towards a patient and public enagement strategy wokingham clinical commissioning group executive...
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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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