Towards a PATIENT AND PUBLIC ENAGEMENT Strategy

Wokingham Clinical Commissioning Group Executive

February 2012

Authors: Andrew Price/Lizzie Page/Ira Ward/Mike Boyle

Draft V6final

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ABOUT THIS DOCUMENT

These slides have been produced to support local discussion and awareness raising about patient and public engagement (PPE) in the context of the organisational development of the Wokingham Clinical Commissioning Group (CCG)

Consideration of the ideas and plans contained within the slides will form the basis of a patient and public engagement strategy for the Wokingham CCG

It is proposed that we seek stakeholder feedback on our strategy in Spring 2012 – this will help build understanding, consensus and trust with our stakeholders

This content of this document draws upon good practice in PCTs and emerging CCGs, published information on CCG authorisation, and informal discussion with some stakeholders

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POLICY CONTEXT

“No decision about me, without me”

Lansley’s four tests

NHS Constitution

Section 242 of NHS Act 2006: duty to involve patients and the public in service planning and operation, and in the development of proposals for changes

Strategic benefits of PPE:

contributes to long term area-wide vision and strategies

provides new ideas for meeting needs

highlights what services are needed, where and how to better deliver them

promotes accountability by showing the reasons why actions are being taken

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WHAT DOES ‘ENGAGEMENT’ MEAN?

© NHS Institute for Innovation and Improvement 2011

Engagement exists on a continuum

The style of engagement varies depending on desired outcome

A key strand of how we will develop trusting and long-term relationships with our stakeholders

Information Feedback EngagementCo-

design Partnership

Patientsknowing whatservices areavailable andwhere to accessthem

Experiencemeasures collectedand analysed andimprovementsmade as a result

Effectivelyinvolvingpatients inredesigning careprocesses

People actuallycontributingalongsideprofessionalssuch as citizen-led services

Engagement incommissioningdecisions andProcurement activities,shared decisionmaking

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CCG AUTHORISATION AND PPE PPE is one of the six domains; also close synergies with other domains e.g.

governance

National expectations:

engagement of patients, carers, public, communities of interest and geography, health and wellbeing boards and local authorities

each practice population has a voice

engagement in service redesign, commissioning cycle, decision-making

diversity of tools and techniques

consider utilisation of existing structures

mindful of resources

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NATIONAL DIAGNOSTIC TOOL The diagnostic tool sets out 6 stages in PPE development:

1) Opted out2) Not considered matter3) Recognised the value of PPE and identified gaps in skills and capacity4) Agreed and documented how and when it will engage, has general principles

and a costed plan to fill gaps5) Communicated PPE intentions but not yet rolled out6) Successfully engaged, and leadership assured of this

We are probably somewhere between Stage 3 and 4; we should aim to be at Stage 5 in Spring 2012 and Stage 6 by the end of 2012

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The following slides suggest the broad content of a PPE strategy for Wokingham

Once the CCG has agreed a direction of travel, a strategy document will be written up in a user-friendly style for discussion with stakeholders

At this stage we particularly need to consider:

being clear about what we will engage about what specific support will we require how that support can be most effectively delivered within the available

management resource

BUILDING A WOKINGHAM PPE STRATEGY

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SUGGESTED PURPOSE OF OUR PPE STRATEGY

“The purpose of this Strategy is to communicate a vision for patient and public engagement in the

commissioning of NHS services for the Wokingham locality, and how the Wokingham Clinical

Commissioning Group (CCG) will work to realise the vision”

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SUGGESTED VISION FOR PPE

“The Wokingham Clinical Commissioning Group recognises that public and patient engagement can

improve the quality and effectiveness of local health services. We will reflect the needs and preferences

of patients and the wider local community when commissioning services and in our decision-making”

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SUGGESTED PRINCIPLES FOR PPE

ensuring our patient and public engagement is meaningful, effective and transparent

giving the patients and the public a voice in our decision-making supporting patients and the public in getting involved ensuring patients are well-informed, given choices and involved in

decisions about their care listening and responding to patient feedback on services and use this

feedback to make improvements engaging with patients and the public when determining local

healthcare needs, designing new services, and evaluating existing services

working in partnership with local agencies, organisations and groups to help us gain valuable patient and public feedback

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WHAT WE WILL SEEK ENGAGEMENT ON AND WHO WITH

We need to engage on the commissioning of secondary care and community services on behalf of the population of Wokingham, in particular:

quality of current services plans to commission or redesign services in the future

Not engaging on primary care services, but we do need to demonstrate how the voice of each practice population will be sought on commissioning issues

We particularly need to engage with:

the general population of Wokingham those directly affected by commissioned services (e.g. patients, carers) those with specialist knowledge (e.g. support groups)

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AUDIENCES Members of the public – most have a view on what they think they will need if they

are injured or ill and should have choice and control over their care

Patients – have experience of using a service and are in a good position to give views on how a service could be improved

Carers – often have a wide experience of health care – their own views may not be the same as those of the people they care for

Members of existing self-help and support groups – should have collective knowledge and experience of a range of services – may be in a good position to represent the views held by patients

Existing user-led groups – may focus on a condition or community

Representatives – are people who are in a position to speak on behalf of other service users, the views they share are the views of the people they are representing, which may not be the same as their own

Hard to reach, seldom heard, vulnerable groups – phrases used to describe people who are ‘easy to overlook’ – Travellers, for example

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Health & Social Care

Housing

Safety

Business

Faith

Community

Education

Information & Advice

Advice

Events

Activities

Service provision

Influence

Local area

Wokingham-wide

Greater Reading

County/regional

National

Charity

Club

Social Enterprise

Public body

Association

INTERESTS FUNCTIONS

CATCHMENT AREAS

ORGANISATIONFORMS

Some Wokingham specific groups Local

Involvement Network

Age Concern, Woodley

BME Forum Older People’s

Forum Learning

Disability Partnership Board

Neighbourhood Action Groups (NAGs)

Tenant and Landlord Improvement Panel

Chamber of Commerce

Interfaith Group Parish and Town

Councils Link visiting

scheme Wokingham

Area Access Group

Other examples Arthritis

Matters Reading

Berkshire Autistic Society

Schools Mother and

Toddler Groups

Bracknell branch of Parkinsons UK

Berkshire Blind Society

Mascular Disease Society Reading Group

University of Reading

3rd Age Women’s

Health Concern, Marlow

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ILLUSTRATIVE MAPPING OF THE COMMUNITY AND VOLUNTARY SECTOR

GROUPS WILL HAVE DIFFERENT…

ENGAGEMENT AND THE ANNUAL COMMISSIONING CYCLE

• Every month, take account of issues arising from the Quality Committee

• Ongoing PPE input into work streams

APRIL

•Include within Annual CCG Report how we have responded to feedback

MAY JUNE

• Work with WN and HW to identify possible future QIPP/work streams

JULY

•Summarise key issues coming out of engagement to feed into QIPP planning

AUGUST SEPTEMBER

• Map PPE within QIPP PIDs

OCTOBER NOVEMBER

•Share initial Commissioning Plan with HWB, W N and HW

DECEMBER

•Feedback revised Commissioning Plan with HWB, WN and HW

JANUARY FEBRUARY

• Participate in LSP Community Conference to communicate plans and get feedback

MARCH14

WN: Wokingham Network (Slide 17)

HW: Healthwatch (Slide 19)

HWB: Health and Well Being Board

LSP: Local Strategic Partnership

PPE representative on supplier evaluation panel

Information from networks, user organisations, Healthwatch, other partners; JSNA

Review existing feedback; hold forum(s); Undertake survey

Use reference group or hold forum(s) to help develop criteria and agree priorities

Use reference group to help develop service specification

Use feedback from complaints, Healthwatch, surveys, KPIs, CQUINs

Use feedback from complaints, Healthwatch, surveys, KPIs, CQUINs

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ENGAGEMENT ANDSERVICE REDESIGN

COMMUNICATION CHANNELS

We need to use the most most cost-effective blend of channels, which might include:

CCG web site

trial use of social media

on-line surveys

media releases

local radio

meetings

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WORKING WITH OTHERS We do not need to design engagement from scratch - some useful existing

arrangements , networks and groups already exists

We will be a “lean” commissioning body and therefore need to resource PPE wisely; our engagement needs to be proportionate; and there may be other organisations in our locality who are keen and able to help (with our support)

Building on this, we need to plan PPE within a relatively complex set of local relationships: we need to understand who our key partners are, and how we might work with them

As a general model, it is suggested that the CCG seeks:

general patient engagement about the business of the CCG through a network of PPGs/virtual groups

specific-interest engagement through existing user groups customer feedback via complaints, surveys a community perspective through Healthwatch and the local authority

The CCG will always need to consider the most appropriate form engagement in each case 17

WOKINGHAM NETWORK A Wokingham Network would:

allow the CCG to engage on commissioning issues with its constituent practice populations

provide a channel for engaging patients on the annual commissioning/business planning cycle

allow PPGs to raise issues of mutual interest about commissioning with the CCG

As an illustration, a Network could be organised as follows:

participation from a patient representative from each practice use of electronic communication where ever possible support from the CCG (e.g. coordinated by a practice manager)

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EXISTING USER GROUPS

It is suggested that we:

recognise the knowledge that existing user groups have about their special interest

engage with user groups on specific issues, as and when required

work in partnership with user groups to organise specific engagement exercises (e.g. identifying participants, engagement design etc)

This approach is in line with that being developed by the local authority

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LINk/HEALTHWATCH

It is suggested that we:

engage with LINk/Healthwatch, and respond to what matters they raise

work with LINk/Healthwatch in the design of engagement exercises

provide help and assistance as required to the local authority in establishing an effective Healthwatch

seek feedback from Healthwatch on their NHS complaints and advocacy work

invite a representative from LINk/Healthwatch to participate in the Wokingham Network

have a named CCG executive contact and lay member who lead on engagement with LINk/Healthwatch

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SERVICE PROVIDERS

We can source patient feedback from service providers at a federated level through contractual and quality channels

This can include:

annual surveys of patient satisfaction linked to contract key performance indicators and/or CQUINS

reports on the nature, volume and outcomes of complaints

reports on quality

engaging with providers and their own PPE/governance structures

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WOKINGHAM BOROUGH COUNCIL We need to work with the local authority:

as a strategic partner through means such as the Health and Well Being Board, Overview and Scrutiny and joint commissioning

to plan community engagement in a coordinated way

to ensure joined-up NHS and public health engagement

to engage with community-based groups and forums supported by the council such as the partnership for learning disability and the Black and Minority Ethnic (BME) Forum

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BROADER ENGAGEMENT We can work together with other CCGs in Berkshire to support a federated

approach to engagement where appropriate, for example:

statutory consultation on significant change or development

the Eye Care Forum (this Forum brings together commissioners, optometrists, ophthalmologists, voluntary groups and local authorities to consider commissioning issues for eye services across Berkshire)

Engagement with the Local Dental Committee, Local Ophthalmic Committee etc

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RESOURCES

Need to clarify a lead manager for PPE once CCG management structure is in place

Support needs to be resourced through the £25/head management allowance

Potential sources of support are the CCG itself, the Commissioning Support Unit, the local authority, and the third sector

Need to resource as much as possible from mainstream work/budgets

We need an expectation that commissioning managers and practice managers have PPE as a core managerial competence

The emergent roles of Commissioning Support Unit include support for formal consultations

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ACTION PLANAREA ACTION

PPE Strategy •Consult stakeholders on a PPE Strategy in Spring 2012

Commissioning •Include in our Annual Report:-information about how people’s views have shaped our commissioning decisions-an engagement programme for the year ahead

Heathwatch •Support the local authority in the development of Heathwatch

PPGs •Work with practices and their PPGs to develop a functioning Wokingham Network by June 2012

Shared decision making •Work with other CCGs in Berkshire West in a pilot of the use of Patient Decision Aids•Work with other CCGs in Berkshire West in the roll out patient information for the choice of Any Qualified Provider services

Governance •Include within our governance structure public board meetings, inviting public questions at Board meetings, and lay membership of the Board •Have a feedback/complaints policy

Resources •Specify the PPE support to be provided by the Commissioning Support Unit

Service Providers •Ensure all service provider contracts include annual surveys of patient satisfaction linked to contract key performance indicators and/or CQUINS, and report on feedback and complaints

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