Personal and Public Involvement (PPI) Trust Board Update Paper

Transcription

1 Personal and Public Involvement (PPI) Trust Board Update Paper Dr G. Rankin June 2009

2 Introduction and Background In line with the Regional Strategy and Departmental Guidelines there has been a growing recognition of the need and value of Personal and Public Involvement (PPI) within the business agenda of health and social care organisations. This priority is reflected within the corporate priorities of the Trust. Following the last briefing paper to Trust Board (November 2008) on proposals to develop the Personal and Public Involvement agenda within the Trust a number of key developments have been realised. This paper provides an update on this work. 1. Draft Strategic Action Plan Framework and Consultation A Draft Strategic Action Plan Framework has been developed to inform stakeholders of the Trusts commitment, vision, priorities, proposed actions and supportive infrastructures for PPI and to seek their ideas, views and opinions on these proposals. The Framework was used to inform an extensive 12 week consultation process with internal and external stakeholders. External Some 2000 copies of the Framework were circulated to community, statutory and voluntary groups, organisations and networks across the Southern area. In 4addition, locality based teams carried out both formal and informal consultation sessions with community groups and service users with whom they have regular contact and also organised 2

3 a number of locality based public consultation sessions. A central consultation programme of local events was also organised for service users, community and voluntary sector groups and Trust staff. A series of presentations were developed in order to maximise consultation opportunities and to ensure continuity of information and approach. These were tailored to suit the needs of the audience and developed with input and feedback from local community/voluntary groups. A consultation feedback form was developed to gather views on the PPI Action Plan Framework. The consultation document and response questionnaire were also made available on the Trust intranet. In addition to the feedback gathered at the consultation sessions a total of 37 written responses were also received, 31 of these came from the community and voluntary sector and 6 from the statutory sector. Overall the response represented a collective view of some 1,000 groups and 5,000+ individuals. A joint Southern Board, Southern HSCT and Community Sector Conference was held in February to consider the way forward for community development and user involvement. This was attended by 80 people, the majority of whom were representative of the voluntary and community sector. Internal The Draft PPI Action Plan Framework was also circulated to Directors for dissemination and comment by managers and staff within their area of responsibility. Managers and staff were also requested to discuss 3

4 the Framework with service users and service user groups with whom they had contact and to provide feedback on the views and comments received as a result. Input was made to staff meetings to raise awareness of the consultation, provide further information and respond to any queries. An internal Trust/Board Workshop was held in January 2009 to discuss the way forward for Community Development and User Involvement. Over 60 managers and staff attended this from both the Southern Health and Social Care Trust and the Southern Health and Social Services Board. A full report on the consultation exercise has been produced including a series of recommendations for consideration and action by the Trust. These findings and recommendations have been presented to SMT. The Trust s Strategic Action Plan for PPI is now being developed and will reflect the findings from the consultation exercise. Directorate and programme specific findings have been shared with the respective Director for consideration and action. A summary of the key feedback received is attached in Appendix Baseline Mapping and Development of Directorate Action Plans A baseline mapping exercise has been completed across Directorates and Programmes of Care to identify and initially evaluate the current range and nature of PPI mechanisms and processes utilised by the 4

5 Trust. The evaluation aspect focused on the Department s four core values of PPI namely: Dignity and respect; Inclusivity, equity and diversity; Collaboration and partnership working; Transparency and openness. Where possible the findings have been cross-referenced with the individuals and groups involved to quality assure the information attained. A summary of the findings is attached in Appendix 2. Directorate specific reports have been produced which provide a breakdown of the information received by their respective divisions and services. In addition to providing these reports to Directorates the PPI team are currently undertaking a series of discussions with senior staff within each Directorate to verify the findings. The outcome of this work will be the development of Directorate specific Action Plans that will shape the ongoing development of PPI across the work of the organisation. During the consultation exercise with stakeholders a number of individuals, groups and organisations expressed an interest in becoming involved in specific areas of work within the Trust. This information has been given to Directorates with a view to their inclusion in any future discussions or initiatives around service planning, development, delivery and evaluation. Any specific issues, ideas or concerns raised during the consultation exercise have also been used to inform the Directorate Baseline PPI Reports. 5

6 3. Development of a Management Infrastructure In line with its commitment to recognise the value and priority of PPI across the organisation the Trust has established a management and coordination infrastructure that will ensure effective leadership, accountability, coordination and ongoing development of this agenda. This includes: the identification of a Lead Director for PPI to ensure overall direction and drive within the organisation; the development of accountability and reporting mechanisms for PPI within Directorate performance plans; the establishment of a Cross-directorate PPI Management Group which will have responsibility for the ongoing coordination, development and implementation of the PPI Action Plan; The creation of a dedicated staffing infrastructure within the Promoting Wellbeing Department that will provide expertise, support and resource for PPI across the organisation and to external partners. 4. Next Steps The Trust will continue to place a particular emphasis on evidencing change and progress as a result of the involvement of users at all 6

7 levels of the organisation. It will continue to ensure that through its management and accountability processes PPI will be a key priority across the organisation. The cross-directorate PPI Management Group will continue to lead, coordinate, monitor and report on progress throughout the Trust on the implementation of the PPI Strategy. A feedback report on the Trust s consultation with stakeholders on PPI will be issued to all those who were involved. Directorates will finalise their Action Plans which will inform the setting of targets against which progress will be assessed. These will be aggregated into an overall Trust Strategic Action Plan for PPI which will be disseminated widely. The PPI team will implement a range of training, development and support initiatives for staff and stakeholders based on the needs identified and good practice guidance. The PPI team will work closely with Directorates to address the issues that have arisen from both the consultation on the Draft Strategic Framework and the Baseline Mapping and Evaluation. They will facilitate and support Directorates and stakeholders to work together and find innovative mechanisms for appropriate and effective involvement. The Trust will review its communication mechanisms and processes in light of the feedback received. It will seek to develop processes that 7

8 will ensure open and easy access to information on all aspects of Trust business and the need to demonstrate in a tangible way to all of its stakeholders how things have changed and developed as a result of their input. Appropriate evaluation frameworks will be developed as part of our participation in the 4 nation (UK wide) evaluation project. These will be adapted and embedded from Autumn 09. The Trust will continue to work with the DHSSPS, Health & Social Care Board, Local Commissioning Group for Southern Area, the Public Health Agency and the Patient Client Council to ensure its developments are in line with Regional Policy, Strategy and Guidance. 8

9 APPENDIX 1 Summary Findings from the Consultation of the Draft Strategic Action Plan Framework In summary the consultation process has identified: A strong welcome for the Trust s commitment to PPI and for the visible investment in a dedicated PPI resource that reflects this commitment; Recognition that there are a number of opportunities for engagement and involvement already in place and that experiences within these have been both positive and negative; Recognition of the enormity of the task of ensuring appropriate, active and sustained involvement from stakeholders; A clear willingness by many individuals groups and organisations to engage with the Trust in the outworking of the PPI agenda; The need to ensure that the Strategic Action Plan and feedback mechanisms are easily understood and in language that everyone can embrace; The need for a variety of approaches, mechanisms and structures that support different levels and types of engagement and involvement; The need for greater clarity on how the values, principles and actions discussed within the Draft Framework would work in practice; The need to embrace PPI values, structures and processes at all levels of the organisation; The potential impact that the current funding crisis being experienced by many community and voluntary groups might have on their ability to engage in this work with the Trust; 9

10 The need where possible to embrace other structures and partnership working mechanisms across organisations that could facilitate this agenda rather than always seeking to establish new structures; The need to support this work through the provision of effective advice, training and support both internally for staff and externally with partners; The need to consider the provision of some form of financial support to cover the reimbursement of expenses without compromising benefit income where that is appropriate; The need to ensure effective involvement at all 5 levels, particularly at strategic and corporate and not just at individual client/patient/carer level; The value and need for effective and meaningful mechanisms of communication and dialogue that recognise the various needs and abilities of individuals, groups and communities; The ultimate test of the Action Plan would be in evaluating its impact and effect on the ground and in seeing real change across the organisation as a result. 10

11 APPENDIX 2 Summary Findings from the Baseline Mapping And Evaluation Exercise There is service user involvement at all five levels of the PPI Framework but the majority of involvement is at Levels 1-3 (see below) There are a wide variety of methods used in identifying and recruiting users; Mechanisms are in place to ensure the inclusion of hard to reach groups; The purpose of involvement is varied from needs assessment, identifying specific service requirements, shaping service development, evaluation, informing planning and priority setting and strategic planning; Various methods of involvement are utilised including 1-1 interviews, questionnaires and surveys, focus groups, committee representation, workshops and support groups; A wide range of service and issue specific information materials exist but difficulties were identified in relation to access and availability and maintaining these up to date; There was evidence of involvement that demonstrated the Departments Core values for PPI (see above) but no single approach/initiative demonstrated all; There is a need for more consistent and comprehensive mechanisms for evaluation; 11

12 A number of barriers to PPI were highlighted such as time, resource, knowledge, support for identifying users, networking, recruitment and transport; Staff identified a range of needs in relation to training, knowledge and skills, help in developing resource materials, networking, motivation and staff time; 339 volunteers were identified across a range of roles within the Trust. Summary of the Levels of User Involvement: Level 1- Individuals involved in the planning, delivery and monitoring of their individual care or service; Level 2 - Individuals, families, carers and the community supported to influence and shape the provision of care and the quality of services provided; Level 3 - Individuals, families, carers and the community supported to influence and shape the planning, development and delivery of services on specific issues or areas; Level 4 - Service Users, carers and communities involved in strategy development, needs analysis, planning, commissioning and changes to significant areas of service development and provision; Level 5 - Communities, stakeholders and partner organisations involved in shaping the corporate and organisational priorities and overall direction of the Trust). 12

13 APPENDIX 3 Small Sample of Current User Involvement across the 5 levels evidenced in the Baseline Mapping and Evaluation Exercise Level of Involvement Acute Children and Young People Mental Health and Disability Older People and Primary Care Level 1 Shaping Individual personal care/ service Renal unit - Service users directly involved in planning, delivery and monitoring of care. Parent/carers and young people actively involved in agreeing goals for their individual plans. Young people influence how staff engage with them. Service user involvement is demonstrated through person-centred reviews, individual care plans and 1:1 interviews. Consultation evidenced in many practices - content and design of leaflets, newsletters, courses and regarding equipment. Individual needs assessment processes embedded across the range of services. Views and experiences of users and carers shape service planning and delivery Development of individual volunteer roles to meet needs of the service and the needs of those wishing to volunteer. Level 2 Shaping service and quality of care provision Cancer & Clinical services user views and experiences facilitated the reshape of Radiology services. Patient information leaflets and satisfaction questionnaires were used and a stakeholder involvement working group was developed. Parents/carers suggestions used to shape services. Carers directly involved in training of staff. Service Users and Carers have the opportunity to evaluate services and plan future services. New On-line information resource is an example of an output of this process of involvement. Consultation with communities on range of health related issues and developing services in response to identified need. Carers Forum is currently increasing participation by carers and their representatives to ensure appropriate support and service development.

14 Level 3 Shaping planning, development and delivery of specific services or areas of work Maternity and Integrated Women s Health Uplift programme developed a training programme for breastfeeding mothers to become peer support workers to complement core service. Parents actively engaged in making suggestions on new service developments. Physical & Sensory support services thresholds for day care project. This focused on developing a multi-agency assessment model to facilitate meeting need appropriately. This has resulted in a range of daytime opportunities such as voluntary work, training and further education. Travellers involved in All Ireland Health Study to shape local and regional services. Enteral tube feeding carers involved in development of care pathways with outputs to date including users and carers feeling more empowered and having better relationships with professional staff. Level 4 Shaping strategic development and significant areas of service development and provision Medicine & Unscheduled Care Carers and their representatives involved in reviewing legacy locality discharge protocols to ensure they remain reflective of their specific needs. Linkages made with Trust carers Reference Group. New approaches include - Young person involved in providing feedback to RQIA on work previously undertaken. The A team is an independently constituted advocacy group who have led the development of Fitness for All. Service users were represented on the project steering group and appropriate support was provided for individuals to access leisure opportunities through the development of peer supporters, carers and partnership models of working. Service users and cares involved in shaping Stroke Services in line with DHSSPS Standards Community Fora have been consulted on a wide range of issues including access to transport, Ageing in an Inclusive Society, Supporting People, PPI and community safety. Interagency partnerships are in place to strategically develop these services. Level 5 Shaping corporate and organisational Patient information audit - mechanism to inform regional GAIN project (cancer focus) Experiences of residential Care in N.I. shared with Scottish colleagues through conferences/publications Service User involvement in lectures at UUJ on social policy and its impact on adults with learning disability. The feedback Craigavon & Banbridge Community Forum enables dialogue with the Trust to influence various elements of organisational development. 14

15 priorities and direction. from this is also used to shape services internally and with partners across education, transport and community and voluntary organisations. This mechanism of engaging with the most senior levels of the organisation is viewed very positively by the forum members. The lobbying function is also directed at other public authorities 15