Head of Communications & Community Engagement Manager Cross reference to other Strategic Commissioning Plan

Transcription

1 Document approved at: CCG Board Date of approval: Version 2- Board 7 th Status of document: Draft for Board Approval Clinical Lead: Chair of CCG Board Author by title: Head of Communications & Community Engagement Manager Cross reference to other Strategic Commissioning Plan documents:

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3 Nothing About You Without You Giving Dudley Borough a Voice on Health & Wellbeing Foreword Communications and Engagement Strategy This strategy sets out Dudley Clinical Commissioning Group s (CCG) commitment to communicating and engaging with the people of Dudley. The CCG recognises that by developing and implementing this strategy we can demonstrate how we will respond to public concerns, define needs and identify priorities. This will lead to a clearer understanding of our investment decisions and we will be able to more easily explain any service changes. Whilst we will undoubtedly make decisions which will not be agreed by all of our population, we are confident that as our relationships and engagement grow, the population will understand that the decisions we make will be in the best interests of the public and patients. Effective communications and engagement will lead to easily accessible information for our population which will enable people to make positive and informed choices about their health. It will enable people to select appropriate services aligned to their needs and empower them to demand high standards of care with a focus on safety and quality. It will lead to improved commissioning and ultimately better health outcomes by enabling our population to become involved in the decisions about their healthcare services. If we do not effectively communicate our intentions and rationale for our decisions, or manage our reputation, our credibility will be damaged and our ability to act effectively will be restricted. If we do not involve our stakeholders in a timely, meaningful and appropriate way, the services we commission will be less effective, plus we run the risk of challenge to our plans which may be costly in terms of time, resource and reputation. The services which we commission will be clinical evidence based and take into account patient insight and experience, ensuring that we get it right first time and meet people s needs with effective patient pathways.we are acutely aware that this is not achievable in isolation and we are committed to the role that the CCG will play with partners to create an effective health economy in which people are enabled to have a voice and feel empowered to influence the direction of health and wellbeing. This journey will not be without its challenges but it is one which we are committed to investing time and resources in, and to learning as we travel.throughout we will be true to our values of being patient centred and a listening organisation to realise our vision, to promote good health and ensure high quality health services for the people of Dudley David Hegarty Chair, Dudley CCG Page 1

4 1.0 Chapter 1: Introduction Dudley Clinical Commissioning Group (CCG) comprises 52 GP practices across Dudley Borough along with the Board members and directly employed staff and support staff. We have a budget of 408 million which we spend on commissioning healthcare for our population of 312,000 people. Everyone in Dudley CCG is responsible for delivering engagement and communications. As we mature in our role as a commissioning organisation, individuals will be supported to develop the skills, knowledge and confidences that will enable them to deliver an empowering and collaborative approach towards engagement and communications. With member practices, CCG staff and partners we will develop a competency framework and seek to provide support and training where necessary. The communications and engagement team will help to support and facilitate learning and provide guidance. We recognise that our member practices need to feel engaged and empowered to work closely with the CCG Board and feel part of the organisation. We will additionally resource the CCG staffing structure to ensure the organisation is membership focused. 1.1 The Vision Dudley Clinical Commissioning Groups (CCG) vision is: To promote good health and ensure high quality health services for the people of Dudley Effective communications and engagement significantly contribute towards the role of the CCG, representing one of the organisations six key things which we do: Set the vision for healthcare in Dudley borough Hold the local health economy to account for delivery Support quality improvements with our members Facilitate improvements and transformational changes Engage with the public, patients and our members Ensure good governance and work with key partners 1.2 What do we mean by engagement? Engagement is the process by which an opportunity is presented so that it reaches and appeals to the targeted people, who make a choice whether to take advantage of it. Barriers to involvement are identified and addressed so that they can participate effectively Community engagement is about developing and maintaining the relationships we have as a CCG with our patients, public, carers (i.e. patients with caring responsibilities) and Page 2

5 communities. We have a responsibility and a drive to understand our communities to ensure that our commissioning decisions are truly patient centred and patient led. We will also need to understand the implications of not involving communities in our decision making and to understand the barriers which prevent people from getting involved. This means we will need to take a proactive role to support and inform our communities, adopt robust working relationships with other stakeholders and demonstrate flexibility to change how things are done by being open to community influence. 1.3 What are the aims of this strategy? Our vision in relation to communications and engagement is: A future in which patients (including patients with caring responsibilities), public and communities will contribute actively, collectively and inclusively to health and wellbeing outcomes underpinned by effective collaboration with, and between, the CCG and its partners. By :- patients and staff will understand the environment in which the CCG will operate along with the wider NHS landscape the CCG and constituent practices will speak with a consistent voice members of the CCG will have genuine relationships with patients, stakeholder and partners patients and stakeholders will feel heard and assured that they can influence outcomes; patients, the public and carers will be supported to look after their own health or will know where to go when they cannot we will act on patient experience and insight and develop mechanisms for patient/carer feedback we will provide opportunities for engagement in all aspects of commissioning To achieve this we will focus on the following: Ensure that the views of member practices, staff, patients, carers, stakeholders, partners and the wider community are fully reflected in decisions about how services are proposed, designed and delivered as well as how they can be improved Lay the foundations which will allow us to effectively communicate and engage in a collaborative and empowering way whilst ensuring good governance Raise the profile and understanding of the CCG and it s role Empower the CCG and member practices to develop the skills, knowledge and confidence for effective communication and collaborative engagement How will we measure the effectiveness of the strategy? We will conduct public surveys to measure the public s awareness of the CCG and it s role We will conduct a staff and member survey of the awareness of the CCG its role and ability to influence decisions made Page 3

6 We will continue the annual survey of how well the CCG is engaging with people (benchmark June 2012) We will record all engagement activity and feedback on how patient involvement experience has influenced commissioning activity (this will be reported to the Board via the new Communications & Engagement Committee which will govern this activity) We will monitor web statistics and ensure that the information displayed is valuable and relevant for visitors We will increase our visibility on Social Media (measured by number of followers) 1.4 Why do it? A huge amount of evidence demonstrates the crucial role communications and engagement plays in helping organisations to achieve their objectives. Much of this relates specifically to the NHS and other public bodies, as follows: Only by truly understanding what is really important to people can a service be efficient, effective and relevant1 The more well informed the public are, the more satisfied they are with public services2, and the more engaged they are with health3 Involving people in making decisions that affect their lives increases their self esteem and self confidence in turn improving their health and wellbeing4 Poor communication damages trust and reputation5 The CCG also has statutory duties in this area, including a duty to engage and report on that engagement. Case law tells us that failure to do so could result in costly and damaging legal hearings. (Full details on legislation is available in Appendix 1) 2.0 Chapter 2: Our Approach This chapter of our strategy sets out our approach to engagement. We are committed to developing an organisational culture which supports an empowering and collaborative approach. 2.1 An Empowering Approach Since 2007 organisations in Dudley Borough have been developing and using an empowering approach to engagement. The five community empowerment dimensions (see below) developed by changes have proved to be very helpful in thinking about how to work in ways which empower people. Community empowerment is not just about communities it is also about organisational structures and processes being empowering, Dudley CCG will take an empowering approach to engagement. We will do this as a contributor to, and beneficiary of, Engaging Together which is used widely in Dudley Borough Community Empowerment Dimensions Page 4

7 By confident, we mean, working in a way which increases peoples skills, knowledge and confidence and instills a belief that they can make a difference. By inclusive, we mean working in a way which recognises that discrimination exists, promotes equality of opportunity and good relations between groups and challenges inequality and exclusion. By organised, we mean working in a way which brings people together around common issues and concerns in organisations and groups that are open, democratic and accountable. By cooperative, we mean working a way which builds positive relationships across groups, identifies common messages, develops and maintains links to national bodies and promotes partnership working. By influential, we mean working in a way which encourages and equips communities to take part and influence decisions, services and activities. 2.2 A Collaborative Approach Dudley CCG S communications and engagement will take place in a wider context. Collaboration is essential and can help us to maximise use of resources. The Health and Wellbeing Board (HWBB) will take overall strategic responsibility for collaborative working between the different partner agencies and reducing barriers and duplication. This strategy will contribute towards the effective achievement of health and wellbeing outcomes of Dudley Borough. 3.0 Chapter 3: Our Environment 3.1 It s not without its Challenges We know that effective communication and engagement comes with its challenges. Even more so when seeking to work in empowering and collaborative ways. Dudley CCG will have challenges internally and externally and will need to consider the whole landscape. Challenges will include: CCG staff (including member practices) and Board members developing the necessary skills, knowledge and confidence to communicate and engage in empowering and collaborative ways Adapting to a new landscape of being a clinically led organisation with membership practices Recognising that effective communication and engagement takes time to be fully effective Understanding how much influence can be achieved and therefore which engagement processes and activities are appropriate without raising expectations How we evaluate and learn from our communication and engagement activity Page 5

8 Recognising that during the forming stage of the CCG as an organisation, engaging is more important than ever to build public confidence in the CCG Despite these challenges Dudley CCG has strengths to build on. These include good relationships with partners and a well established and valued public Healthcare Forum. The organisation also has a real appetite for success in this area, recognising the vital role that effective engagement plays in the commissioning cycle. Opportunities include linking into Engaging Together and the wider work across the borough for support in overcoming our challenges. These opportunities include Practice Participation Groups, the Patient Opportunity Panel, the new Dudley Healthwatch and the evolving Health and Wellbeing Board. (Full SWOT analysis can be found in appendix 2) 3.2 Our key stakeholders To achieve our objectives, we need to develop effective relationships with all stakeholders. Throughout this document the term stakeholder has been used to describe any person or organisation whose interests are affected by, or can affect, our work to secure the best health outcomes for the people of our area. (Our full range of stakeholders can be found in appendix 3) To make do this, we need to identify all stakeholders, and prioritise them. We have used a simple planning model to achieve this Stakeholder planning model 4.0 Chapter 4: Taking shape 4.1 Research We believe that we have already made good progress in establishing our identity and in starting to build relationships with other people and groups who share our interest in the health and wellbeing of local people. In developing this strategy, the Communications and Engagement team have worked with closely with partners and active members of local groups and patient fora. Activities have included: Workshops in which we discussed meaningful engagement; how the CCG should engage and how patients, public, carers and communities can be represented in CCG decision making A Board Development session to explore our understanding of engagement Online survey and visits to several community groups to ascertain how they thought engagement could best be strengthened and work effectively Page 6

9 CCG public event Nothing About You Without You. Over 260 people participated in an interactive workshops and information session on the role of the CCG Appointment of a Lay Member on the Board who will champion patient and public involvement Conversation with Healthcare Forum participants Our ongoing contribution to Engaging Together The information and views drawn from the various activities demonstrated a strong desire for an empowering and collaborative approach to engagement from the CCG (full details can be made available on request). By listening to the views which were expressed, we believe that effective communications and engagement can be achieved: By giving the right information, at the right time in the right way By listening to what you tell us and taking the time to hear what you are saying By making it easy for you to get in touch with us By working with partners to give you the skills, knowledge and confidence you need to participate By being transparent in our decision making processes By recognising and valuing your contributions By learning to appreciate and make better use of what we already have in our communities By feeding back to you even if it is a difficult conversation This is our pledge to Dudley people! 5.0 Chapter 5: 360 degree commissioning Communication and engagement need to occur throughout every stage of the commissioning cycle. As a commissioning organisation it is important that the CCG understand the skills and time that is required and appropriate engagement processes and activities to use. Page 7

10 Engagement Cycle InHealth Associates Choosing appropriate engagement processes and activities at any stage of the commissioning cycle requires a clarity of the purpose of engagement and influence that can be achieved. Engagement activities can broadly be grouped along a spectrum. Ranging from: Information giving (e.g. our website, publicity campaigns and Healthcare Forum) Online networking (twitter, facebook, other social media) Consultation (asking opinions on a pre determined number of options) Representation (e.g. reflecting the views of others) Co-production (ranging from co-design to co-delivery and co-evaluation) Commissioning others to deliver services The table on the following page sets out the CCG s communications channels and lead responsibilities. (Brand details & positioning can be found in appendix 4) Engagement Activities Key targets Who leads/helps Information giving Online networking Patients, public, carers, communities, Groups GPs/member practices Patients, public, carers, communities Groups Page 8 Communications/engagement team Complaints Dudley Healthwatch Communications/engagement team Board

11 GPs/member practices Consultation Practice Participation Groups (PPGs) Patient Opportunity Panel Groups GPs/member practices Representation PPGs Dudley Healthwatch Groups Board Co-production Patients, public, carers, communities Dudley Healthwatch Groups Communications/engagement team Communications/engagement team Dudley Healthwatch Communications/engagement team, CCG staff Dudley Healthwatch Commissioning others to deliver services Social enterprises Groups Providers Communications/engagement team, CCG staff Dudley Healthwatch 5.1. Unpacking Commissioning Commissioning decisions should not be treated a simple, single entity. The CCG will seek to adopt the most effective approaches to engaging with people outside the organisational health economy. It will also seek outcomes from such engagement - the evidence which tells us how effective it has been. The CCG will show how engagement has influenced or shaped the decisions we have made. We will strengthen all aspects of communications and engagement by actively seeking the views of stakeholders about the outcome of commissioning decisions so that we can fulfill our 360 degree commissioning. Dudley CCG understands the importance of providing real opportunities for empowering and collaborative communication and engagement at each of these different levels of commissioning. The attached action plan identifies the actions with costs which will be required to implement the strategy. (a useful checklist is available in Appendix 5 for reference when deciding to consult) 6.0 Chapter 6: Communications channels and messages 6.1 What do we mean by communication? Communication is an effective exchange of information between 2 or more people Strong and clear communication underpins effective engagement and that they are both intrinsic to each other. Our approach to communications will support all of our key messages from simple information sharing to active collaboration. All communication will be two way, listening and responding- Listening means valuing people s views, acting on feedback and changing behaviour. It is only by continuously improving what we do, and the way we do it through inviting and welcoming feedback, that we will enable the CCG and staff to evolve. As a listening organisation, the CCG will ensure Page 9

12 that the views of stakeholders are taken into account when it is engaged in communicating with it s internal and external audience. Effective communication requires planning and preparation. Communication processes will be pro-active, positive and planned. The power of communication should not be underestimated. Positive or negative publicity can have serious impact on public confidence and staff morale. It is important that the CCG works with opinion formers, politicians and the media to ensure that information is accurately conveyed. Training and supporting staff to be good communicators is fundamental in all areas of service. (Media management approach can be found n Appendix 6) Communication will be embedded into all levels of the organisation- Communication needs to run through every process, policy and part of the CCG. A breakdown in communication is the single most common cause of problems or complaints and effective communication is integral to all that we do in order to improve the health and wellbeing of the local community. Open Communication promotes trust. We have a duty of confidentiality and responsibility. Trust can only be earned by open and honest communication. Messages must be delivered in a timely fashion because they will be of more interest to the audience. Delayed communication will create a vacuum which may lead to informal channels providing misinformation which may cause unnecessary concern or anxiety. Targeted- Understanding the audience prior to information cascade is vital to effective understanding of the intended message. Adopting a social marketing approach to the communication function will advise people on combining the existing information (Health Needs Mapping techniques, staff opinion surveys, admission data) with imaginative communication techniques to successfully reach the intended audience with the right message. Measured- We will measure our success in terms of what has been achieved, not just what has been produced. This means thinking about desired outcomes for any activity as well as the outputs. Evaluation will be written into each project or programme of activity. Objectives will be clear, precise and measurable. 6.2 Communication Channels A range of different channels will be used to ensure effective, targeted communication with different stakeholders. The channels below are not exhaustive. The team will seek the appropriate channels to meet specific tasks and audiences. The list is intended as the core set of channels for CCG communications. Page 10

13 A single website will be developed for the Dudley CCG which will replace the current PCT website. This will provide timely key information about the CCG. Information will be presented clearly and every effort will be made to increase accessibility and ease of use. This will be refreshed once we choose a service provider. A GP Member & staff area/intranet will be developed to replace the current intranet area sites available for practices. This will include a news section to reflect and build on the current CCG News. An address will be set up for the CCG and regular ed stakeholder bulletins will be produced to identify stakeholders to update them on current activities. Opportunities will be sought to develop networks and relationships with key audiences, including community and neighbourhood newsletters. Existing internal communication channels such as CCG news will be used to ensure that staff and members are kept up to date and engaged with the development of the CCG and its policies Social media resources will be developed as appropriate in order to have an online presence and facilitate accessible information and dialogue with the public and partners. The media will be engaged to help update and inform the public about the CCG. We will further nurture and develop this relationship. We will make better use of networks with partner organisations which will be used to cascade bulletins and updates. Including membership lists of Dudley and Walsall Mental Health Partnership Trust and Dudley Group of Hospitals NHS Foundation Trust.. We will have and promote a 'contact Julie' section on the web to encourage dialogue with the public over any issues We will have a quarterly public facing newsletter distributed to GP practices and other locations to update on CCG News. Quarterly Healthcare Forum Annual priority setting public meeting Annual report Promotion of the dates and locations of the Board meetings which will be held in public, including use of the local free press and public locations 6.3 Key Messages Underpinning all our communications will be the key organisational messages which encapsulate the CCG Values and way of working: We are clinically led- an organisation made up of local clinicians working together to improve the health of Dudley communities We will be a patient-centred- Doing things with you not to you, acting as advocates for patients, helping patients care for themselves. We value partnerships- we are committed to working together with other organisations who can help us to achieve the best health outcomes for the people of Dudley We are a listening organisation - we will actively seek out and value the views of staff, members, patients and the public, acting on their feedback to shape and improve services We will spend funds wisely- we are committed to investing the funds allocated to us in the best interests of our local communities to ensure value for money. Page 11

14 We will be an inclusive- We will uphold the principles of equality and diversity. We will be respectful and impartial in our dealings. We will recognise vulnerability We will have a focus on prevention- We will seek to educate our population. We will support initiatives which promote health, prevent ill-health and support people to live longer and with a better quality of life. We will be innovative- We will seek to be leading edge and embrace innovation and new technology. We will seek to work smarter not harder and modernise healthcare provision. And specifically for internal audiences: We are clinically led but our managerial and administrative staff are integral to the successful delivery of our commissioning plans. In that respect we are equal and work together to achieve the best outcomes for patients We are committed to ongoing service improvement through innovation and inspiring one another to do great things We will be a learning organisation. We will have a philosophy of accepting the past, forgiving and moving on. We will support individual learning. We will be outward looking. We will support and empower staff. We will actively listen and learn from others. We will work together as teams within the organisation and with partners (sharing good practice, improving integration, taking shared pride in work, winning hearts and minds to work collaboratively) Key messages will be developed for specific marketing and communications initiatives, based on research and insights, and tailored to the target audience. 7.0 Evaluation Ongoing evaluation of our engagement and communications activities will help us to: learn how well communication and engagement systems work and how they can be improved monitor if the systems are functioning to an acceptable standard hold ourselves up to scrutiny by internal and external stakeholders. The CCG will develop a culture that is facilitative towards reflective practice and will build on a shared vision of empowering and collaborative communication and engagement. Evaluation will take place through a combination of quantitative and qualitative methods including: Ongoing media evaluation Patient surveys Website usage statistics Internal communications audits Patient, staff and stakeholder feedback, including compliments, comments and complaints. An annual report will be prepared on consultations carried out (duty to report), which will include an assessment of the influence that the results of consultations have had on our commissioning decisions. These will also be regularly recorded on the Community Engagement Database shared with Dudley MBC). Page 12

15 Continuing to contribute and be a beneficiary of Engaging Together Setting key performance indicators Linking in closely with patient experience Strengthening relationships with the Overview and Scrutiny Committee Building a robust relationship with Dudley Healthwatch We will ensure good governance of the organisations engagement and communications activities including: Regular reports to the Board on the effectiveness of engagement CCG committee structure (including Terms of Refernce) Dudley Healthwatch challenge Building relationships with the Overview and Scrutiny Committee 8.0 Resources This action plan has been costed to account for core activity of the Communications and Engagement Team. For any new commissioning activity individual budgets will need to account for the cost of effectively engaging and communicating. 1 Insight: Understanding Your Citizens, Customers and Communities, IDeA and LGA (2008) 2 The Business Case for Reputation Project, MORI (2006) 3 Securing Good Health for the Whole Population. Wanless, D. (2004) 4 Saving Lives, Our Healthier Nation, Department of Health (1999) 5 The Business Case for Reputation Project, MORI (2006) Appendices 1. Legislation 2. SWOT 3. Stakeholders 4. Identity 5. Consultation Checklist 6. Media management Appendix 1- What is the statutory context for this strategy? 1.0 Legislation The National Health Service Act 2006 consolidated much of the previous legislation concerning the health service. Section 11 of the Health and Social Care Act 2001 became section 242 of the consolidated NHS Act Section 242 applies in England to: strategic health authorities; primary care trusts; Page 13

16 NHS trusts, and NHS foundation trusts. Section 242 states Each relevant English body must make arrangements, as respects health services for which it is responsible, which secure that users of those services are, whether directly or through representatives, involved (whether by being consulted or provided with information, or in other ways) in a) the planning of the provision of those services b) the development and consideration of proposals for changes in the way those services are provided, and c) decisions to be made by that body affecting the operation of those services. The duty applies if implementation of the proposal, or a decision (if made), would have impact on - a) the manner in which the services are delivered to users of those services, or b) the range of health services available to those users. A person is a user of any health services if the person is someone to whom those services are being or may be provided. In the Health and Social Care Bill 2012 parts (a), (b) and (c) above are repeated (with minor changes in wording). The relevant sections are reproduced below: This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by the Board in the exercise of its functions ( commissioning arrangements ). (2) The Board must make arrangements to secure that individuals to whom the services are being or may be provided are involved (whether by being consulted or provided with information or in other ways): (a) in the planning of the commissioning arrangements by the Board, (b) in the development and consideration of proposals by the Board for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which the services are delivered to the individuals or the range of health services available to them, (c) in decisions of the Board affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made)have such an impact. (3) The reference in subsection (2)(b) to the delivery of services is a reference to their delivery at the point when they are received by users. The Health and Social Care Act 2001 extended the scope of the local authority Overview and Scrutiny Committees ( OSC ) to review and give opinions on the health services in their area. This provision is contained in Section 244 of the National Health Service Act Page 14

17 Regulation 4 of the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002 provides that where a local NHS body has under consideration any proposal for a substantial development of the health service in the area of a local authority, or for a substantial variation in the provision of such service, it shall consult the overview and scrutiny committee of that authority. Key parts of the Department of Health's guidance 5 are provided below: The NHS body will need to discuss any proposals for service change with the overview and scrutiny committee at an early stage, in order to agree whether or not the proposal is considered substantial. At this point there should also be discussion about how consultation will be undertaken. This latter discussion should include agreement about the length of time the consultation will last and methods to be used taking into account local needs. One exemption is that local NHS bodies do not have to consult the committee if they believe that a decision has to be taken on an issue immediately because of a risk to the safety or welfare of patients or staff. The Regulations for overview and scrutiny do not define substantial. Local NHS bodies should aim to reach a local understanding or definition with their overview and scrutiny committee(s). This should be informed by discussions with other key stakeholders including patients forums. In considering whether the proposal is substantial, NHS bodies, committees and stakeholders should consider generally the impact of the change upon patients, carers and the public who use or have the potential to use a service. More specifically they should take into account: a) changes in accessibility of services, for example both reductions and increases on a particular site or changes in opening times for a particular clinic. - Communities attach considerable importance to the local provision of services, and local accessibility can be a key factor in improving population health, especially for disadvantaged and minority groups. At the same time, development in medical practice and in the effective organisation of health care services may call for reorganisation including relocation of services. Thus there should be - discussion of any proposal which involves the withdrawal of in-patient, day patient or diagnostic facilities for one or more speciality from the same location; b) impact of proposal on the wider community and other services, including economic impact, transport, regeneration; c) patients affected, changes may affect the whole population (such as changes to accident and emergency), or a small group (patients accessing a specialised service). If change affects a small group it may still be regarded as substantial, particularly if patients need to continue accessing that service for many years (for example, renal services). There should be an informed discussion about whether this is the case and which level of impact is considered substantial; Page 15

18 d) methods of service delivery, altering the way a service is delivered may be a substantial change for example moving a particular service into community settings rather than being entirely hospital-based. The views of patients and patients forums will be essential in such cases. A statutory consultation? A statutory consultation should be considered if: New services are being planned or there are changes to current services, for example changes in: - The location of services - The range of services provided - The manner (format or channel) in which they are delivered Who is delivering the services Large groups of populations are affected or small groups are affected on an ongoing basis If there is a 'legitimate expectation' that there will be a formal consultation - This is a key example of where organisations have been challenged in court if there is a 'legitimate expectation' that a consultation will take place then commissioners can be challenged if a consultation is not carried out. In addition to the above, there is also section 24a of the NHS act 2006 Duty to Report. This places a legal duty to report annually on the influence people s views have had on their decisions made by the CCG. Evidence is required to show how the feedback from patients and the public has been used to shape the reconfiguration, and if it has not been possible for the feedback to influence the proposals to give the reasons for this The Equality Act 2010 Section 149 of the Equality Act 2010 states that a public authority must have due regard to the need to a) eliminate discrimination, harassment and victimisation, b) advance Equality of Opportunity, and c) foster good relations. It unifies and extends previous disparate equality legislation. Nine characteristics are protected by the Act. 1.3 The NHS Constitution The NHS Constitution came into force in January 2010 following the Health Act The constitution places a statutory duty on NHS bodies and explains a number of rights which are a legal entitlement protected by law. One of these rights is the right to be involved directly or through representatives; In the planning of healthcare services; The development and consideration of proposals for changes in the way those services are provided; and In the decisions to be made affecting the operation of those services. Page 16

19 2.0 Our responsibilities As part of the structure of the reformed NHS, CCGs will be responsible for: building and protecting the reputation of the local NHS building relationships with the media, stakeholders, staff, public, patient, carers and partners brand and identity, marketing and campaign management providing different ways in which patients, carers, stakeholders, staff and the public can share their views ensuring the provision of information for patients is appropriate and timely responding to parliamentary questions and other statutory requests for information ensuring patients and the public are involved in commissioning health services ensuring consultation and engagement around service changes and developments is carried out and reported within the legal requirements. Appendix 2 Dudley Clinical Commissioning Group SWOT Analysis Strengths Weaknesses Page 17

20 Clinical Leaders of CCG know population & area Clinical Leadership Clinical Engagement and Buy in from Practices Clinician to Clinician relationships with providers Clinically driven decisions Clinician/ Manager symbiosis Clinical leaders are practicing clinical professionals Decisions made with patients interests at heart Chief Executive of Local Authority on Board Leaders hearing patient experience everyday in consultations Solid configuration from the start Coterminous with upper tier boundary Local Authority Strong relationships with other CCGs to influence commissioning outside borough and meet patient flow expectations Opportunities Build on trust and credibility that GPs have to communicate difficult decisions Clinicians developing as public sector leaders (aspiring directors) To work differently & think differently Primary Care Trusts were not that well understood so will not be missed and opportunity to start with fresh reputation To build an empowering and collaborative approach to communications and engagement To provide a real challenge for engagement To develop a whole system approach with other agencies across Dudley To develop a robust relationship with the new Dudley Healthwatch Newly formed organisation Limited management experience in Clinical Leaders Not traditional leaders of people Awareness of CCG is low amongst public Immature decision making processes Different approach to decision making Managers used to autonomy working and now need to work in partnership with clinicians Not enough time and planning for effective communications and engagement Threats Time commitments of clinical leaders Potential for conflicting time commitments and priorities. (patients, practice commitments) Challenge to bureaucracy and maverick behaviour could make certain policy difficult to implement Chance of change to policy direction Misunderstood by public / reporters due to lack of experience in public meetings Lack of understanding and confidence to communications and engagement N.B We recognise this SWOT has been developed based on an internal audience but that many of the points would also reflect on our stakeholders too Page 18

21 Appendix 3 In order to ensure communication and engagement activities are tailored around individual and population needs, it is important to analyse local stakeholders. The table below, whilst not exhaustive, shows some key stakeholders and information relevant to the CCG and the success of this strategy. New Stakeholders Stakeholders Objectives Health Wellbeing Board and The Health and Wellbeing Board was established as a committee of Dudley MBC in April 2011 and is currently in shadow form. the Board will be an extremely important stakeholder in the new NHS landscape and will steer the development of Dudley Borough s Joint Health and Wellbeing Strategy. This overarching document will seek to ensure consistency and complementarity in a range of other partnership strategies including the CCG s commissioning strategy Patient Opportunity Panel This is a new group that is being developed. All practices that have a Patient Participation Group are invited to send one or two representatives to attend a bi monthly meeting to informally network and to strengthen CCG engagement Existing Stakeholders Stakeholders Objectives Health and Adult Social Care Scrutiny Committee Healthcare Forum Dudley Healthwatch The CCG recognises the good working relationship developed between Dudley PCT and the scrutiny committee and intends to build on this. As local arrangements change, the CCG will continue to maintain a relationship with scrutiny which considers the wider health agenda and not just matters of substantial variation. The Healthcare Forum meets quarterly. It has terms of reference and is attended by patient representatives of organisations/agencies; by lay members of the LINk, by local health organisations; councillors, voluntary sector organisations and by individuals. In recent months there has been increased representation from established Patient Participation Groups. Healthwatch is supported through Dudley Council for Voluntary Services and will have a place on the CCG Board. The CCG will work closely with Dudley Healthwatch to listen to views and ensure that there is opportunity to share information and influence commissioning decisions. Page 19

22 Patient Participation Groups Dudley Council for Voluntary Service Carers Network Provider organisations Local Councillors & MPs Organisations and Forums representing people with protected characteristics There are over 30 active patient panels across the Borough (approximately 2/3 of all Practices have a patient panel). A Directed Enhanced Service is in place until March 2014 which encourages practices to develop groups. These are supported by the communications and engagement team witjin the CCG. We have worked closely with colleagues in DCVS as the new model for patient representation has been developed, and we recognise the huge importance and contribution of voluntary and community sector organisations in delivering health and social care services and in enabling people to engage meaningfully with decision-makers in the borough. The CCG recognises the huge contribution made by carers as part of the health landscape and we have good links with the carers network and carer s strategy group hosted by Dudley Council. The knowledge of carers, and their experiences of healthcare services, are an invaluable source of intelligence as we improve the measurement of and response to patient experiences We are building relationships with our key providers and working together to improve experiences of healthcare. Dudley CCG recognises the significant and influential role played by local elected councillors and the relationship councillors have with local people including MPs. The CCG will benefit from the extensive list of contacts developed by the PCT in different parts of the Borough and the relationships established with colleagues at the Council; with community centres across the Borough; CfED (Council for Equality and Diversity) and we are constantly adding to our geographic intelligence about the particular concerns of local communities for example in Lye in anticipation of the LIFT development; in Halesowen around concerns about interpreting services Page 20

23 Appendix 4- Branding Dudley CCG will clearly identify its visions, aims, and identity, creating a platform that will underpin all engagement and communications activity. The positioning helps us to outline the engagement vision and aims of the Clinical Commissioning Group, as well as starting to identify the audiences and key engagement messages. It has been informed by the overall vision of the CCG (see organisational development plan) so there is consistency with the Group s overall aims. The CCG s identity will focus on health service development which will be led by clinicians and informed by clinical evidence and patients together with the relationship between clinicians in the health economy. This basic understanding of the CCG position is already helping to frame communications messages. The clarity of the brand positioning will also enable us to develop a visual identity and brand guidelines for the CCG. We will be producing a communications toolkit with templates for posters, newsletters and other materials to be shared with staff and with GP practices. Brand positioning What we do? Scope: What area of activity are we in? Working with the community to promote good health and ensure high quality health services in Dudley. Status: What status do we want to achieve? Health service decisions led by Clinicians and informed by the people of Dudley Why we do it? Ambition: What is our heart-felt ambition? Healthier lives for the people of Dudley Ethos: What are the principles behind our actions? Passionate about the health, and compassionate about the care of the local community Compassionate about your care Supportive of local services for local people How we do it? Style: How do we go about our business? Thinking differently/ giving things a new perspective Clinician to clinician engagement supported by managers Reaching out to everyone Focused on the public, patients and carers Simple and straight forward/ plain talking Response: What outcomes do we want to achieve? I m heard, My views are being represented, I m healthier, I m cared for Focus: Our basis for making decisions The best results for people in Dudley Page 21

24 Appendix 5- An engagement question checklist i. Are you clear what the future will look like if the proposals are implemented? Is there a clear rationale for doing this? Is it clear who will be affected by the proposals this the starting point for identifying who to engage with (eg a small group or wider implications for all patients see iv below) What will the future look like from a patient s perspective put yourself in their shoes. Remember the Independent Review Panel s critical list especially the three issues most likely to excite local opinion money, transport and emergency care. Are you clearly distinguishing unavoidable drivers (eg financial imperatives) from the clinical evidence or considerations for enhanced patient experience and safety? What does the data tell us and how robust is it is it clear and unequivocal? How would we explain complex data/information to the general public? ii. iii. iv. What is positive about the change? Is there a good news story to tell? How can we assuage any fears or negativity about the change? What reassurances can we offer? Who needs to be involved? Stakeholder analysis will help to identify who needs to be engaged and the mechanisms of engagement available. If a proposal affects a distinct group of patients then the focus of engagement will be with them. If there are wider implications, then the engagement can include specific groups as well as representative forums (eg Healthcare Forum, Dudley Healthwatch); or reference groups (eg: Service User Network; Registered users on Your NHS Dudley). Are you clear what influence the public and patients can have on the proposals and any decisions to be made? ie what can and what cannot change? Check the principles of engagement does the intended engagement process cover all these adequately? Especially be clear about if there are real choices on offer? Page 22

25 Appendix 6- Media Management Dudley CCG is committed to being open, honest and transparent in all that it does. One of the best ways to do this is via the media. We have therefore a responsibility to inform the media about health services, changes to services, the policies of the organisation and the way it works. All members are committed to promoting the work that we do internally and externally. The majority of the public hold opinions on the local and national NHS based largely on media reporting, so good relationships with the media are essential. Messages delivered through the media are seen as independent and more credible than advertising or corporate publications and they are a free resource. Whilst we have less control over the message or its timeliness it is a communications channel which is trusted and reaches a large population. The CCG will take a very proactive stance with media relations and is already successfully engaging with local journalists to promote positive health stories and to ensure correct, balanced and fair reporting of issues. A key part of our communications is therefore to ensure that any local health achievements are highlighted in the local press. Building on the enhanced relationship that our Communication team has with the local media is key. It s well developed relationships have resulted in most enquiries being centralised but in some instances where unfamiliar reporters are seeking information we recognise that reporters may approach a department directly or an individual member of staff. In these cases advice and support is available from the Communications Team and media training is provided for staff. As the CCG is clinically led it is preferable for a clinician or other representative to front media stories. Full media briefing will then be available prior to interview. We are actively building a bank of representatives who can talk on a range of subjects promoting the work of the CCG and the services which we commission. Page 23