, or people reached) and outcomes (e.g. changes in awareness, perceptions, and behaviours – or in services following co-production and/or feedback).

Our strategy will focus on outcomes as much as possible but recognise the challenges in effective measurement of outcomes (confidence in attributing changes in perception and behaviour to any single factor) could take some time to see a return, and so therefore will need to include a mix of input, output, and outcome measures.


We are ambitious in this strategy to deliver communications and engagement activity which comes from the Clinical Commissioning Strategy. However, the ongoing Covid-19 pandemic, historic vaccination programme and NHS Recovery, together with further organisational change has the potential to impact on delivery of business and usual work. As a result, it is likely that much of the activity undertaken in the immediate 12-months will be focused on:

- NHS Restoration and Reset - Vaccination programme - CCG / ICS Transition - Build the foundations to deliver with and through partners - Health inequalities work with the Health and Wellbeing Boards for our

communities. - Continued partnership working with ICS Partners, Healthwatch, the voluntary

sector.

Input

Develop a narrative and produce briefing packs on the new organisation, what it stands for, and its immediate priorities for all key audiences – staff, members, stakeholders and public - by 1 April 2021

Communicate at least weekly to relevant audiences, bringing to life and creating relevant talking points - focused on delivering the Clinical Commissioning Strategy 2021/24 - between April 2021 to March 2022

Develop a stakeholder relations and operational delivery plan and supporting resources for example, pen portraits, briefings, lines to take by 30 April 2021

Identify any gaps in the CCG’s communications and engagement activities with key audience groups, including the seldom heard, digitally excluded and those with protected characteristics, and develop a plan to fill them by 30 April 2021 (working with local authorities as appropriate)

Develop a programme of staff, member and stakeholder engagement and supporting resources for example, slide packs, FAQs, digital content by 31 May 2021

Ensure communications and engagement support is provided for all service reviews, where informal engagement/involvement and/or formal public consultation is required to meet the CCG’s statutory duties, as necessary.

Output

Capture staff, member, stakeholder, and public engagement activity including feedback, ongoing quarterly

Provide a written summary of the feedback received to the monthly clinical commissioning strategy meetings to feed into discussion, planning and decision-making, ongoing

Develop a ‘you said, we did it together’ summary of the feedback received, the CCG’s response to it and how inclusive and representative activities are, each quarter (30 June 2021, 30 September 2021, 31 December 2021 and another by 31 March 2022) for the CCG governing body


Consistent narrative and messaging should run through our corporate communications and engagement activity, measured by a quarterly audit of a sample of our communications and engagement activity and materials, including media and social media, ongoing quarterly

We will seek to grow engagement rates with our corporate communication products (internal and external) measured ongoing quarterly, and will measure their effectiveness once a year through our perceptions audit, annually

We will ensure all our campaigns include SMART objectives and evaluation mechanisms, ongoing.

Outcome

Result of ongoing quarterly staff ‘temperature checks’ (attitude/perception surveys) show that the organisation is increasingly seen to live by its values, ongoing

At least 10% increase in engaged and interested audience groups (staff representatives, clinical leaders, high priority stakeholders, and public and patient representatives as per ‘key players’ on stakeholder mapping grid, see appendix 2) by 2022 (rising to 20% by 2024) reporting they are aware of our organisational goals and can contribute to work programmes that are relevant/interest them, measured through a leadership workshop and perceptions audit for high priority stakeholders, and survey of public and patient representatives against a baseline measure by April 2022

At least 5% increase in less engaged but interested audience groups (wider stakeholders, and local communities and the public as per ‘show consideration’ on stakeholder mapping grid, see appendix 2) reporting they are aware of our organisational goals and can contribute to work programmes that are relevant/interest them, measured through survey of stakeholders, patients and public against a baseline measure by April 2022 – rising to 10% by 2024.

9 Audiences and insights

The full list of our target audiences is at appendix 2. Audiences have been categorised based on the nature of their relationship with the new, single CCG and their communications and engagement needs.

A detailed review of the ongoing engagement regarding the creation of the BLMK CCG can be found in the Detailed action plan of the CCGs ongoing engagement

regarding the creation of the BLMK CCG, December 2020.


10 Narrative and key messages

Establishing a core narrative and messages is key to ensuring our messaging is consistent with staff, members, and stakeholders. Each audience will have different needs and so our messaging and engagement approach needs to be tailored for each. It is important to note that our narrative and messaging will be regularly reviewed and evolve over time to reflect where we are on our journey as well as respond to audience insight.

See appendix 3 for our current narrative.

11 Activity/key components

The approach we adopt must consider the different needs and perspectives of those we are seeking to engage with. Our activity will be characterised by using multiple channels to deliver consistent but nuanced messages:

Increased focus on staff engagement and dedicated activity programme to support wellbeing and ongoing transition

ICS/CCG accountable officer, ICS Chair, clinical chair, medical director, chief operating officers/managing directors and other executive directors and senior leadership team to act as main advocates for change going forward

utilise existing CCG primary care, PCN and ICS, GP provider alliances, and local medical committee meetings and channels to continue to communicate with and engage the CCG membership and develop a programme of additional online meetings / drop in sessions at key milestone points

provide a range of mechanisms and opportunities for ongoing communication and feedback including face to face, online meetings, and email correspondence with all audience groups

ensure effective insight data and engagement activity supports the CCG and key workstreams to deliver their goals.

Delivery channels The CCGs have a well-established suite of delivery channels across the recognised communications spectrum of paid, earned, shared, and owned channels with a regular frequency. This includes, for example, weekly all staff briefings, weekly bulletins and regular meetings. This strategy advocates the continued use of these established, recognised channels during this transition period, but recommends a regular review to make sure they continue to be effective, and they may need consolidating in time.

We will continue to focus on increasing collaboration and working with and through partner networks and channels, using existing channels rather than creating new ones, to reach our key audiences.


See the delivery plan appendix 4 for an overview of our activities.

Supporting materials The activity we undertake will be supported by a range of materials. These will be regularly reviewed, refreshed and adapted to reflect where we are on our journey and/or phase of implementing our Clinical Commissioning Strategy and supporting programmes of work as well as respond to audience insight. They will include:

narrative and key messaging documents to support communications and engagement activity with staff, GP members and key stakeholders

question and answer, and ‘line to take’ documents briefing documents to support one-to-one and group engagement podcasts which go into the detail of topics of particular interest/concern to our

audiences. Focus topics may include how the proposals fit with the ICS development, what ‘place’ means, how we are working with local authorities to improve population health, etc.

video recordings of key events including all staff meetings, question and answer sessions

a central email address where staff, GP members and stakeholders can direct their queries.

12 Communications and engagement in the new organisation

The new, single clinical commissioning group will work with its stakeholders to support the delivery of its statutory functions, including with the ICS Board, provider alliances, place based partnerships, PCNs, health and wellbeing boards, as well as all other key audience groups outlined in this strategy.

We will continue to take into account the feedback received from different audiences about how we need to work and what we need to do to mitigate concerns, particularly about potential loss of local focus and local voice. This has already shaped the new CCG’s governance arrangements, clinical leadership structure, our Clinical Commissioning and Communications and Engagement strategies, and will continue to shape how we work and our messaging going forward.

We have heard some concerns about whether the issues for local people, clinicians and communities would be heard and acted upon by a new, much larger CCG. We have addressed these concerns by setting up the CCG, its governance and clinical leadership so that localities are fairly represented. We are determined to keep a strong focus on place and communities, bringing together the best local knowledge and understanding and combining it with commissioning at scale where appropriate. We are working closely with health and care professionals, our members and staff, the public and elected representatives across BLMK to ensure their experience and insight continues to shape what we do and how we do it.


Priority areas for communications and engagement activity Support the organisation to meet its business goals: this strategy and associated delivery plan sets out how communications and engagement will support the new CCG to meet its business goals, as set out in the clinical commissioning strategy. This strategy will be reviewed and updated to reflect the development of ICS/CCG strategic priorities which will commence in June 2021.

To maintain and deepen a supportive culture, we will:

support the implementation of vision, values, behaviours and brand (which have been developed with staff and partners)

develop strong consistent messages of support for staff going through transition as they settle into the new CCG and move into new roles in other parts of the ICS, building on NHSEI’s ambition to take a different approach to

transition limiting uncertainty and distraction from the ‘day job’ support engagement with staff to develop new ways of working and a different

mindset, building on the agility, pace of change and partnerships developed as we respond to COVID-19.

We will regularly measure staff sentiment, and the effectiveness of our work, through the development of a regular staff ‘temperature check’ survey.

Develop constructive and open relationships with our partners and stakeholders, we will:

undertake a workshop with leaders to identify individual stakeholders, prioritise relationships, and to understand what our key stakeholders think, feel, know and believe and identify where we want them to be in the future. We will use the recent work undertaken to inform the development of the strategic commissioner role (supported by Carnall Farrar) and supplement this with some further work to establish a baseline stakeholder perceptions audit to inform our progress going forward.

develop a plan, and identify relationship owners, to improve stakeholder perceptions and move them closer to what we want them to think, feel, know and believe

work closely with all key stakeholder audiences outlined in this strategy to ensure timely, accurate and meaningful communications and engagement

ensure the insight is regularly fed into executive and Clinical Commissioning Strategy meetings to inform team insight, planning and decision-making.

We will measure the effectiveness of this activity with an annual perceptions audit and annual leadership workshop.

Develop and maintain a rolling organisational narrative and messaging: which would flow through all our communication channels and activity.

This would be measured by a quarterly audit of a sample of our communications activity and materials.


Support reviews of services and transformational change: as required as we implement our Clinical Commissioning Strategy in line with statutory requirements. Going forward service reconfiguration will take place at both strategic commissioner and Care Alliance levels. The former will lead large scale, system-wide proposed service reviews and change programmes; the latter will lead smaller (but no less significant) proposed changes, such as to primary care facilities and services on a ‘place’ basis.

There are statutory and legal duties to consult and involve that the CCG is responsible for, but in addition engagement and involvement are embedded in our approach across all programmes, to gather insight, to co-design solutions and to make stronger and better links to the communities we work with so we can serve them. Consultation comes into play when we are proposing service change that is substantially different but is just one part of our ongoing engagement and involvement work.

Build confidence and trust: through timely, open and honest, and consistent communications; and meaningful engagement; working with HR to support leaders and staff to live our values and demonstrate appropriate behaviours. To support this we will develop:

internal communications – we will develop a range of channels/mechanisms for one and two-way communications and engagement, for example team brief and all staff meetings, and a suite of corporate communications products and an intranet/app. We will seek to grow engagement rates with our communication products, and regularly engage staff about their effectiveness

campaigns – we will develop detailed plans for identified campaigns including SMART objectives and evaluation mechanisms

stakeholder engagement and public affairs – as described above we will develop a detailed plan to ensure we engage with all our key audiences, and ensure feedback is fed into decision-making, and assess the effectiveness of this year on year, through an annual perceptions audit and leadership workshop

corporate communications – we will develop a range of channels/mechanisms for one and two-way communications and engagement, for example a suite of corporate communication products and a website. We will annually assess their effectiveness with target audiences

media and social media – we will develop a media protocol and social media policy for the new CCG, and ensure key spokespeople are media trained. We will develop handling plans to manage any issues, and develop a proactive editorial plan which will support the new organisation to meet its business goals by identifying case studies and appropriate stories to highlight priority areas of work and successes. We will measure success by reviewing our communications on a quarterly basis to assess inclusion of our key messages

insight and engagement – we will develop a coherent approach to developing insight from our engagement activity, working with our staff, members, local communities, local authorities and voluntary organisations. We will develop


both a staff and a citizens’ panel, work with local PPGs, utilise foundation trust membership networks, and work with local authorities to extend our local networks into new communities (of interest and place) beyond those traditionally involved in health. We will measure our success through the development of quarterly ‘you said, we did’ updates and reviewing how inclusive and representative activities are

crisis communications – we will scenario plan for potential crises, including how we would handle our response if we became the focus of national (media) interest. We would evaluate our success based on the effectiveness of our handling of any high-profile issues and adapt our plan accordingly.

Channels for the new CCG We will build on existing CCG channels, to embed communications and engagement with different audiences in our day-to-day work. Channels we anticipate will be used include:

Staff communications and engagement channels:

Weekly all staff briefing led by the AO via MS Teams Monthly Senior Leaders Group (Executive and Associate Directors) meeting

via MS Teams Staff panel (to be developed) BLMK CCG intranet BLMK WhatsApp - key message sharing for staff (limited sign up to date) Updates and key documents shared on NHS Futures platform Wellbeing / support workshops Drop in sessions (ad hoc – depending on key topics for involvement and

feedback) Screensaver updates with key information eg. BLMK Keep Well Service Dedicated HR and generic email for questions/ feedback Induction Trade media, local media, social channels - Facebook, Twitter, YouTube,

Snapchat Geographically (place) focused channels, frequency tbc – based on place Regular staff ‘temperature check’ survey led by HR, with communications

input Specific arrangements established for teams going through restructure.

Clinical communications and engagement channels: GPs, provider alliances and PCNs

Weekly primary care bulletin Members’ forums for each LA – quarterly Clinical Leadership Forum Attendance at/email to practice managers


PCN Director meetings – monthly CCG community teams Annual members’ meeting Tbc geographically (place) focused multi-professional team meetings

Stakeholder communications and engagement channels:

Stakeholder briefing – Monday and Thursday (Covid specific) ICS CEO meetings - fortnightly ICS Partnership Board (monthly) MP briefings (weekly at the moment though typically quarterly including for

specific issues) ongoing engagement with presentations and briefings to scrutiny committees

and health and wellbeing boards Councillor briefings (currently Bedford only but looking to roll out to others) Healthwatch meeting (monthly) plus regular ongoing engagement Regular meetings with our VIP stakeholders (these will be determined in the

stakeholder relations workshop with leaders) Development of a monthly stakeholder bulletin CCG governing body meetings will be held (virtually) in public.

Patient and public communications and engagement channels:

Patient Participation Groups – regular communications via chairs CCG engagement group - PPEC Citizens’ panel (with patient panel subset) – to be developed CCG’s website CCG’s social channels – Twitter/ Facebook/ YouTube/ Snapchat Partner organisation websites/social media channels Healthwatch communications – digital channels and use of their community

partners including faith leaders Media Display screens in surgeries/ hospitals/ community/ LA sites Posters in GP surgeries British Sign Language (Access Bedford) Voluntary organisations/charities Ad hoc campaign specific.

13 Insights, engagement and experience

As a new organisation we will establish systematic ways for our people, our partners and stakeholders, and patients and the public to proactively work with us in shaping how we do things. Our approach will ensure we meet our statutory duties as well as support place-based work, whether that is a ‘place’ with our local authorities, across


acute hospital footprints, in primary care localities or as one for Bedfordshire, Luton and Milton Keynes.

System working provides an opportunity for insights to become central to the way we ‘do business’ in the future. We will work closely with local authorities, using data and insight generated from Joint Strategic Needs Assessments (amongst other sources) to make sure we are engaging with relevant communities.

As a CCG we will not only focus on clinical and operational needs we will place more emphasis on how to understand and address user (patient and our local communities) needs. Our approach will be to ensure these insights lead to action at strategic and tactical levels, as illustrated in the figure below.

Figure: Synthesising insights into action; NHS Bristol, North Somerset and South Gloucestershire CCG

Priority areas of focus include:

Insight and experience - focus on actionable insight at strategic and tactical levels working with local authorities and voluntary organisations to effectively reach our local population and their representatives, including those who are seldom heard, digitally excluded and those with protected characteristics. Priorities include development of a:

o Staff panel – to strengthen staff insight and engagement. Activity would include quarterly meetings, with opportunities to hear from and talk with members of the executive team

o Citizens panel (including a service user sub-set) to achieve population, geographic and service user perspectives. Activity would include regular quarterly surveys, plus ad hoc work for example in-depth interviews, focus groups, online surveys on CCG work programmes such as NHS 111, management of chronic disease, stroke services etc as and when required to support work programmes


Community engagement – focus on co-production, working across the system at ICS/CCG, locality or place level to guide and support programmes to work in partnership with local people and communities, to encourage two-way dialogue to help deliver change on the ground

Inclusion – recognising we have an incredibly diverse demographic we will collaborate with colleagues to share resources and challenge how we work more inclusively to gather insight and engage with our communities, reflecting the diversity of our population

Supporting the communications team – to test and iterate messaging, campaigns and communications products

Working with our Patient and Public Engagement Committee (PPEC) – to ensure their feedback is considered in our work and in other major CCG work programmes. See Appendix 5 for membership details and their terms of reference.

Example framework (based on developing interventions with young people) to appraise and consider how to work in the future

Figure: Consultation, co-production and prototyping of interventions; Hawkins et al. 20177

The approach set out in the framework above, whilst only an example, can be used to make a positive impact on major work programmes such as NHS 111 and mass vaccination. The first step is to work collaboratively with programme teams/local authorities to review current and existing evidence and insight and consult with stakeholders. The middle part is where we use the insight and collaborate/co- 7 Principles for co-production of guidance relating to the control of COVID-19, 8 July 2020 (publishing.service.gov.uk)

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/954977/op0001-principles-co-production-guidance-covid-19.pdf

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/954977/op0001-principles-co-production-guidance-covid-19.pdf


produce an intervention/resource. The final part, prototyping is something we need to do more of, iteratively testing and refining, content, messages, service concepts, campaigns etc.

14 Implementation

A rolling plan of communications and engagement activities and opportunities will be maintained and delivered by the CCG’s communications and engagement team,

working in partnership with communications colleagues across BLMK.

A supporting delivery plan for the communications and engagement strategy has been developed and is at appendix 4. The plan sets out the activities necessary to deliver this strategy.

The delivery of this strategy will be led by the CCG’s Director of Communications and Engagement. Existing CCG communications and engagement teams across BLMK have been brought together to form one team. See appendix 6 for the structure of this team. It is notable that the team is small compared to CCG communications and engagement teams in other health systems. The team is currently focused on responding to the pandemic and implementation of the vaccine roll-out. Priority activity identified in this strategy, particularly on system-wide and local place issues, will be delivered working with local authority and provider colleagues. If work programme priorities are greater than the available capacity, we may need to consider additional temporary support and/or a review of the capacity required in the team over the longer term.

Funding for specific communications and engagement activities and any additional short-term capacity needed will come from the programme budget with proposals made on a case-by-case basis.


15 Risks and mitigation

We have identified a number of risks to the effective delivery of this strategy and have set out their mitigations below.

Risk Mitigation Owner Behavioural change takes time – and so the organisation does not achieve one of its most significant changes related to culture change – and changing the way our people work and behave

Ongoing engagement with our people prior to merger to inform the development of, and garner interest in and ownership of, the new organisation through the development of mission, vision and values Leading by example from all senior leaders, ‘walking the walk’ in terms of values, behaviours, and development of organisational culture Ongoing work and the development of practical tools to support the organisation to deliver a shared purpose, values, and behaviours i.e. incentives which guide everyday behaviours, create awareness and understanding, engagement to create ownership and keep values alive Regular staff ‘temperature check’ survey e.g. through Survey Monkey or similar

Director of Performance & Governance Governing body, SLT and other senior leaders Head of People & Development/Director of C&E Head of People & Development/Director of C&E

Vocal and influential detractors of merger take focus off work in hand

Ongoing engagement with known detractors to listen and respond to concerns, addressing them where possible Supported by consistent messaging, FAQs, and LTT Ensuring there is also capacity to focus on engaging with quieter members/stakeholders to get balanced views or a range of views

Accountable Officer, CCG place lead directors Director of C&E Director of C&E, CCG place lead directors

Stakeholders become disenfranchised if they lose established and

Ambition to keep people in roles which maintain ongoing relationships Where this is not possible, induction and handovers are planned

Head of People & Development Place lead directors


effective relationships

sensitively – with a particular focus on managing important relationships Communications ahead of any transition stages to manage expectations and maintain relationships Conscious messaging in communications and engagement activity that refers to the importance of local place as much as to commissioning at scale (a ‘both and’ approach)

Director of C&E Director of C&E

There is confusion, about the role of the ICS and CCG, because both are in transition

Consistent narrative to describe the CCG and ICS agreed and used by the system Included in FAQs for staff audiences Agreement that focus on the names of the new health and care structures (ICSs and PCNs) and internal systems and processes are not the focus of communications with lay audience groups. Wherever possible, the changes and improvements we are expecting should be illustrated by human stories (either real case studies or fictionalised patient or staff scenarios/stories)

Director of C&E Director of C&E Director of C&E

Potential for lots of messaging landing at the same time – COVID-19, vaccination programme, winter pressures – which could impact awareness and engagement with key work programmes

Continue to use established channels for communications and engagement, working with partners to build new ones and avoid duplication Bring key work programmes to life setting out how they support the CCG’s new vision and ‘what this means for you/patients/communities’ and generate interest/excitement about the impact the new organisation/work programmes will have Ongoing communication throughout the period reinforcing a similar but rolling narrative to build awareness

Director of C&E Director of C&E Director of C&E


Include relevant work programmes/updates about the new organisation as an agenda item on existing meetings rather than creating new ones A focus on direct engagement (face-to-face, phone etc) for our most important stakeholders

Accountable Officer, programme leads Accountable Officer, Place lead directors, programme leads

Language does not resonate/is not meaningful/causes confusion – ICS, PCNs, provider alliances - to key audience groups

Agreement that focus on the names of new health and care structures (ICSs, provider alliances, and PCNs) and internal systems and processes are not the focus of communications with lay audience groups. Wherever possible, the changes and improvements we are expecting should be illustrated by human stories (either real case studies or fictionalised patient or staff scenarios/stories)

Director of C&E

Imminent legislative change brings uncertainty about our role as a GP member organisation, this could disenfranchise GP members, a critical stakeholder, at a time when they are crucial to the success of system working going forward

Remain sighted on commentary about and detail of proposed legislative changes Continue to engage with members and GPs in an open and transparent way, working through any proposed legislative change together with our governing body Ensure GPs remain central to BLMK system working and an influential stakeholder in whatever organisational form the ICS/CCG has going forward

Accountable Officer, Medical Director, Director of Primary Care, Director of C&E Accountable Officer, Medical Director, Director of Primary Care, Director of C&E Accountable Officer, Medical Director, Director of Primary Care, Director of C&E


16 Evaluation

The delivery of this strategy will be evaluated quarterly, against the agreed SMART objectives set out in section 7. In addition to this, input, output and outcome measures will be shared with the CCG governing body on a quarterly basis.

Appendix 1: ‘Think, feel, do’ aims for each audience group

Appendix 2: Stakeholder mapping grid

Appendix 3: Narrative for the new organisation

Appendix 4: Communications and engagement delivery plan

Appendix 5: Patient and Public Engagement Committee – team members and terms of reference

Appendix 6: Team structure

Appendix 7: Glossary of terms


17 Appendix 1: ‘Think, feel, do’ aims for each audience group

Audience

What we want them to… Think Feel Do

Practice members and governing bodies

The merger to create one CCG is bringing benefits for me/us, the local population and primary care – combining the best of local knowledge through place and working at scale

Clinical leadership is strong and remains pivotal to commissioning

I understand the CCG’s goals and how this fits with the wider system and what this work means for me/how I benefit or can get involved

I have been given enough information, and been engaged in the process throughout

Responsible for delivering own role in partnership effort

Confident that I know how and where within the CCGs to find out more, and feel confident I will be listened to, so I don’t feel the need to highlight concerns in the media, on social media or through other external channels

Actively support the transition to one CCG and future system development

Positively engage in the development of the new organisation and the delivery of the Commissioning Strategy

Staff The merger to create one CCG is bringing benefits for the local population and GP practices – combining the best of local knowledge through place and working at scale

I understand the CCG’s goals and how this fits into the wider system and how my role contributes to this

That the new organisation is a good place to work, and offers opportunities for development

That I can help shape the development and am important to the success of the new organisation

Understand that there will still be some uncertainty for some as some commissioning is devolved to place

Energised and motivated about their role within the new organisation

Confident that I know how my, and my team’s, role contributes to the future organisational vision

Confident I will be listened to, so I don’t feel the need to highlight concerns in the media, on social media or through other external channels


Positively contribute to the delivery of the CCG’s goals and Commissioning Strategy

Actively support the new organisation by demonstrating new values and behaviours in day to day role

Health and care system partners

The merger to one CCG is bringing benefits for the local population – combining the best of

Assured the merger to one CCG and the delivery of the Commissioning



local knowledge through place and working at scale

Understand the CCG’s goals and how this fits into the wider system and how my/our role plays a part

The CCG is committed to working and engaging with local partners, and I/we will be kept up-to-date and provided with opportunities to contribute to the CCG’s work

Strategy will bring benefits for the local population


Confident I/we will be listened to, so I/we don’t feel the need to highlight concerns in the media, on social media or through other external channels

Positively work with the CCG to contribute to the delivery of the CCG’s (and wider system’s) goals and Commissioning Strategy

Regulators BLMK have robust plans for the new CCG Confident in local leadership’s ability to

transition to one organisation and deliver their plans going forward

Assured of the plans and local leadership’s ability to deliver them

Their approach to stakeholder relations will allow them to take key stakeholders with them

Encourage system partners to play their part

Facilitate any additional political ‘air cover’ as needed whilst change is implemented

Local stakeholders

The merger to one CCG is bringing benefits for the local population – combining the best of local knowledge through place and working at scale

Understand the CCG’s goals and how this fits into the wider system and how I/we can engage in this

The CCG is committed to working and engaging with local stakeholders, and I/we will be kept up-to-date and provided with opportunities to contribute to the CCG’s work

Assured the merger to one CCG and the delivery of the Commissioning Strategy will bring benefits for the local population


Confident I/we will be listened to, so I/we don’t feel the need to highlight concerns in the media, on social media or through other external channels


Positively work with the CCG to contribute to the delivery of the CCG’s (and wider system’s) goals and Commissioning Strategy

Patients and the public

The merger to one CCG is bringing benefits for the local population – combining the best of local knowledge and working at scale

I/we can regularly hear about, get involved and have opportunities to shape work programmes I am interested in

I/we have enough information Confident changes are the best for

patients and local communities Engaged and confident that I/we know

how and where within the CCGs to find out more information, and confident I/we will be listened to, so I don’t feel

Engaged audiences: Publicly support the single CCG’s

goals and Commissioning Strategy Commentate fairly on areas of concern Positively work with the CCG to

contribute to the delivery of the CCG’s


That the merger won’t negatively impact the local NHS’ response to the COVID-19 pandemic or roll-out of the vaccination programme

the need to highlight concerns in the media, on social media or through other external channels

(and wider system’s) goals and Commissioning Strategy

Local media The merger to one CCG is bringing benefits for the local population – combining the best of local knowledge and working at scale

There are opportunities for local people and stakeholders to shape the work programmes they are interested in

That the merger won’t negatively impact the local NHS’ response to the COVID-19 pandemic

Supportive of the process Promote the CCG’s goals and plans fairly

Help to tell the story of change, why it is necessary, what this will mean for patients and local communities and to support the CCG in putting a ‘face’ to the benefits of change through positive staff and patient stories


18 Appendix 2: Stakeholder mapping grid


19 Appendix 3: draft delivery plan


20 Appendix 4: Narrative and key messages for the new organisation

A new, single CCG for Bedfordshire, Luton and Milton Keynes is being established from 1 April 2021, and following the publication of the White Paper on health integration in February this year, this organisation will join together with the Integrated Care System to provide one organisation by 2022.

Our role is to improve health and wellbeing and reduce inequalities for people living in Bedfordshire, Luton and Milton Keynes.

We will work together with our local communities and partners to improve the health and wellbeing of our population. We will do this by:

Enabling effective collaborations of providers and primary care networks, supporting an evidence-based approach to the design of health and care services

Enabling local place-based partnerships to support more people to manage and improve their own physical and mental health and wellbeing, and tackle the wider factors that impact people’s health

Promoting clinical best practice and quality improvement across the system

We will positively impact the care of people living in Bedfordshire, Luton and Milton Keynes. Examples of the integration we aim to achieve is described in the following case studies.


Working as a new CCG, the levers for providing more integrated and joined up care for local people include:

a) Increasing the focus and support we provide to primary care and to the development of primary care networks. General practice is the cornerstone of the NHS and the first port of call for most people who seek health advice or treatment. Increased demand coupled with challenges securing the necessary workforce and investment have resulted in unprecedented pressures on practices. We are committed to supporting general practice and PCNs, which are at the heart of the integrated care model, and will increase the focus and resources in this area.

b) Pursuing deeper integration of health and care with council partners, building on the arrangements and relationships already in place in Bedfordshire (Bedford Borough and Central Bedfordshire), Luton and Milton Keynes. The alignment and integration of the NHS and local government is key to our success in the future. As well as maintaining our focus on communities and the places where people live and work, collaboration with local authorities provides the best opportunity to use our collective resources to make genuine impact on preventing ill health and reducing inequalities, to join up health and care delivery, and to improve people’s independence, experience and quality of life. Public health teams in local authorities play a vital role in our collective work to improve population health.

c) Enabling provider alliances in Bedfordshire, Luton and Milton Keynes to thrive. Based around the geographies served by the acute hospitals in Bedfordshire, Luton and Milton Keynes, provider alliances bring organisations together to co-ordinate and improve the delivery of services for the population they serve. For some services it makes most sense to plan, transform and co-ordinate service delivery on provider alliance footprints. Alongside our work to integrate health and care with local authorities, our CCG will also support provider alliances to thrive. In time we will see leadership responsibility for tasks such as pathway redesign and service development, including patient and public involvement and co-production which have traditionally been led by CCGs, transfer (with the associated teams and resources) to partnerships of providers as they form.

d) Creating a single strategic commissioning function for Bedfordshire, Luton and Milton Keynes Integrated Care System. The ICS will work collaboratively, involving clinical, professional and managerial leaders from across the whole system in all of its work. The CCG’s leadership team and infrastructure will focus on the Bedfordshire, Luton and Milton Keynes geography as a whole and on what can be achieved by working at scale across this area. This ‘strategic commissioning’ function will support


and enable the ICS, accelerating the simplification and effectiveness of planning, transformation and infrastructure in place across the geography as a whole.

21 Appendix 5: Patient and Public Engagement Committee

Committee terms of reference

https://www.blmkccg.nhs.uk/get-involved/patient-and-public-engagement-committee/

22 Appendix 6: Team structure

https://www.blmkccg.nhs.uk/get-involved/patient-and-public-engagement-committee/


23 Appendix 7: Glossary

BLMK – Bedfordshire, Luton and Milton Keynes.

Clinical Commissioning Group (CCG) – health commissioning organisations. CCGs are led by GPs and represent a group of GP practices in a certain area.

Commissioning – planning, buying and managing local health services to meet the needs of the local population

Co-production – involving patients as equal partners in the planning and provision of health services

ICPs/ Provider alliances - ICPs (integrated care providers) are population-based models of care that integrate primary, secondary, community and other health and care services under one single provider contract. ICPs are distinct from sustainability and transformation partnerships (STPs) and integrated care systems (ICSs), both of which focus on achieving integration without contractual change

Health inequalities – are unfair and avoidable differences in health across the population, and between different groups in society. Health inequalities arise because of the conditions in which we are born, grow, live, work, and age.

Integrated Care System (ICS) - In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve.

Multi-disciplinary team (MDT) – a team made up of people from different parts of the health and social care system with different skills.

NHS Long Term Plan - published in 2019, a 10-year plan which shows how extra money for the NHS will be spent to help people. It is based on what the public and NHS staff thought the NHS needs.

Place based partnerships - engage communities and coordinate local health, social and economic development

Primary Care Networks (PCNs) - Primary Care networks were introduced by the NHS in 2019, establishing GP practices within networks of between 30,000 and 50,000 patients. The aim is to create fully integrated community-based health services.

Provider alliances - design and deliver well integrated health and care services and/ or ensure standardisation and equal access to at scale services & a contract model where a group of providers (eg a group of GPs) enter into a single arrangement with a CCG to deliver services.

Primary care – services which are the main or first point of contact for the patient, provided by GPs, community providers and others.


Secondary care – hospital or specialist care that a patient is referred to by their GP or other primary care provider.

Specialised commissioning – Specialised services support people with a range of rare and complex conditions. They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions, and by their nature tend to be services required by a smaller number of people. Specialised services are not available in every local hospital because they have to be delivered by specialist teams of doctors, nurses and other health professionals who have the necessary skills and experience. Unlike most healthcare, which is planned and arranged locally, specialised services are planned nationally and regionally by NHS England – the planning and buying of these services is known as specialised commissioning.

Strategic commissioner – ensures delivery of system priorities through understanding the needs of local populations and commissioning for health outcomes

Target Operating Model (TOM) - a description of the desired state of the operating model of an organisation.

Author: Jane Meggitt, Director of Communications and Engagement




A discussion regarding the work programme for the Patient and Public Enagagement Committee

How? An update by Jane Meggitt, Director of Communications and Engagement followed by a discussion


To note the programme and agree how the PPEC should be developed to deliver the programme effectively.


N/A


N/A


31 March 2021


Agenda item 10 – Work Programme 2021/2022

Information


patient and public engagement committee

Documents