Initially approved August Consultation Scheme Personal and Public Involvement

Transcription

1 Initially approved August 2011 Consultation Scheme Personal and Public Involvement March

2 Contents 1. Introduction 3 2. Description of arrangements for PPI 5 3. Arrangements for meeting the legislative obligations of the Health and Social Care reform Act 9 4. Protocol for consultation requirements in exceptional circumstances for PPI consultation schemes Arrangements to assess effectiveness of PPI in organisations Arrangements for ensuring that people are aware of the organisations consultation schemes Arrangements for ensuring PPI is an integral part of the organisations business Appendices 23 2

3 This document can be made available on request in alternative formats e.g. plain English, Braille, disc, audio cassette and in other languages to meet the needs of those who are not fluent in English. For alternative formats please contact: Orla Barron Health and Social Inequalities Manager INTRODUCTION Belfast Health and Social Care Trust was formed in April The Trust currently employs around people and has a budget of approximately 1 billion. The Trust is structured into clinical and corporate Directorates that deliver services to a population of , plus the delivery of regional specialist services. The Board of the Trust is made up of the Chief Executive, ten Directors, seven non-executive Directors and a non-executive chair. The Belfast Way, A Vision of Sustainable Excellence in Health and Social Care for Citizens ( ),produced in 2008, sets out the strategic direction for the Trust. The purpose of the Trust is to improve health and wellbeing and reduce health inequalities, and the Trust strives to work in 3

4 partnership with other statutory, voluntary and community organisations to secure this purpose. The business of the Trust is to work in partnership with others, and through engagement of staff, to deliver safe, improving, modern and cost-effective health and social care. The Belfast Way also outlines the values of the Trust to guide behaviour, attitudes, and decisions and these were developed through a process of engagement with staff, service users, carers and patients. The four key values of the Trust are: Respect and dignity Accountability Openness and trust Learning and developing Based on these values, five strategic objectives have been developed. These are: Safety and quality Modernisation Partnership Our people Resources Annual targets in relation to each objective are detailed in the organisations corporate management plan. 4

5 2. Description of arrangements for Personal and Public Involvement Belfast Trust is committed to ensuring that Personal and Public Involvement (PPI) is embedded into all aspects of its business. The Chief Executive is the accountable officer for PPI, with the Medical Director appointed at board level to have a leadership role for PPI. Functional leadership for PPI sits with the Associate Medical Director for Public Health, supported by the Senior Manager - Patient and Public Involvement / Community Development and the Community Development team. The Belfast Trusts document Involving You A framework for community development and user involvement outlines the Trusts approach to community, service user, patient and carer involvement in the planning, design and delivery of services and health improvement programmes (insert hyper link). The Framework was developed to comply with the DHSSPS (2007) Guidelines on personal and public involvement Following the formation of the Trust in April 2007, the Chief Executive and the Trust Board prioritised the development of the Involving You framework. In June 2007, a project board, comprised of six directors, agreed the way forward for its development. The project board met bimonthly to over-see the process and ensure ongoing support for the Framework. A project steering group was established to plan, co-ordinate and drive the development of the Framework. This team was made up 5

6 of representatives from Trust senior managers, the community and voluntary sectors and from other statutory organisations. An advisory panel was formed to provide advice and guidance on the development of the framework. The advisory panel had representation from a range of community and voluntary sector organisations, the public sector, services users, carers and senior Trust staff (see appendix 3 of Involving You ). The advisory panel met on six occasions to advise and comment on the process of developing of the framework. Between October 2007 and March 2008, the project steering group facilitated 40 discussions between the Chief Executive and a wide range of partnerships, groups, organisations and individuals, including service users, carers, patients, communities, voluntary organisations, other public sector organisations and staff (see appendix 2 of Involving You ). Some 150 written responses were also received in response to the question Do you or the people you work with have any suggestions on how you could better have your views heard within the Belfast Health and Social Care Trust?. All the information gathered was analysed to identify common themes and issues. A set of guiding principles, based on the information gathered through the engagement process and the DHSSPS guidelines, has been developed and these are used to inform all PPI activity within the Trust. The guiding principles are: 6

7 Commitment the Trust will demonstrate evidence of its commitment to community development and user involvement at all levels of the organisation and through clear lines of accountability and leadership Communication the Trust will establish clear lines of communication with patients, service users, carers and communities, facilitating dialogue and providing accessible information that is understandable and available when and where it is needed Partnership it is only by working in partnership with users, carers, patients, communities and other agencies that we will successfully address inequalities. The Trust will build partnerships based on mutual trust and equal ownership to achieve shared goals. Valuing people the Trust will develop a culture in which people from all backgrounds are valued, and their right to articulate their needs and preferences and be involved in decisions regarding their care, is respected Tackling health inequalities The Trust will focus on the most disadvantaged groups while seeking to promote the right of all people to the highest attainable standard of health, within available resources. Health and wellbeing issues The Trust will work with patients, service users, carers and communities to maximise opportunities to promote health and wellbeing, prevent ill health and to empower them to take responsibility for their own health. 7

8 Action points were identified for each guiding principles (see Involving You Framework ). The Trust is currently reviewing and updating the Involving You Framework to ensure it reflects current structures and processes. A PPI Steering Group has been operational since May 2008 and provides a co-ordinating and challenge function for PPI. The Steering Group is made up of representatives from senior management within the Trust, and from community and voluntary organisations and carers (see appendix 1). Community, voluntary and carer representatives have all been drawn from constituent groups to enable a good flow of communication between the PPI Steering group and a wider number of people, promoting broader debate and discussion of the issues. The PPI steering group is cochaired by the Associate Medical Director for Public Health and a non-trust representative. The group meets four times a year and has the following terms of reference: To share information about our plans and activities, to promote a more coordinated and cohesive overall approach to PPI within the Trust, avoid duplication, identify gaps and ensure consistency of message To identify opportunities for joint working and use our synergy to be creative in our collective approach to PPI To assist in implementing the Community Development and User Engagement Framework To seek opportunities for consulting external and internal stakeholders jointly to minimise the demands being created by the need for consultation 8

9 To combine our boundary spanning roles to provide early warning of emerging issues and ensure they are managed Representatives from the Trust PPI Steering Group sit on the Regional PPI Forum to ensure a co-ordinated approach to common objectives. A scoping of PPI activity was carried out in January 2008 (hyperlink) and while this did provide some useful information about PPI within the organisation, it was limited in the detail that it provided. As a result, guidance on the planning and registration of PPI has been developed to facilitate the prospective recording of PPI activity (see attached Guidance document). This process is currently being reviewed as part of the review of Involving You. The Trust also produces an annual PPI report detailing work at a corporate and directorate level. A database of contacts for community development and user engagement has been developed. Over 1500 groups and individuals were contacted in order to gain their consent to be part of the database and to state their areas of interest in relation to Trust business. This database will be update during 2012/ Arrangements for meeting legislative obligations of the HSC Reform Act. Section 20 of the Health and Social Care Reform Act outlines a specific role and function of public involvement and details an expectation for engagement at three broad levels: 9

10 Patient Client Council Service Users Carers of Service Users Patient Client Council (PCC) The Trust is fully committed to working with the Patient Client Council in the development, implementation and monitoring of the consultation scheme, and on broader issues relating to PPI. The lead for the Belfast office is a member of the PPI Steering Group for the Trust and this ensures good communication and partnership-working in relation to PPI. The PCC lead for the Belfast office chaired the Advisory group for the Involving You process and played a key role in the development of the community development and user engagement framework. Introduction to PPI training for staff was developed in partnership with the PCC Belfast Office lead and was co-facilitated with the PCC Belfast lead. The Trust is also committed to maintaining a strong relationship with the PCC to develop strategic areas of work. Carers A strong model for the engagement of carers has been developed within the organisation. A Carers Working Group (CWG) was established over four years ago and has 15 members who are all current carers. The carers represented on this group are drawn from a range of caring backgrounds The aim of the Carers Working Group is to be a voice that raises the profile of carers within Belfast Trust and influences the development of the Trust's 10

11 strategic plan, in order to improve the health and wellbeing of carers in the Belfast area. The CWG is facilitated by the Belfast Trust s Carer Co-ordinators and meets on six-weekly. This on-going support of the Carers Coordinator has been important in securing the commitment of the carers, as the workers have provided a group secretariat and are a key link to the Belfast Trust. The group has recognised the importance of accessibility and has been inclusive by involving the seldom heard voices from within the community of carers. These have included carers with sensory issues and brain injury. Representatives from the carers working group also sit on the Trusts Carers Strategy group and the CWG were instrumental in the development of the Trusts Carers Strategy. Service Users The Trust is committed to hearing the voice of service users. The Long Term Conditions Alliance is represented on the PPI Steering Group along with service user representatives for older people, disability and ethnic minorities. Membership of the PPI Steering Group will be kept under review and expanded as appropriate. Directorates produce a yearly action plan for PPI. These action plans detail how each directorate will ensure the engagement of service users specific to their area. Section 75 of the Northern Ireland Act 1998 Equality, human rights and diversity are intrinsically linked to the PPI agenda however engagement under PPI cannot constitute 11

12 nor substitute formal consultation as required by Section 75.. Section 75 of the Northern Ireland Act 1998 requires the Trust, when carrying out its functions in relation to Northern Ireland, to have due regard to the need to promote equality of opportunity between nine categories of persons, namely :- o between persons of different religious belief, political opinion, racial group, age, marital status or sexual orientation; o between men and women generally; o between persons with a disability and persons without; and o between persons with dependants and persons without The Trust must also have regard to promoting good relations between persons of different religious belief, political opinion or racial group. Belfast Trust has also included Disability and Human Rights considerations as an integral part of these considerations so that all policies are subject to scrutiny to ensure they are compatible with the Disability Discrimination Act 1995 (NI) Order and the Human Rights Act The Revised Equality Scheme for Belfast Trust was approved in September 2011 by the Equality Commission Northern Ireland and provides a framework for implementation of the Section 75 duties and demonstrates the Trust s commitment to equality and addressing Section75 inequalities. 12

13 The Trust are currently exploring ways for PPI and section 75 statutory responsibilities to be reflected in Directorate performance management and accountability reviews to ensure good governance and effective mainstreaming in relation to both of these statutory functions. Screening This means that any policy, proposal or change in the way services are provided must undergo an assessment known as screening - to ensure that it will not adversely impact on any individuals covered in the nine Section 75 categories. This pertains to all Trust functions across employment, procurement and service provision. A screening outcome can be either for the policy or proposal to be screened out (i.e. that there is not a major adverse impact), or to be subject to an ongoing screening or that it is screened in for a full equality impact assessment EQIA). Equality Impact Assessment An Equality Impact Assessment is a thorough and systematic analysis of a policy, whether that policy is written or unwritten, formal or informal, and is carried out in accordance with the Equality Commission for Northern Ireland s Guide to the Statutory Duties. Whilst an EQIA must address all nine Section 75 categories, it does not need to afford equal emphasis to each 13

14 throughout the process rather the EQIA must be responsive to emerging issues and concentrate on priorities accordingly. An EQIA should determine the extent of differential impact upon the relevant groups and in turn establish if the impact is adverse. If so, then the public authority must consider alternative policies to better achieve equality of opportunity or measures to mitigate the adverse impact. Consultation Consultation provides an important opportunity for all those affected, to influence policy development and decision-making. It makes the process more transparent and accountable, as individuals have the opportunity to input in the development of policies that impact on them. Consultation by the Trust must be meaningful and be conducted before a decision is made, while it is still possible to influence the outcome. Consultation with those affected by Trust decisions is central to the effectiveness of the Section 75 equality duties. All consultations will seek the views of those directly affected by the policy / decision, representative groups of section 75 categories, other public authorities, voluntary and community groups, our staff and their trade unions and professional bodies and such other groups who have a legitimate interest in the matter, whether or not they have a direct economic or personal interest, The consultation process must take into account the circumstances and specific needs of the group or groups and the 14

15 nature of any barriers, including dissemination of information in alternative formats, forms of consultation process, including time and place, and patterns of communication. Consultation with all stakeholders will begin as early as possible. We will engage with affected individuals and representative groups to identify how best to consult or engage with them. We will ask our consultees what their preferred consultation methods are and will give consideration to these. Methods of consultation can include: Face-to-face meetings Focus groups with service users, carers or the public to inform service change or improvement projects Written documents with the opportunity to comment in writing Questionnaires Information/notification by with an opportunity to opt in/opt out of the consultation Internet discussions Telephone consultations Workshops with services users, carers or the public Inclusion of service users, carers or the public on steering groups or committees. 15

16 This list is not exhaustive and the Trust may develop other additional methods of consultation more appropriate to key stakeholders and the matter being consulted upon. The Trust will consider the accessibility and format of every method of consultation used, in order to remove barriers to the consultation process. Specific consideration will be given as to how best to communicate with children and young people, people with disabilities (in particular people with learning disabilities) and minority ethnic communities. We take account of existing and developing good practice, including the Equality Commission s guidance Let s Talk Let s Listen Guidance for public authorities on consulting and involving children and young people (2008) Consultation guidelines have been developed to support staff in planning for consultation at a range of levels. These guidelines will support staff to make decisions to ensure that consultations are timely, relevant, open and inclusive. The Trust PPI Steering group also have a role in promoting and advising on consultations. Current consultations are promote via the Trust website, circulation to stakeholder groups including services users, carers and communities and through relevant Trust staff engaging with stakeholder group. 16

17 4. PROTOCOL FOR CONSULTATION REQUIREMENTS IN EXCEPTIONAL CIRCUMSTANCES FOR PPI CONSULTATION SCHEMES Consultation BHSCT recognises the importance of proper and timely consultation as an integral part of fulfilling its statutory obligation to make arrangements with a view to securing involvement and consultation with service users, their carers, the public and the Patient Client Council on decisions on planning and proposals for change affecting the provision of the health and social care services for which BHSCT is responsible.bhsct will endeavour to conduct consultations in a timely, open and inclusive way. Normal timescale and exceptions BHSCT will aim to provide a consultation period of a minimum of twelve weeks to allow adequate time for groups to consult among themselves as part of the process of forming a view. However BHSCT has identified the following exceptional situations when this timescale may not be feasible:- Changes (either permanent or temporary) which must be implemented immediately to protect public health and/or safety; Changes (either permanent or temporary) which must be implemented urgently to comply with a court judgement, or legislative obligations. 17

18 In such instances, BHSCT may decide to shorten timescales for consultation to eight weeks or less. In line with current best practice guidance on consultation BHSCT should seek to outline the reasons for a shorter timescale in the consultation document, or in correspondence relating to the changes, as appropriate. However, having considered the need to consult, the organisation may decide that it is necessary in the interests of patient safety to implement the change immediately. BHSCT will monitor and keep under review such occurrences and report on them in its annual PPI review report, which will be published on its website. Where changes are temporary in nature, and may be considered as part of the day to day management of services, and are considered to be non-contentious, the requirements for consultation will not apply. 5. Arrangements to assess effectiveness of PPI in the organisation A number of indicators were identified for each of the guiding principles detailed in the Involving You framework. These will be revised following the review of Involving You. The Trust is represented on the regional PPI Forum and its sub-group on Measuring Impact. The Trust is participating in regional work to develop standards for PPI and will implement these once developed. PPI Annual report is submitted and endorsed by Trust Board, detailing PPI activity across the Trust and the impact on services. 18

19 The Trust are currently exploring ways for PPI and section 75 statutory responsibilities to be reflected in Directorate performance management and accountability reviews to ensure good governance and effective mainstreaming in relation to both of these statutory functions. An Experience, Equality and Engagement Governance Steering Group has been established to assure formal accountability mechanisms for reporting on PPI, patient experience and Section 75 to Trust Board. This group is chaired by the Director of Human Resources and has representation from Directors, non-executive directors and senior managers from corporate and clinical Directorates. 6. Arrangements for ensuring that people are aware of your organisations consultation scheme The Involving You Framework has been widely publicised both internally and externally and continues to provide a foundation for PPI activity within the organisation. It is available online on the Trust website and the Trust s intranet site. The Trust works collaboratively with other Health and Social Care organisations, including the PCC and the Belfast LCG to promote the consultation scheme. The Trust has relationships with a wide range of community and voluntary sector partnerships. It will continue to use these networks to promote the consultation scheme. The staff in the Community Development Team support the promotion of the scheme through its wide range of community networks. The Community Development Practitioner for Ethnic Minority 19

20 Communities has a particular role in ensuring that the scheme is promoted with a wide range of ethnic minority groups in the Belfast Trust area. Information about the scheme will also be sent to the organisations and individuals on the Trust s community development and user engagement database. The Communications department coordinates all programmes of consultation to ensure maximum involvement. It is the role of Communications to ensure staff are involved in any consultation and that external stakeholders have maximum opportunity to become involved in the decision-making process. The Trust employs a Service User Consultant for Mental Health who plays a key role in ensuring that the scheme is promoted amongst people with mental health issues, their families and carers. 7. Arrangements for ensuring PPI is an integral part of your organisation s business. The Trust is committed to the values and principles of the DHSSPS Guidance on PPI. The Involving You framework outlines clear direction for the Trust in relation to PPI. A structure to support the integration of PPI within the Trust has been developed and the PPI Steering Group has an active role in challenging the Trust on its progress in relation to this agenda. A number of other structures are in place which help promote and develop personal and public involvement: 20

21 Inequalities Forum, which is chaired by the Chief Executive, Disability Steering Group, which is chaired by the Director of Nursing and Patient Experience Ethnic Minority Health and Well-being Steering Group chaired by the Director of Adult, Primary and Social Group Traveller Health Strategy Board, also chaired by the Director of Adult, Primary and Social Group Carers Strategy Group, chaired by Co-Director of Nursing The Trust continues to strive to involve service users, carers and communities at all levels across Trust Directorates and has adopted the regional reimbursement policy which was developed by the Regional PPI forum to ensure that those people engaged in PPI activity are covered for relevant cost incurred. Introduction to PPI training continues to be delivered for a range of staff from across the Trust. The Trust also plays a key role in the regional PPI training sub group and will use the recently produced framework to inform the future delivery of training. The Trust is committed to ensuring that PPI does not become an add on but an integral part of all that we do. The Trust will continue to work with the PPI Steering group to develop ways to ensure that PPI is embedded in its planning processes. The Trust will continue to report back to all stakeholders on PPI activity using a range of communication methods including internet, PPI Steering group, other aforementioned structures, links 21

22 with service user groups and community networks, use of newsletters, the media and other appropriate communication channels. The Trust is committed to embedding the Patient and Client Experience Standards throughout the organisation and continues to roll out the regionally agreed programme of activity to monitor these standards. 22

23 Appendix 1 Membership of the PPI Steering Group Dr Leslie Boydell Associate Medical Director for Public Health Bronagh Dalzell Head of Communication, Belfast Trust Sandra McCarry Senior Manager Community Development / PPI Orla Barron, Senior Manager Health and Social Inequalities Joan Peden Co-Director Bernie McQuillan Co-Director Peter Bohill Service Manager Mental Health Nicky Vincent Governance & Quality Manager Tommy Boyle Mental Health Services Sally Campalani Cancer services Valerie Larmour Allied Health Professionals Laura Collins Carers Working Group Representative Danny Power Healthy Living Centres Alliance Richard Dixon Patient Client Council Linda Armitage Health Strategy Manager, East Belfast Partnership Board Anne Greenan Older Person Patrick Yu Ethnic Minority Forum 23

24 Steve McBride Long Term Conditions Alliance Bernie Kelly Physical & Sensory Disability Service Manager Liz Gracey Upper Springfield Development Trust Donald Harley Carers Working Group Representative Margy Washbrook, - Engage with Age Caroline Bloomfield Public Health Agency Gabi Mornhinweg Community Development Yvonne Cowan Community Development 24

25 Appendix 2 Involving You A framework for community development and user engagement see attached 25