Engagement paper for Our Future Wellbeing Programmes

Engagement paper for Our Future Wellbeing Programmes

Version Date Issued Summary of Changes 1.0 Document Created Author S. Joslyn and C. Williams TARGET READERSHIP This document has been distributed for the following readership:- Project Team Project Board Engine Room Technical Team Site Specific Project Teams

Contents Contents: Outline Introduction Purpose Our Vision for the Future Why Engagement is Needed Communications and Engagement Principles Addressing Perspectives Our Audiences and Stakeholders Key Messages The Focus for Co-production and Engagement Project Plan / Delivery Methods of Communication Patient Engagement and Involvement Digital Communications Measuring Effectiveness Progress to Date Summary Appendix 1: Health Literacy Information Appendix 2: Co-production Approach

Outline The plan will focus on the audiences, messages, communication methods and feedback mechanisms for engaging and co-production with key stakeholders throughout the various stages in the programmes. It will be the responsibility of the project/ technical team to develop the communication /engagement materials and facilitate the delivery of communications. For key information and documents it will be necessary to verify the distribution of those communications. The resources required to develop the communication materials and to support the delivery of communications will be included as part of the detailed plan for each stage of the programmes. The actual delivery of many of the communication messages will be through designated representatives of the project / technical team. They will have responsibility for presenting and facilitating briefing sessions, delivering communications locally and gathering feedback. Having been identified as major transformation programmes that operationalise the Shaping our Future Wellbeing Strategy, the programmes are high profile and there are a significant and diverse number of stakeholders involved. By effectively communicating with stakeholders, the success of the programmes can be maximised.

Introduction Cardiff and Vale University Health Board (UHB) is working with citizens, patients and partners to make it a reality that: a person s chance of leading a healthy life is the same wherever they live and whoever they are. The context for engaging with stakeholders is the implementation of the Shaping Our Future Wellbeing Strategy. At its heart, the UHB strategy aims to achieve joined up care based on home first, avoiding harm, waste and variation, empowering people and delivering outcomes that matter to them. It focuses on the health and care needs of our local population, the promotion of healthy lifestyles, the planning and delivery of healthcare in people s homes, community facilities and hospitals whilst recognising the need to work more collaboratively with our partners to provide sustainable services, including those which we provide to the wider Welsh population. The UHB is currently undertaking a number of programmes of work aimed at delivering the strategy. Focusing on establishing suitability, these will transform services through new clinical pathways and service models. There will be a greater focus on a social model of health which promotes physical, mental and social wellbeing through the integration of primary, community and ambulatory care services within the UHB and also in partnership with our stakeholders within the Local Authorities and the Third Sector. It is acknowledged that significant stakeholder engagement has already been undertaken, the outcome of which has shaped our plan to transform the way we deliver services within the community.

Purpose The purpose of this engagement plan is to establish a framework for communication, engagement, co-production and co-ordinating the wide range of communications that will take place directly and indirectly as part of the Perfect Locality and Shaping our Future Wellbeing : in the Community programmes. This document defines the key engagement objectives to be achieved by the programmes, the key principles that will underpin all engagement, and the roles and responsibilities. To do this we will: Improve engagement with citizen by... Putting the citizen at the centre of all we do and ensuring they remain central. Improve engagement with community by... Valuing the role of people and communities in their health and wellbeing, including through co-production, volunteering and social movements for health. Enabling health and care professionals and the wider workforce to understand and work in person- and community-centred ways. Making greater use of behavioural insights in implementing person- and community-centred approaches and spreading change. Improve community services by... Investing in a new generation of integrated health and social services centres alongside the transformation of our hospital estate. Developing strong and sustained networks as an integral part of implementing and scaling up person- and community-centred approaches. Improve partner working by... Valuing everyone's contribution to a comprehensive engagement approach. Designed and delivered with, rather than for people, using shared vision and goals: wellbeing, resilience, autonomy, connection to others.

Our Vision for the Future The programmes, Perfect Locality and Shaping our Future Wellbeing: in the Community are the next step in making Shaping the Future Wellbeing strategy (Published in 2015) a reality. In producing the Shaping the Future Wellbeing strategy the UHB has an agreed set of principles which provide the foundation for our vision that a person s chance of leading a healthy life is the same wherever they live and whoever they are. The principles ensure sustainable, cost effective, integrated services that are centred around the person, these principles were developed in partnership through conversations between people who both use and provide services. Our aim is to build on strengths and assets to provide services to citizens in their homes or communities that improve their health and well being. In order to build a social model of health and social care which better matches local needs and services we need to Develop a 'Made in Cardiff & Vale' approach reflecting local needs and aspirations. Empower the Person Home first Outcomes that matter to People Avoid harm, waste and variation

Why is Engagement Needed? Communicating and engaging with our citizens, patients, partners, local communities, and the third sector is central to achieving our vision to improve health, wellbeing and health services in Cardiff and the Vale of Glamorgan. It is important that we recognise communication and engagement is a two-way process and work accordingly. To be effective, we need to actively listen to the opinions and ideas of the people and groups we communicate and engage with, and provide feedback, rather than solely providing information. Issuing a barrage of information is not good practice Our vision, the way we work and our priorities must be shaped, implemented and finally conveyed through an on-going relationship with all our stakeholders, based on mutual respect and openness. To assist the development of community services designed by those who live and work in the community (clusters/ neighbourhoods) to address the health and wellbeing of its citizens we need to : Change culture through meaningful engagement (more than being informed), to develop and deliver solutions and own services. Ensure our partnerships are build on trust, sustained, well managed and transparent. Only then can we improve health and reducing health inequalities and move to a wellbeing model.

One of the particular strengths of the Health Board is that our staff listen and engage with large numbers of patients on a day to day basis. Being led by staff increases our knowledge and means that engagement is embedded into our programmes, which in turn allows us to plan for what people need, not just what we think they should have.. The voice of patients and their communities will inform: Our decision-making throughout our organisation on an ongoing basis; Our quality improvement work by contributing towards needs assessments, strategy development and service redesign; and Our quality assurance work by highlighting patient, carer and community experience to inform our monitoring and evaluation of existing services, care pathways, providers and healthcare interventions. We will employ a range of mechanisms, methods and information sources to inform, listen to and involve our local population. These will develop in response to feedback from our communities, to ensure they meet the needs of all our varied communities. To help us achieve our vision we will: Ensure appropriate and proportional involvement from the third sector, (this includes charities, voluntary organisations and / or community groups ) and communities, when commissioning proposals affect them, at an early stage in the commissioning cycle.

Communications and Engagement Principles Cardiff & Vale UHB has signed up to the National principles for Public Engagement in Wales. We want to ensure that we are always: Accessible and inclusive, to all people in our community. Clear and professional, demonstrating pride and credibility. Targeted, to ensure people are getting the information they need, Open, honest and transparent. Accurate, fair and balanced. Timely and relevant. Sustainable, to ensure on-going mutually beneficial relationships. Two-way, we won t just talk, we ll listen and provide feedback. Embed the principles of health literacy. (See appendix 1) Cost effective, always demonstrating value for money. Promote co-production as the approach for all developments- (See appendix 2) (Participation Cymru http://www.participationcymru.org.uk/media/288366/pc_national_principles_poster3.pdf)

We will create an engagement and consultation framework to ensure that any engagement activity carried out, follows a consistent approach. The framework will ensure high-quality and expert service is offered by the communications and engagement team. It will be focused on the effective engagement of stakeholders across the local health community. The key levels of involvement for service users, staff, other stakeholders and the general public which will create conditions for successful implementation of the project are: A general awareness element which will take stakeholders to a general level of knowledge and understanding. A participation element for those affected by the project directly, which will take them from awareness to involvement. A commitment element for key stakeholders which will take them to full commitment. Communication of the right message at the right time to the right people will be critical in ensuring the required level of understanding and support is achieved. To minimise risk and ensure a consistent and effective message, a number of common principles should be followed to ensure successful communication between the project team and identified stakeholders. These principles have been used in defining this Communication Plan to support the project THE FOLLOWING KEY PRINCIPLES SHOULD BE APPLIED IN ENGAGEMENT / COMMUNICATIONS:

Credibility Communicators whom people trust / respect Involve, not Inform Visible management support Face-to-Face communication Avoid information overload Consistent messages Repeat messages through different mechanisms Create demand for information Credible communication approach and credible communicators, ensures individuals will believe in the end goal. Reinforces credibility of the message and allows for better and more open information sharing between the project team and stakeholders Promotes ownership of the project and product, ensuring that stakeholders are bought-in to the change. Minimises risk for project failure through lack of information transfer between implementation team and stakeholders. Active management commitment will give added credibility to communication. Visible management support of the project team and goals will encourage stakeholders at all levels to support the project. Audience is actively involved in the process; communication is two-way and less hierarchical. Provides an instant feedback mechanism. Too much information leads to confusion and irritation. Accurate and timely information focussing on what an audience wants to know will ensure a more successful message. Inconsistency can result in loss of credibility for the project. Audiences will be confused and frustrated about the progress and aims of the project. All communications involving the project, formal or informal must be consistent. Using different mechanisms to reinforce message, ensures repetition without loss of interest or individuals switching-off. Keep stakeholders excited and eager to hear about the project progress. This ensures they will be more willing to support the project and more open to future developments.

Tailored communication Central co-ordination Manage expectations Encourage and react to feedback Ensure that the information provided is real to a particular audience. Stakeholders will be more likely to listen if the information is pertinent to their own situation. Centrally led communication ensures a clear and consistent message at all times. Realism about the change encourages an audience to believe in what they are being told. Over or under expectation can result in let down and loss of confidence in the project. Encourages support in the approach by being responsive to the needs of the stakeholders. Ensures the approach meets the changing audience needs. Minimises risk of failure as a result of project team isolation from users.

Addressing Perspectives Citizen Lens Community Lens Hospital Lens Recognising that citizens have told us (during Shaping our future wellbeing (SOFW)) that they want services close to home, where possible that we (UHB) need to involve people in decisions that affect them/ the service they receive. Recognising we (UHB and partners) have skills, knowledge and good practice examples already underway. Within Primary and Intermediate Care (PCIC)/ Public Health Wales (PHW)/ General Practice (GP) services/ 3 rd sector, town councils etc and need to build on any sustainable examples. Recognising that citizens have told us (during SOFW) that they want services close to home, where possible Framing the question: How do we improve information about services? How do we embed partnership / co production of services? Framing the question: How do we improve GP sustainability? What do we need to assist partnership / integrated services? How do we embed partnership / coproduction of services? How do we work better together to improve outcomes? Framing the question: What can we move from hospital to community? How do we work better together to improve outcomes?

Our Audiences and Stakeholders We are committed to engaging with: Citizens Carers Community staff Hospital staff Cardiff Council Vale of Glamorgan Council Third Sector Cardiff and Vale Community Health Council Regional Partnership Board Welsh Ambulance Service Trust (WAST) Public Services Boards Primary Care

Key Messages The Perfect Locality and Shaping our Future Wellbeing ; in the Community programme will provide a consistent high-level message We are focussed on Caring for People: Keeping People Well and to achieve this we must work in partnership with our two Local Authorities and third sector organisations. We are committed to making it a reality that: a person s chance of leading a healthy life is the same wherever they live and whoever they are. Our over-arching key messages are: We are working together to improve the health and wellbeing of the citizens of Cardiff and the Vale of Glamorgan. We will plan and deliver our services by engaging people who use and work in the services, producing high-quality healthcare services for the people of Cardiff and Vale of Glamorgan to use. We will work with our citizens to help prevent them from becoming ill and to support them to live longer and better quality lives. We are committed to working with our partners across the NHS, social care and third sector to improve the health and wellbeing of our citizens. We continually work to improve the quality of health and social care services. We always encourage feedback from local people and will act on it wherever possible. We make our best efforts to use the funding and resources we have to provide prudent, sustainable primary care.

The Focus for Co-production and Engagement Perfect Locality Specification to commission a "Perfect Locality Whole system service models (joint commissioning where appropriate) Sustainable Primary Care, reducing demand on General Practice. Priority deliverables for 2017/18 SOFW :In Our Community Programme Programme Business Case Describe the likely network of Health and Wellbeing Centres and Wellbeing Hubs responding to the particular needs of locality and cluster populations and the improvement of our primary care estate Three tranches of projects (tranche 1, very detailed, tranche 2, desktop detail, tranche 3 outline detail) refreshed and updated with further detail each time a Project Business Case is submitted SOFW :In Our Community Projects Project Business Cases Describe the specific location and services provided in the Health and Wellbeing Centre / Wellbeing Hub responding to the particular needs of locality and cluster populations and the improvement of our primary care estate Detailed service development and implementation plan Perfect Locality Implementation plan

Project Plan Project Purpose Project Objectives, Scope, Vision Project approach Timescale Current Status Outcomes : Benefits for patients Outcomes : Benefits for staff Outcomes : Benefits for the organisation Methods of Communication Newsletter & web page Coproduction workshops Information / engagement sessions Specification Awareness session Project plans, inc highlight reports

Digital Communication Six in ten UK adults (62%) now use a smartphone, an increase from 54% in 2012. This increase is driven by 25-34s and 45-54s, and those aged 65-74 are almost twice as likely to use a smartphone now compared to 2012 (20% vs. 12%). Therefore, we will need to continually develop and build new ways of communicating and engaging with our audiences and stakeholders, to develop strong, enduring and mutually beneficial relationships. Using a multi-platform approach will enable us to: Be open and transparent about the work we are doing; Help to improve health and local healthcare through targeted marketing communications, linked to our strategic priorities; Engage with our partners by becoming more approachable. The informal nature of social media should encourage more people to have a conversation with us, challenge us or make their views known by attending our events or taking part in consultations; and Encourage others to share our news by helping to increase our followers and attract new interest from a wider and more diverse audience. Our Digital Objectives We will effectively manage our digital media communication methods by linking them to our strategic objectives and work streams. Our main objectives will be to: Build a strong community of patients and stakeholders online through social media; Establish a relationship built on trust; Encourage stakeholders to support our work by sharing our posts on social media platforms; Share partners health and social care messages; Website We will ensure that we keep the website up-to-date with the latest information on our work and increase the number of visitors to the site by promotion of the web pages through social media. We will encourage stakeholders to share the information on our web pages via social media, and their own websites, as well as asking them to link to our site from their website.

Progress to Date Stakeholders have played a key role in identifying a way forward through a number of engagement exercises: Development of the Shaping Our Future Wellbeing Strategy Engagement events with citizens Partnership Planning Events Population needs and wellbeing assessments (undertaken under the banner of Lets Talk ) Focused conversations with Clusters, primary care teams and clinical board teams Discussion at BIG room and with Clinical Boards

Summary As part of the engagement for the Perfect Locality and Shaping our future Wellbeing : in the community programmes engagement, we will Ensure appropriate, timely information is provided to citizens, patients, staff and partners. Engage as many partners as possible to shape community services ensure a community lens. Ask people to provide solutions that impact on the health and wellbeing of themselves, their families and their community / neighbourhood / cluster. Approach health literacy as an organisation-wide issue and develop plain-language initiatives. Ensure the principles of health literacy are used in all information. Provide further opportunities for coproduction. Continue to build trusting relationships with the people who use services, staff who provide services and third sector partners. Making sure we keep people informed and engaged. Ensure we recognise peoples expertise to produce creative solutions. Listen, Listen, listen and then feedback to our citizens, workforce and partners.

Appendix 1: Embedding Health Literacy Health Literacy is needed for citizens to understand and act upon health information, to become active and equal partners in co-producing health. It enables them to take control of their health to help shape health environments, and health services for themselves, their families and their communities. Inaccessible and unduly complicated systems and information can limit a person s health literacy. It is critical to acknowledge that people s health literacy depends on not only individual ability, but also on the responsiveness of health and social care systems; it is essential that health and social care providers ensure that services and information are clear and accessible, barriers to access are removed, and people are engaged with and needs understood. In summary, health literacy is made of: Basic health knowledge Comprehending and evaluating health information Prevention, health promotion and self care behaviours Verbal communication with healthcare professionals Health decision making Navigating the healthcare system A two way process between healthcare user and provider

ACCESS, UNDERSTANDING & INFORMATION = IMPROVED HEALTH LITERACY Health literacy refers to people having the skill, knowledge, understanding and confidence to access, understand, evaluate and use health and social care information and services. Poor health literacy reduces peoples ability to take control of their health and the conditions that affect their health. Health providers need to ensure that services and information are clear and accessible, removing barriers to access, engagement and understanding for everyone. There is evidence that improved health literacy can: Build resilience Reduce disease severity Improve mental health Increase health knowledge Improve adherence to medical instruction Promote healthy lifestyle changes Improve engagement and involvement in health Improve confidence and self esteem Empower people to effectively manage long term conditions When providing information about services or health instructions/ advice: Simplify language and check readability Format material to make it user friendly Use audio/ visual aids, if appropriate Use pictographs, cartoons etc to instruct and inform, if appropriate Write in short sentences Provide information in bullet points Avoid unnecessary jargon

Appendix 2: Taking a Coproduction Approach In order to build up relationships based on trust we need to take a co-production approach, and doing with as opposed to doing for or doing to individuals and communities. (See engagement ladder). We are living in challenging times, uncertainties on funding and how we respond to need, no longer seem clear. Inequality, poverty, reduced funding on public services, and rises in population require us to collaborate both with organisations and citizens, as this is where we can unlock hidden assets and work together to do things differently and more innovatively. We need to take an assets based approach, which is an integral part of community development and involves facilitating people and communities to come together to achieve positive change using their own knowledge, skills and lived experience of the issues they encounter in their own lives, to achieve the Perfect Locality.

The co-production principles are:;. Valuing each other Building on our strengths Developing peer-support networks Relationships of trust Mutuality and reciprocity