Community Engagement and Communications Strategy. Updated Version: November

Transcription

1 Community Engagement and Communications Strategy Updated Version: November

2 Table of Contents SECTION 1 Executive Summary Page 3 SECTION 2 Introduction Background and rationale 2.2 NHS Worcestershire leading the local health economy 2.3 Communications and Engagement key functions SECTION 3 Situational Analysis where are we now? NHS Worcestershire Vision and Objectives 3.2 Legislative context 3.3 Key issues facing NHS Worcestershire World Class Commissioning 3.4 Communications and engagement activity SECTION 4 Community Engagement and Communications Objectives where do we want to get to? Engagement and Involvement 4.2 Brand Management and Reputation Development 4.3 Internal Communication 4.4 Building Capacity 4.5 Campaign Management and Social Marketing 4.6 Promoting Equality, Diversity and Accessibility SECTION 5 Target audience and Stakeholder Map 28 SECTION 6 Evaluation 29 SECTION 7 Resources 31 APPENDIX 1: Implementation Plan : Community Engagement Annual Report Community Engagement & Communications Strategy

3 SECTION 1: Executive Summary The Strategy outlines how NHS Worcestershire will further develop its engagement and communications functions to deliver world class commissioning on behalf of Worcestershire residents. It includes a vision of what a world class function should look like, the key functions of the team that leads work in this area and incorporates commentary on the current situation and the issues that are facing the organisation. The Strategy then goes on to propose six strategic communications objectives that form the basis for communications and engagement work in the future: Engagement and Involvement Brand Management and Reputation Development Internal Communication Building Capacity Campaign Management and Social Marketing Promoting Equality, Diversity and Accessibility A Stakeholder Map is included that seeks to outline the various target audiences as well as the level of influence over and the interest that they may have in issues facing the organisation. Evaluation and measuring success and impact on health services and outcomes is of obvious importance and a section of this document outlines how this will take place. Community Engagement & Communications Strategy 3

4 SECTION 2: Introduction 2.1 Background and rationale This strategy is aspirational, ambitious and challenging and seeks to outline how NHS Worcestershire will work towards further developing its engagement and communications functions over the next three years. Involving local communities in the provision and development of health services in Worcestershire and building confidence in the NHS are two of the most significant challenges facing the organisation in the next few years. The Communications and Engagement functions are inextricably linked and this Strategy seeks to outline how work in both of these areas will result in a better informed, more satisfied and increasingly engaged local population. Vision what does world class look like? As a commissioner of all healthcare services for the people of Worcestershire, and a provider of some of those services, NHS Worcestershire is totally committed to working towards the creation of a service where all of the community are well informed, educated and satisfied with the treatment and care they receive, they understand the difficult decisions that have to be taken and where there is widespread confidence in the NHS and consideration of public needs and wishes in every decision that is taken. The changing financial environment, in particular the economic challenges presented by restrictions in future funding for the NHS, place further emphasis and importance on communications and engagement. Commissioning decisions have to be taken with full public confidence and participation, and the sharing of information and communicating consequences and service changes become absolutely crucial. A key objective in recent years has been to build public confidence in the local NHS in Worcestershire and maintaining this confidence when difficult decisions in relation to services are being taken is a key element of this strategy. Communications and sharing information are inextricably linked to performance and in particular the public perception of the services that are provided. Research from IPSOS/MORI that is well regarded and reliable identifies that there is a very clear correlation between public satisfaction with a public sector organisation and how clearly that organisation is able to explain its role and priorities. Understanding of these issues leads to better patient experiences and increased satisfaction and those must be considered to be the most significant performance measures available to the organisation. A commitment to effective and considered communications is therefore a major step towards in dealing with the challenges ahead. This is going to be particularly relevant for the organisation to achieve its aspirations to be a World Class Commissioner and in ensuring that the local health service in Worcestershire is truly patient-led. 4 Community Engagement & Communications Strategy

5 2.2 NHS Worcestershire leading the local health economy Worcestershire Primary Care Trust changed its name to NHS Worcestershire in June 2009 to ensure that this more accurately reflected its role as the leader of health services in the County and to promote more accountability for this with the public and stakeholders. Part of this role is to lead the local health agenda and engagement and communications are integral to doing that successfully. As the commissioner of all health services in the county NHS Worcestershire has a responsibility to provide appropriate information to ensure that the system is accessible and understandable to the local population and to ensure that services that are commissioned effectively and reflect the needs of local communities. 2.3 Communications and Engagement Key Functions In order to manage expectations and to be very clear about the aims of NHS Worcestershire with regard to communications and engagement it has been important to define the role that the team will fulfill. Key functions and priorities for the Communications and Engagement team are to: build communications and engagement into the commissioning process and ensure that all commissioned schemes have been developed considering patient and stakeholder feedback proactively work with partners inside and outside of the health economy to achieve joined up engagement, messages and campaigns provide professional communications and engagement advice to managers, clinicians and partner organisations work with the Executive Management Team to influence an organisational culture that involves patients and the public at all levels of decision making and facilitates a customer and marketing orientation assist the organisation to develop a real understanding of the local population and significant ideas and opinions amongst communities effectively manage NHS Worcestershire s reputation in the media develop processes, infrastructure and capacity to deliver effective communications and engagement define and establish protocols and guidance for the positioning and presentation of NHS Worcestershire s brand ensure that all communications are accessible and take into account the varying needs of different groups of the local population support the planning and delivery of campaigns and initiatives provide and promote a professional, empathic and efficient Patient Relations Service. NHS Worcestershire is a diverse and complex organisation with many partners involved at various levels in the commissioning and subsequent delivery of healthcare services to the people of Worcestershire. The Communications and Engagement team will be required to provide leadership of the function across the local health economy and to provide clear guidance to partner organisations, the Provider Services arm of the PCT, GP s, Pharmacists and other stakeholders. Research is very clear in concluding that the wider public have no comprehension of the distinction between these various tiers of service delivery and that the single NHS brand is in fact one of the service s greatest assets. This will be an integral theme of this Strategy and as a principle will guide much of the complementary work. Community Engagement & Communications Strategy 5

6 Communications and engagement considerations need to be a part of all operational management decisions and significant progress has been made in the last 12 months to effect a culture change that makes this common practice. Campaigns and engagement activity are developed based on demographic and epidemiological information as well as being managed strategically with a clear link to NHS Worcestershire Business Planning. It is also very important that the organisation proactively works with partners inside and outside of the health economy to ensure that activity is integrated with joined up messages where possible and incorporating existing and established communications and involvement channels. All communications campaigns and projects should be developed using a standard template that includes an assessment of risks, key messages and enables them to be measurable and evaluated against pre-determined objectives and targets. The principle of partnership is also very relevant to this Strategy. Within the local health economy regular meetings are held with communications leads from other Trusts and these relationships will be strengthened with more work being undertaken on joint campaigns and initiatives. NHS Worcestershire is also already committed to developing a Concordat for joint working with Worcestershire County Council on communications and engagement and this is expected to deliver several mutual benefits, not least of which is that work can be undertaken to assess how engagement activity can become more integrated and how messages can be joined up to make them easier to understand for the general public. 6 Community Engagement & Communications Strategy

7 SECTION 3: Situational Analysis Where are we now? 3.1 NHS Worcestershire Vision and Objectives NHS Worcestershire is responsible for improving health and health services in Worcestershire. It currently has an annual budget of over 800 million to commission healthcare services for the 557,000 people who live in the County. The main functions of NHS Worcestershire are to: Promote healthy lifestyles and improve the health of the population Reduce health inequalities Commission (buy and arrange) hospital, community, mental health and learning disability services. These services are commissioned from a range of NHS, private, independent and voluntary organisations both within and outside Worcestershire. NHS Worcestershire works closely with Worcestershire County Council and commissions jointly many of the services needed by people in Worcestershire Work with general practitioners (GPs) to develop primary care and to support GPs who wish to hold their patients share of the commissioning budget and exercise a more local influence on the commissioning of services for their patients. The 5 year Strategic Plan Investing in Health for Worcestershire articulates how NHS Worcestershire plans to further develop and improve health services and outcomes for people who live in the county. Included within the document are a vision and a set of values that guide the work of the organisation. Our Vision is of a county where people live longer and live better, have the support they need to adopt healthy lifestyles and have the choice of high quality services which are delivered as close to home as possible. Community Engagement & Communications Strategy 7

8 NHS Worcestershire adopted a set of core values that reflect the results of work with local stakeholders and uphold the national values of the NHS: Everyone Counts services which are based on needs assessments and arranged for the benefit of the whole community Commitment to Quality an organisation that is patient-focused and insists on high quality care and services Improving Lives valuing excellence and professionalism in the everyday things that will improve the health and well-being of the people of Worcestershire Working Together an environment where organisational boundaries and roles do not stand in the way of what is best for communities Respect valuing people as individuals and respecting their dignity. 8 Community Engagement & Communications Strategy

9 NHS Worcestershire has identified eight Strategic Priorities that are considered to be of particular importance to Worcestershire. Each of the priorities has a goal and a series of performance indicators that are outlined in more detail in the Strategic Plan: Strategic priority Goal 1. Staying Healthy To improve health and wellbeing overall, and close the gap between the health of the worst-off and best-off in Worcestershire. 2. Maternity Services To transform services to improve choice, quality of care and the range of services for women and infants to improve health outcomes. 3. Children and Young People 4. Adult Mental Health and Wellbeing 5. Long Term Conditions 6. Falls Prevention To improve the mental and physical health and healthcare of children and young people. To promote mental health and wellbeing through timely access to talking therapies, development of comprehensive demensia services and improvements to existing services. To improve the management, experience and outcomes of patients with long term conditions, focussing especially on patients with cardiac disease, cancer, chronic obstructive pulmonary disorder (COPD), diabetes and stroke. To reduce deaths and disibility related to falls, adding life to years, and reducing emergency admissions in older people. 7. End of Life Care 8. Planned Care To give people a choice of end of life care and improve the quality of care for adult patients with less than one year to live, including allowing more people to die in their own homes. To commission a range of clinically effective services which enable patients to receive the right care, in the right setting, at the right time with an emphasis on moving care closer to home. 3.2 Legislative Context There is a very clear legal responsibility for NHS Worcestershire to involve and engage users and the public and the Health and Social Care Act 2008 has reinforced the organisation s duty to involve. Section 242 of the Act is very explicit in that it places a duty to consult with the public and involve them in decisions on: The planning and provision of services The development and consideration of proposals for changes in the way those services are provided. The Department of Health has also strengthened this by reiterating the need for patients and the public to be involved in ongoing service planning and decisions about general service delivery, not just major changes. The guidance they now give is that NHS bodies should be in continual dialogue with patients and the public, and should seek to involve them in discussion of all significant future plans. Community Engagement & Communications Strategy 9

10 The High Quality for All work and the NHS Constitution merely re-emphasise these responsibilities and give them further profile and endorsement. As a statutory organisation, NHS Worcestershire may also be obliged to undertake a consultation as part of the due process prior to NHS organisational change or any major reforms of service provision. In this context the responsibility is to ensure that stakeholders are fully briefed about any proposed changes and options available and ensuring that all views are reported, collated and fed back appropriately. Decisions taken without due consultation and involvement are open to legal challenge and potential judicial review so this formal consultation activity needs to be undertaken robustly. This Strategy separately outlines how an Engagement and Involvement Framework ensures that the more informal involvement and consultation activity is effectively undertaken and monitored. 3.3 Key issues facing NHS Worcestershire - World Class Commissioning The World Class Commissioning programme is designed to raise standards and ambitions amongst Primary Care Trusts and to put excellence, quality and assurance at the heart of the commissioning role fulfilled by these organisations in delivering their health agendas. The programme is also clear about the role that effective communication can play in understanding, informing, engaging and leading the organisation. Communications needs to support the work that will be undertaken to improve the health outcomes that are chosen by the PCT and to facilitate clear understanding amongst the community of their local services and the opportunities that exist for them to be involved in shaping service delivery. World Class Commissioning has been one of the drivers of the clear mandate and support that now exists within NHS Worcestershire for a professional, strategic and intelligence-based approach to communications. The communications and engagement function has been the subject of significant investment during the last 18 months and is in a position to make a substantial contribution across the commissioning functions. NHS Worcestershire s scores for the first round of the World Class Commissioning process were acceptable, placing the organisation in an average position amongst PCTs across the country. Years 2 and 3 of the assurance system offer an opportunity to really improve on this and targets have been developed that outline an ambitious trajectory of progress across the competencies over this period. Communications and engagement has an influence across all of these, with particular obvious links to Competencies 1 and Communications and Engagement Activity NHS Worcestershire s communications and engagement function has been the subject of significant investment during the last 18 months, both in additional posts and extra resources to enable increased activity. This investment is indicative of an organisation-wide commitment to improved communications and sharing of information, and to involving patients, communities and stakeholders more in commissioning healthcare services. The first draft of this Community Engagement and Communications Strategy, agreed and adopted in September 2008, outlined the initial steps that would be taken and key areas of activity to focus 10 Community Engagement & Communications Strategy

11 on. The period since then has seen significant progress being made across all of the six main areas of work and a noticeable higher profile for the function. Some particular areas of progress during 2009 to highlight include: Implementation of the Engagement and Involvement Framework, in particular the formation of a Patients Panel, a Health Insight Panel and formal agreement to work with partners on the Worcestershire Viewpoint, a joint Citizens Panel with local authorities, the Police and Fire Services comprising of 6,000 local residents Development of new internet and intranet sites for the Trust Combining the previous PALS and Complaints functions into a new Patient Relations team, formally feeding in trends, issues raised and lessons learnt to contract monitoring arrangements with providers Investment in new internal communication channels including an e-newsletter and a formal team briefing process Development of formal internal media monitoring systems and sharing information across the organisation and with the Trust Board Agreement on a shared Social Marketing post with Public Health to lead on campaign development and behaviour change Planning and implementation of a joint capacity management campaign for winter pressures Media responses and stakeholder communications during the first wave of the Swine Flu pandemic Supporting the development of the Local Involvement Network (LINK) including joint events and initiatives Agreement of an NHS Worcestershire Brand Book that includes templates and specific advice on presentation of documents and material Improved communications with stakeholders with the development of a bi-monthly Stakeholder Brief summarising key decisions and performance issues Put an outreach programme in place to ensure the needs of seldom heard groups are reflected in commissioning Developed communications channels such as a monthly patient and public involvement newsletter outlining volunteering opportunities Implementation of a new volunteering induction process Setup an in-house design function and developed relationships with key suppliers Produced a Wellbeing magazine and guide to health services circulated to all Worcestershire households Agreed a workforce development programme to raise awareness of patient involvement Ran a series of seminars across the county to promote equalities and diversity Refreshed terms of reference and membership of the PPI Sub Committee Promoted The Compact and good relationships with the voluntary sector Developed a Single Equalities Scheme that includes a section on communications and engagement Involved public and patients in the development of several high profile care planning pathways. Community Engagement & Communications Strategy 11

12 SECTION 4: Community Engagement and Communications Objectives Where do we want to get to? The objectives of this Strategy can be summarized within six main areas of work: Engagement and Involvement Ensure patient and public involvement into decision making Internal Communications Engaging and leading the PCT workforce Capacity Building Building communication capability and capacity Campaign Management and Social marketing Promoting key health messages and priorities Brand Management and Reputation Development Enhancing the reputation of NHS Worcestershire and the NHS Promoting Equality, Diversity and Accessibility Supporting improved access to services Figure 1 - summary of Community Engagement and Communications work areas 4.1 Engagement and Involvement To maintain an engagement and involvement framework that ensures all local citizens have the opportunity to contribute to decision making and maximises opportunities to build local ownership of health services There are huge benefits to be gained for the organisation from public and patient participation in decision making and also by ensuring services are shaped by community needs and are socially inclusive. NHS Worcestershire through the commissioning process is responsible for investing public funds on behalf of the people of Worcestershire and we need to ensure that services reflect the needs, priorities and aspirations of local people. The community needs to be at the heart of the development, planning, commissioning decisions, and directly provided services, and communications plays a major part in this. 12 Community Engagement & Communications Strategy

13 Creating and sustaining an organisational culture that enables us to listen and respond to people s experiences and opinions is crucial to future success. The more that patients feel informed and have the opportunity to be involved, the more positive impact that this can have on their patient experience and on their satisfaction with their health service. Good ideas often come from patients and the public Workable solutions are much more likely to result from involving patients and public Communicating effectively ensures involvement is undertaken from an informed perspective Culture change is necessary is some areas to facilitate meaningful involvement. NHS Worcestershire wants to work with local people to engage them in developing and improving health services and ensuring that the services we currently commission and deliver are done so effectively. The organisation is committed to proactively seeking the views of the public, patients, their carers and other stakeholders and to consult widely across all levels of decision making. It is important that patients and the public also understand how their views will be used, which decisions they will be involved in, when and how decisions will be made. Good communications is quite obviously an integral part of this process. NHS Worcestershire has made considerable progress in this area in the last 12 months but there is still significant room for further improvement and development. An Engagement and Involvement Framework has bow been embedded within the organisation and is providing a structure and process for consultation and involvement work across commissioning. Engagement and Involvement Framework Key principles of the framework include: Collaborative working with partners to ensure good practice is shared, duplication avoided and that we make the most of our resources; The need to identify processes systems and infrastructure that are convenient and suit the community s capacity to get involved; The need for involvement to be on an informed basis, with participants in possession of the full facts and background information; Opportunities to get involved will be flexible and will allow participation at varying levels, from armchair to formal attendance at regular meetings. There is a recognition that not everyone wants to have a view or an opinion on every issue and that the important aspect is that there should be opportunity for the local population to get involved if and when they want to do so. The Framework itself outlines various levels of influence and how the different aspects of engaging with the public should relate to each other. Strategy and Policy Strategy and Policy is defined by the Trust Board and specifically the PPI Sub Committee of the Board that is delegated to lead on this work. That group retains an overview and is the steering group that Community Engagement & Communications Strategy 13

14 ensures that engagement activity is appropriate and integrated. During 2009 the terms of reference and the membership of the Committee were refreshed, This committee also assists in giving engagement a profile at Board level and is able to contribute to the culture change necessary across the organisation that is ensuring that involvement of the public is a given across all levels of decision making. Ideas and Opinions A key element of the framework is a recognition that there are lots of groups already in existence that are generating ideas and opinions about health services and these need to be considered. Engaging and involving the public should not just be on the NHS Worcestershire s terms and there needs to be a flexibility to allow for this kind of feedback to also influence decisions. The PPI Sub Committee have an important role in ensuring that this is taken into account, selecting appropriate feedback and ideas and opinions that have merged to give to commissioners and the Trust Board. A constructive relationship with the Local Involvement Network (LINK) is an integral part of this. NHS Worcestershire has fully supported the new arrangements and continues to actively seek to have a constructive and positive relationship with Worcestershire LINK. This is very much a two way relationship, with NHS Worcestershire co-operating fully with projects that LINK decide to pursue but also inviting the LINK to lead on involvement and seeking resident s views on issues likely to affect commissioning where it is appropriate. Alongside the LINK Worcestershire is fortunate to have a broad range of other mechanisms in place for the local population to make their views known. These mechanisms often allow a specialised or very focused input from a particular geographic location, age group; socio-economic group or ethnic background and this can be very relevant to certain issues. Neighbourhood Forums, Young People s Groups, the Voluntary and Community Sector and other forums that are set up to represent the views of minority groups are all very relevant to this point. The LINk itself is developing good relationships with these groups but the framework allows for separate consultation where and when appropriate. When setting the local health agenda it is also very important to consider the views of diseasespecific user groups and the Care Pathways work is particularly relevant to this. NHS Worcestershire also has established a new Patient Relations Service that combines the previous Complaints and PALS functions. This is an important mechanism for identifying issues and learning as well as opportunities to understand the patient s perspective. Real time patient feedback is also an evolving area that provides a very tangible guide to public and patient opinion, as will reviews on websites such as NHS Choices. NHS Worcestershire is also externally focused in terms of a presence at events that facilitate opportunities for the public to feedback about their local health services. The Engagement and Involvement Framework encourages the development of an annual programme that ensures this activity is co-ordinated and focused. Local community profiles are used to identify communities that experience the worst health outcomes and communications and engagement around raising health aspirations is an important component of delivering improved outcomes. NHS Worcestershire also commissions specific research that is related to a particular issue where the organisation needs to be certain of public opinion. The framework allows for participation at varying levels and degrees but does recognise that not every Worcestershire resident will want to get involved. Engaging with these harder-to-reach groups may well be necessary in some circumstances 14 Community Engagement & Communications Strategy

15 and this may need to be additional to the other general work underway. It is also relevant to mention one-off specific consultations based around service changes. There will always be a need to undertake these exercises and the challenge is to make sure these are underpinned by the more prominent ongoing activity. Finally within the ideas and opinions section the framework recognises that there are often arrangements in place locally, maybe based around GP Practices or Clusters. The framework incorporates the fact that those groups will often have ideas and opinions that need to be considered, both on a local level and a more strategic level. Activities The third tier of the Framework relates to day to day engagement and involvement activities whereby patients and the public s views are being proactively sought and fed into decision making at a variety of levels in the organisation. There are basically three elements of this, the most prominent being a Patients Panel that is one of the means of allocating volunteering and involvement opportunities (such as participation in particular projects, procurement exercises, attendance at meetings, quality inspections, representation of patients views on panels etc). The participants involved in the Patients Panel are positioned as PPI advocates and champions in Worcestershire and generally are in a position to give more time to being involved and do so from an informed basis. The Panel meets quarterly and includes an opportunity to feedback their experiences and the specifics of their input to fellow volunteers. A formal induction process and an opportunity for new volunteers to be mentored by other more experienced patient representatives supports the activity and a regular bi-monthly newsletter outlines new involvement opportunities and relevant feedback. Another element is a Health Insight Panel, which is a database of people who are willing to be consulted on health issues. Participants indicate their desired level of involvement, how often they want to be contacted, their particular areas of interest and the mechanism that they would prefer to use ( , post etc). The aim from NHS Worcestershire s perspective is to use the 500 people on the database as an external challenge mechanism, testing out potential approaches and getting valuable patient input into exercises like care pathway design and prioritisation of services. Participants are invited to attend issue based workshops, relating to the areas of healthcare that they have indicated an interest in, and receive questionnaires on relatively detailed health issues. The eventual aim is to ensure that the Health Insight Panel is demographically representative of the Worcestershire population and some targeted recruitment is planned to move towards this. Community Engagement & Communications Strategy 15

16 The third element of the Activities tier of the Framework is the Worcestershire Viewpoint. This is a joint resident s panel of 6,000 Worcestershire people and is a partnership initiative involving the County and District Councils, and the local Police and Fire Services. Worcestershire Viewpoint participants are geographically representative across the County, with an equal number in each of the six District Council areas. Participants are sent two questionnaires a year, although the agencies involved have the opportunity to add to this if there are significant strategic issues that require some county wide input. From a health perspective the main initial use of the Viewpoint is to monitor public opinion and satisfaction with health services, although additional questioning around prioritisation of services is also planned for the coming months. Worcestershire Viewpoint Number of participants Health Insight Panel Patients Panel Required level of background knowledge and information Figure 2 - Activities tier of the Framework Pictured: Patients Panel participants 16 Community Engagement & Communications Strategy

17 Engagement and Involvement Framework Worcestershire PCT Board PPI Sub Committee Strategic Steering Group for all engagement activity Responsible for policy development and feeding progress back to Trust Board and for identifying further opportunities to work in partnership. Activities Ideas and Opinions Strategy and Policy PPGs and PBC Cluster Groups Opportunities for two way dialogue with these groups, both listening and considering their feedback but also asking questions. Commissioned Research A regular programme of commissioned survey and research work on specific issues and general topics. Existing Mechanisms Proactive use of existing mechanisms for engaging with the public, eg. neighbourhood forums, outreach work and events, young peoples groups etc. Patient and Service User Satisfaction Proactively monitor patient and service user satisfaction levels. LINK Effective relationship with LINK, considering issues they raise and commissioning work where appropriate. Patients Panel Group of interested volunteers who are able to participate on an informed basis. Contirbute to day to day NHS activity, inspections, visits, meetings, tender evaluations, reviewing policies. PPI Champions and advocates, role in induction of other volunteers. Health Insight Panel Database of people registering particular interest in health issues. Opportunity to perticipate and be involved by atttending focus groups, completing questionnaires etc. Categorised by interest groups eg.stroke, long term conditions, diabetes etc as well as giving opinions in general NHS services. Worcestershire Viewpoint Panel of 6,000 Worcestershire residents Joint initiative with County and District Councils, Fire and Police. Regular questionnaires reviewing trends, opinions, perceptions and satisfaction needs. Community Engagement & Communications Strategy 17

18 4.2 Brand Management and Reputation Development To develop a clear brand and a set of values that are continually positively associated with the organisation through everything that we do and enhance the reputation of the organisation The ability of the organisation to present a consistent message that is communicated through all contact that we have with our patients, public, customers and stakeholders is crucial to managing NHS Worcestershire s reputation and achieving a strong brand identity. Branding is about an organisation defining how it wants to be perceived and this is generally achieved by identifying some key messages that are then continually reinforced through all communications. It is important to note that this does not merely refer to publications and the use of logo but will also need to incorporate elements such as our website, appearance of buildings, signage and uniforms and the key messages and themes that we communicate via the media. The challenge for the Communications team is to be in a position where they are able to influence every contact between the organisation and stakeholders. The brand values become key messages that need to be incorporated into all communication. The NHS brand is one of the service s key strengths and the challenge is to translate that advantage to a local level. Research suggests that the wider public has little comprehension about the difference between the roles of the various Trusts so the name change in June 2009 which allowed the PCT to become NHS Worcestershire was a significant step forward. The reputation of NHS Worcestershire and the way in which the organisation is portrayed in the media has to be very relevant to any Communications Strategy. Dealings with the local media are currently reasonably effective but there is certainly scope for further development of this relationship. Much of the development work in this area again needs to be undertaken in partnership, specifically in this instance with other health economy partners. The regional SHA have a major stake in this and provide significant support in terms of media monitoring and evaluation, as well as being the point of contact for national activity by the Department of Health. It is clear that to enhance the reputation of the NHS in Worcestershire we will need support from service providers at all levels. 18 Community Engagement & Communications Strategy

19 Familiarity Ipsos/MORI research also demonstrates that the more familiar and well-known NHS Trusts are within their local community the more satisfied the public are with their local health service Favourable Figure 4 - Public Satisfaction and Awareness of NHS Trusts (source Ipsos/MORI) This does suggest that managing reputation effectively can therefore quite obviously make a significant contribution to higher public satisfaction scores. An important element of this work is to understand the organisation s reputation and what are the drivers behind that. NHS Worcestershire has programmed research activity that will review user s expectations of services and subsequent satisfaction as these factors clearly will have a major impact on reputation. Information resulting from this research will then be used to develop an action plan that addresses issues raised. Expectation Reputation Satisfaction Figure 5 - Influences on reputation Community Engagement & Communications Strategy 19

20 Managing knowledge is also crucial to influencing reputation. The organisation needs to ensure that comments, compliments, complaints and PALS issues are effectively responded to and more importantly that information relating to these issues is fed into service planning. The former PALS and Complaints functions have been combined into a Patient Relations Service that is actively promoted and is proactive in seeking out patient and service user views and then feeding these into the performance monitoring and commissioning process. Every issue that arises is an opportunity to improve services and public perception so we should ensure that appropriate learning is actioned. It is also particularly important to ensure effective scanning of websites such as NHS Choices where patients can leave their own feedback on services. This scanning is undertaken regularly and the organisation seeks to ensure that where appropriate responses are posted and followed up. This is also a significant and effective means of protecting and enhancing reputation. NHS Worcestershire uses monthly Clinical Quality Review meetings with our main providers to monitor standards and quality issues, in particular patient experience that includes a variety of performance measures. 4.3 Internal Communication To ensure that all of our staff and stakeholders have the information that they need to do their job effectively and to clearly understand NHS Worcestershire s business It is very clear that the role of employees and partners as brand ambassadors and advocates for the service is integral to any communication strategy. The NHS employs 1.3 million people nationally and NHS Worcestershire and Worcestershire Primary Care Trust employ over 2,800 directly in the county. Research suggests that one in four people get their information about the NHS from someone who works there. Recent Ipsos/MORI research also demonstrates that the opinion of staff, particularly if it is a negative opinion of the NHS, is in fact the third most relevant factor influencing an individual s satisfaction with the NHS. This is the opportunity from a communications perspective to ensure that motivated, well informed staff that understand the organisation s objectives, challenges and vision are likely to give a positive message and be strong advocates of the NHS locally in their communities. Relationships, communications channels and the flow of information to Providers, GP s, Pharmacists, Dentists and other partners are absolutely integral to this element of the Strategy. The development of the Life Channel in GP surgeries and public buildings is a good example of where the organisation has been able to proactively influence this audience. 20 Community Engagement & Communications Strategy

21 Greatest drivers of overall satisfaction Most Political allegiance Age: year olds are most negative Staff opinion Least Experiences of A&E services Media coverage Gender - Women are most negative Positive experiences of inpatient services Figure 6 - Influencing factors on satisfaction with health services (source Ipsos/MORI) 4.4 Building Capacity To get the most out of the resources that we have and to ensure that we have sufficient capacity to deliver effective communications NHS Worcestershire is the latest manifestation of the local organisation charged with responsibility for local health care but there is clearly an expectation that it carries out its work in a very different way. Significant additional resources have been invested during the last 18 months into increasing capacity to be a more effective leader of the local health economy and communications and engagement is one of the areas that has benefited from this investment. The challenge now exists for the organisation to further build on this initial investment with further development of processes and infrastructure, and in financial terms to ensure that sufficient capacity exists to effectively deliver these objectives. The investment in the workforce development programme for increasing awareness of the role of public and patient involvement is a good example of this. From an engagement and public involvement point of view there are several elements to the need to build capacity, both from an internal and external perspective. Externally to the organisation there is a need to increase the number and quality of volunteers and people willing to provide input and an opinion about their local health service. Key workstreams to address this include a new induction programme for volunteers, increased support, proactive recruitment of new Community Engagement & Communications Strategy 21

22 volunteers and a buddying scheme whereby experienced volunteers offer support and advice to newer recruits. Internally there are two main aspects to increasing capacity, firstly to raise awareness amongst staff as to the value of effective patient involvement and secondly to use that awareness to increase opportunities. The main work programme seeking to influence this is the PPI Workforce Development initiative that is being ran in conjunction with NHS Herefordshire and aims to increase the profile of PPI across healthcare staff. An integral element of building capacity will be the organisation s ability to work in partnership with other health and public sector organisations. NHS Worcestershire will actively seek to develop partnerships with other organisations in order to share resources and other communications channels that are already well established. This is particularly relevant where the target audience of Worcestershire residents is concerned, and joint activity with the Acute and Mental Health Trusts, the Local Strategic Partnership and Worcestershire County Council will form a significant component of the development of communications capacity moving forward. The key challenge for work in this area is to ensure that communications and engagement are effectively integrated into the commissioning process. Reviewing service provisions Deciding priorities Designing priorities needs Assessing Strategic Planning Seeking public and patient views Patients/ Public Monitoring and Evaluation Procuring Services Shaping structure of supply Planning capacity and managing demand Managing performance Supporting patient choice Figure 7 - WCC Commissioning process 22 Community Engagement & Communications Strategy

23 NHS Worcestershire has adopted its own local version of this and developed a Worcestershire Commissioning Cycle. Manage the local health system COMPETENCY 4 Manage knowledge and assess needs COMPETENCY 5 Prioritise investment COMPETENCY 6 Secure procurement skills COMPETENCY 9 Stimulate market COMPETENCY 7 Promote improvement and innovation COMPETENCY 8 Service redesign; work with community partners; engage with public and patients; collaborate with clinicians COMPETENCIES 1, 2, 3 AND 4 Figure 8 - Worcestershire Commissioning Cycle This diagram outlines how the commissioning process works throughout the organisation and in particular highlights the importance of communications and engagement, both in the overall leadership and strategy development but also crucially in the community engagement related to competency 3 and engaging with clinicians and health leaders to appropriately inform strategy. The communications input to this work is on several levels, not least of which developing channels and information flows that create opportunities for comment and input. Building capacity in these areas is critical and communications has a vital role to play. 4.5 Campaign Management and Social Marketing To use social marketing to its full potential and to manage campaigns effectively so that messages are clear, concise, equitable and integrated More efficient central co-ordination of campaigns and messages is an opportunity for NHS Worcestershire to get better value out of its investment, particularly in social marketing and health promotion work. During the last few months a vacant post has been amended to create a new Social Marketing Officer role that jointly reports into the Communications and Public Health teams. This new resource is already proving to be a valuable addition and is assisting with the strategic development of campaigns, and in making sure that social marketing techniques are used to their full potential. Community Engagement & Communications Strategy 23

24 NHS Worcestershire has been able to make good progress in this area, with several high profile campaigns around increasing access to NHS Dentistry, GP Extended hours, Choose and Book and capacity and demand management relating to winter pressures all meeting their initial targets and objectives and making a tangible impact. Smile! There are NHS dental places available in Worcestershire for the whole family To find out where, call NHS Worcestershire Dental Helpline on or findadentist@worcestershire.nhs.uk NHS Worcestershire Dental Helpline, NHS Worcestershire, Wildwood, Wildwood Drive, Worcester, WR5 2LG Choose the right treatment at the right time Serious or life-threatening conditions. Go to Accident and Emergency (A&E) at the Worcestershire Royal Hospital in Worcester or the Alexandra Hospital in Redditch or telephone 999 Cuts. Sprains. Head to a Minor Injuries Unit in Bromsgrove: Evesham: Kidderminster: Malvern: or Tenbury: Ear pain. Stomach bugs. Back ache. See your GP or visit the Worcester Walk-in Health Centre ( ). If your GP surgery is closed, telephone the out of hours service on Toothache. Gum problems. Visit your dentist or a Dental Access Centre. To find your nearest NHS dentist getmeadentist@worcestershire.nhs.uk or telephone Diarrhoea. Runny nose. Painful cough. Go to a pharmacy. For a list of pharmacies and opening times take a look at Your right to choose If you need to go to hospital to see a specialist, you have the right to choose which hospital you re referred to by your GP. This legal right, which was introduced in April 2009, lets you choose from any hospital offering suitable treatment that meets NHS standards and costs. If you re not offered a choice of hospital, talk to your GP first. If you re still not given a choice, contact your Primary Care Trust s Patient Advice and Liaison Service (PALS). Whatever your reason, it s your right to choose. Flu symptoms. Call the National Pandemic Flu Service (NPFS) on or visit their website at FLU Unwell? Unsure? Confused? Need help? For confidential health advice and information contact NHS Direct on or visit Hangover. Grazed knee. Sore throat. Cough. Take care of yourself. For tips on keeping warm and healthy in winter visit Pick up a leaflet or visit our website for further information. Unwell? Choose well. A central database and calendar of campaigns planned throughout the year has also been developed to remove any un-necessary duplication and maximise these efficiency benefits. Opportunities also exist to centralise procurement of print and other promotional material to realise benefits in terms of value-for-money as well as ensuring correct application of branding and that evaluation is properly considered. A Design and Multimedia Officer is an in-house design resource and leads on maximising value from print and external design procurement where appropriate. Self care is also an important principle for the NHS and communications and engagement activity plays a key role in promoting this. This promotion takes a number of forms, in particular making sure appropriate information is available and accessible and in making sure community and patient groups are fully aware of the potential for self care where it is appropriate. In practice this has included initiatives such as the development of a Your Health, Your Way patient prospectus and directory of services and campaigns such as the Books on Prescription service for mental health service users. 24 Community Engagement & Communications Strategy

25 4.6 Promoting Equality, Diversity and Accessibility To use communications and engagement to support increased access to services Effectively communicating and engaging with the whole of the local population is an important part of this strategy. There is a real need to recognise that different people have different needs in this respect, both in terms of how they receive information and communications from NHS Worcestershire and how they need and want to be involved in decision making about their local health services. NHS Worcestershire has developed an Accessible Communications Policy that includes details of minimum standards that will be met in terms of accessibility of communications material and patient information. This policy covers the framework agreement with Applied Language Solutions to provide translations and a commitment to provide information in suitable formats for those with disabilities. A third party has been engaged to undertake a disability accessibility audit across the organisation and an action plan to address some of the gaps and improvements required is now being implemented. Community Engagement is a cornerstone for equalities and all public organisations are obliged to ensure effective inclusion towards improving the health and social wellbeing of the communities it serves. It is important not to see this process simply as a tick-box exercise solely for the benefit of the organisation. Involvement of local residents and all communities is core to shaping provision around the expressed needs of service users and their advocates. There have been joint inaugural community engagement seminars delivered by NHS Worcestershire, Worcestershire Acute Hospitals NHS Trust (WAHT), and the Mental Health Partnership NHS Trust. This process results from the work of the Single Health Equalities Partnership (SHEP) Group to jointly improve the health, wellbeing, social care and provision of high quality facilities & services for the residents of Worcestershire and beyond and with specific reference to Equality & Diversity. The purpose of the seminars is to demonstrate to local residents, minority communities and voluntary agencies the NHS Trusts commitment to ongoing and broad based consultation. As a direct aim of the SHEP and legal obligation of all NHS Trusts, this ongoing process of engagement with local and minority communities and voluntary agencies to work with NHS Trusts in partnership to improve health & social care provision, with specific attention to reducing inequalities in line with current legislation. Engaging with seldom heard groups is also a key theme of work in this area. Significant time has been allocated to identifying ways in which seldom heard groups can become more represented through the patient involvement process and outreach work to these groups has already started to prove advantageous. One recent effective example is the close working with Worcestershire Association for the Blind who have nominated a representative to attend meetings of the Ophthalmology Commissioning Group, giving a direct opportunity for those patients to have a direct impact on service commissioning in that area. Community Engagement & Communications Strategy 25

26 Worcestershire Profile It is important from a communications and engagement perspective to understand the local population. In general, the population of Worcestershire is growing and getting older. Census estimates predict that there will be a net growth from 552,000 in 2006 to 558,000 in The population is largely White British (94%, reducing to 93% by 2011) although there are areas with a higher concentration of ethnic minority groups. There is a net inward migration of 11.6 migrant workers per 1,000 working age population annually from the A8 Accession Countries most commonly from Poland. Ethnic Group Population % of total White British 516, White Irish 4, Other White 8, White & Black Caribbean 2, White & Black African White & Asian 1, Other Mixed 1, Indian 3, Pakistani 4, Bangladeshi 1, Other Asian Black Caribbean 1, Black African Other Black Chinese 1, Other Ethnic Group 1, All Ethnic Groups 5 48, Figure 9 - Proportion of Total Population made by specific ethnic groups, mid Community Engagement & Communications Strategy

27 The 2001 Census shows that the number of people with a limiting long-term illness was 90,433, this is about 16.7% of the population, (this includes any longer term illness, health problem or disability which limits daily activity or work). The Statistics for limiting long term illness by District is as follows:- District Numbers Bromsgrove 14,683 Malvern Hills 13,028 Redditch 12,432 Worcester 14,808 Wychavon 18,136 Wyre Forest 17,346 Figure 10 people with limiting long term illness by District Health inequalities in Worcestershire There are four main groups in Worcestershire who experience health inequalities i.e. their health status is poorer than the County as a whole: Disadvantaged communities. As identified on a geographic basis in the areas of highest need that are described in more detail in NHS Worcestershire s Strategic Plan. This is largely due to low incomes and unhealthy behaviours Black and ethnic minorities. People from black and ethnic minority communities suffer from specific diseases (for example sickle cell disease in Africans; high rates of coronary heart disease in South Asians). In addition they tend to have lower income than the White population, and may have difficulty accessing services due to language or cultural barriers Migrant workers. Although they are often young and healthy, migrant workers may experience difficulties due to language barriers and lack of familiarity with local systems. For example they often have high rates of industrial accidents and low rates of registration with a general practitioner People with mental health problems and learning disabilities. Whilst it is important to provide for their specific condition, it is important not to forget that these people have the same physical health needs as the rest of the population, that are often unmet. For example people with mental health problems have high rates of smoking and people with learning disabilities and diabetes are often poorly managed. Communications and engagement activity needs to take these inequalities into account and action plans need to consider how progress in these areas can be made. An important element of this will be the organisation s ability to develop links with these communities which, in reality, can only be achieved by effective outreach work through communications and engagement. Community Engagement & Communications Strategy 27

28 SECTION 5: Target audience and stakeholder map High Keep Satisfied - Work together where common ground exists Key Player and Partner - need to find common ground MP s Local Councillors County Council District Councils Local Area Agreement partners Media NHS and health economy pertners GP s, Dentists and Pharmacists Local communities in Worcestershire Patients Strategic Health Authority and Dept of Health NHS Worcestershire staff Keep Informed - Information Discussed - NHS Worcestershire needs to listen and respond Wider public Service User groups Health Overview and Scrutiny Committee Voluntary and Community Sector LINK Local pressure groups Power and Influence Low Low Interest High 28 Community Engagement & Communications Strategy

29 SECTION 6: Evaluation As outlined in the background and rationale to this Strategy the ultimate measure and evaluation tool should be public satisfaction with their local health services. A number of the proposed engagement and involvement mechanisms will consider this issue and proactively gather information that can be fed back into planning processes and into the reviews of this Strategy. The forthcoming Place Survey undertaken by Local Authority partners will also incorporate questioning around the specific issue of public satisfaction with the public services in their area. An ongoing important principle for all communications work is that it should be measurable and evaluation criteria will be considered at the planning stage for all activity. On an ongoing basis there is also a need to ensure that selected common questions are incorporated into engagement and research activity so that improvement over time can be measured. Evaluation Principles We will: Agree evaluation methodology at the outset of every communications plan or engagement activity; Act on the results of research work that we commission; Use patient experience data and real evidence of the quality of services to drive commissioning; Include feedback mechanisms in all of our communications and engagement activity; Actively monitor media coverage and how it reflects on the reputation of NHS Worcestershire. NHS West Midlands IPSOS/Mori Survey The local SHA commissioned a telephone survey that was undertaken across the region in April and May 2008 and repeated in This survey looked at attitudes and awareness of the NHS and in provided analysis at a PCT level illustrating how perceptions and attitudes differed across the region. This survey is due to be repeated on an annual basis and it is useful to use as a benchmark when looking at the implementation of the Strategy. Community Engagement & Communications Strategy 29

30 Through the partnership work with local authorities and Police and Fire Services, and the creation of the joint citizen s panel Worcestershire Viewpoint, 6 monthly surveys are being undertaken using the 6,000 members of the panel. The general satisfaction question relating to prospects for improvement will be incorporated into every survey, along with several others around service satisfaction and priorities for investment so that these can be tracked over time. In terms of establishing targets progress towards the following milestones will be one of the useful measures of success for the Strategy: Measure National West Mids Worcs Worcs Target average PCTs score score average Percentage of people 28% 33% 28% 31% 35% who think that the local NHS will get better Percentage of people 61% 61% 59% 73% 75% in Worcestershire satisfied with their NHS Percentage of people 65% 70% 67% 79% 85% in Worcestershire who agree that their local NHS is providing them with a good service There are also several assessment tools that the organisation is required to participate in and that give some indication and feedback, particularly in relation to the organisation s capacity and progress in involving local communities: World Class Commissioning Assurance Framework Auditors Local Evaluation (ALE) Care Quality Commission Standards for Better Health. Progress in each of these assessments can be used as a benchmarking tool to demonstrate progress over the period of this Strategy. Community Engagement Evaluation It is difficult to set objective measures of success that evaluate specific community engagement activity. Lots of feedback is qualitative and the most important thing is that it is considered and fed into the commissioning cycle. The countywide place Survey includes questions on how involved people generally feel in their local community and NHS Worcestershire s future programme of commissioned research will include exploring the health specific aspects of this in more detail. 30 Community Engagement & Communications Strategy

31 Campaigns An over-riding principle of all communications campaigns is to incorporate metrics so that progress can be measured and a return on investment quantified. This has proven particularly useful in the last 12 months, with campaigns in particular relating to NHS Dentistry and Choose and Book being judged to be successful. NHS Dentistry in Worcestershire campaign Promotion of a telephone hotline for residents to ring and get details of NHS Dentistry places available in their area. Calls to the hotline from people who went on to register with an NHS Dentist increased from 723 (Feb May 08) to 1462 (Feb May 09) after the campaign, an increase of 102%. Choose and Book Campaign to raise patients awareness of their right to choice and to encourage them to discuss this with their GP at the time of referral contributed to an overall increase from 20-50% of patients using the choose and book system. We have published two editions of our Wellbeing - Guide to Health Services that is distributed annually to every household in the county. The 2008 edition was cited as best practice nationally by the Department of Health self care leads. Community Engagement & Communications Strategy 31

32 SECTION 7: Resources Staffing The following staff are directly employed within NHS Worcestershire s Communications and Community Engagement team: Budget and financial resources A central budget exists to incorporate the activities of the Communications and Engagement team. This is designed to include sufficient ongoing financial resources to fund recurring engagement, involvement and communications work at a corporate level. In addition to this campaign based expenditure is provided by the relevant service area. 32 Community Engagement & Communications Strategy

33 Appendix One Community Engagement and Communications Strategy Implementation Plan 2010 Community Engagement and Communications Objective Engagement and Involvement Action Increase the number of people registered on the Health Insight Panel to 400 target seldom heard groups to ensure appropriate representation engage with and develop comprehensive database of seldom heard groups to act as consultative groups review the demographic make up of the panel to ensure countywide coverage and participation Agree programme of commissioned research Agree a calendar of community engagement activity/events Facilitate effective stakeholder input into development of a cancer and dementia strategies Agree programme of engagement with young people in a range of settings including schools, community settings and voluntary sector settings regarding health issues relating to young people Further develop internet and position www. worcestershire.nhs.uk as the primary resource for healthcare information in Worcestershire Timescale September 2010 April 2010 April 2010 April 2010 September 2010 September 2010 World Class Commissioning Priority Area All 8 All 8 All 8 Long Term Conditions Staying Healthy Children and Young People Staying Healthy Community Engagement & Communications Strategy 33

34 Community Engagement and Communications Objective nternal Communications Building Capacity Campaigns and Social Marketing Action Develop a strategy to ensure that feedback from consultation and engagement activity is readily available to staff, patients, public and key stakeholders. Introduce team briefing process to commissioning arm of the organisation Further develop the intranet (in particular information regarding who s who and contact details) and continue to promote to increase number of hits Facilitate the Life Channel being added to office locations Development of intranet in the sharing of good practice of PPI activity and the impact of PPI. Implement the pilot workforce development programme for PPI and establish a sustainable training programme. Develop a communications plan to promote the Patient Relations Service Develop a communications plan to respond to the findings from the NHS Dentistry Dr Foster social marketing research Develop a calendar of national events (ie, Timescale July 2010 January 2010 April 2010 April 2010 July 2010 July 2010 January 2010 January 2010 November 2009 World Class Commissioning Priority Area All 8 All 8 All 8 Staying Healthy All 8 All 8 All 8 All 8 Staying Healthy All 8 34 Community Engagement & Communications Strategy

35 Community Engagement and Communications Objective Brand and Reputation Management Action Alcohol Awareness Week) to enable a coordinated approach to campaign planning Build links with external organisations in the community (ie, supermarkets) with a view to maximising reach of social marketing campaigns Produce a calendar of key national announcements (ie, CQC ratings) to facilitate proactive approach to PR Further develop NHS Worcestershire brand guidelines Develop communications plan to position and establish NHS Worcestershire as the local leader of the NHS Develop and promote media resource section on NHS Worcestershire website on each of the key strategic priorities and hot topics Introduce an annual Audience with.. event for key stakeholders to question senior management on key strategic priorities and hot topics Timescale March 2010 January 2010 February 2010 February 2010 March 2010 April 2010 World Class Commissioning Priority Area All 8 All 8 All 8 All 8 All 8 All 8 Community Engagement & Communications Strategy 35

36 Community Engagement and Communications Objective Promoting Equality, Diversity and Accessibility To establish a method via the membership of Action the View Point Countywide Panel to monitor the reputation and satisfaction of the local health service Work towards gaining The Information Standard kite mark Develop producing patient information policy incorporating accessibility criteria Facilitate the development of the knowledge across the workforce regarding Equality and Human Rights issues and their impact on service delivery and patient access to services Timescale June 2010 April 2010 December 2009 November 2010 World Class Commissioning Priority Area All 8 All 8 All 8 All 8 36 Community Engagement & Communications Strategy

37 Appendix Two Community Engagement Annual Report 2009 Community Engagement & Communications Strategy 37

38 Table of Contents SECTION 1 Introduction Page 39 SECTION Activity Report Knowing our PPI representatives and creating a real sense of involvement 2.2 Panel members induction and ongoing support 2.3 Staff development raising the profile of PPI within NHS Worcestershire 2.4 Listening and responding 2.5 Influencing decisions 2.6 Involving community groups including LINk 2.7 Equality impact involving everyone 2.8 Promoting independence, health, wellbeing and personalisation 2.9 Trends in feedback (PALS and complaints) SECTION and the future 66 SECTION 4 Summary and conclusions Community Engagement & Communications Strategy

39 SECTION 1: Introduction This report explains the purpose of Community Engagement in NHS Worcestershire and the different methods used to gain patient views and experience. It will also outline what has been achieved through NHS Worcestershire s Community Engagement activity during 2009 and describe the activity that is planned for NHS Worcestershire s approach to Community Engagement is explained in the Community Engagement and Communications Strategy (2009): To maintain an engagement and involvement framework that ensures all local citizens have the opportunity to contribute to decision making and maximises opportunities to build local ownership of health services There are huge benefits to be gained for the organisation from public and patient participation in decision making and also by ensuring services are shaped by community needs and are socially inclusive. NHS Worcestershire through the commissioning process is responsible for investing public funds on behalf of the people of Worcestershire and we need to ensure that services reflect the needs, priorities and aspirations of local people. The community needs to be at the heart of the development, planning, commissioning decisions, and directly provided services, and communications can play a major part in this. The Engagement and Involvement Framework included in the Strategy describes the mechanisms that are used for involving patients and the public in decision making about health services. These mechanisms include the Patient and Public Involvement (PPI) Sub Committee, a Patients Panel and a Health Insight Panel. Community Engagement & Communications Strategy 39

40 Engagement and Involvement Framework Worcestershire PCT Board PPI Sub Committee Strategic Steering Group for all engagement activity Responsible for policy development and feeding progress back to Trust Board and for identifying further opportunities to work in partnership. Activities Ideas and Opinions Strategy and Policy PPGs and PBC Cluster Groups Opportunities for two way dialogue with these groups, both listening and considering their feedback but also asking questions. Commissioned Research A regular programme of commissioned survey and research work on specific issues and general topics. Existing Mechanisms Proactive use of existing mechanisms for engaging with the public, eg. neighbourhood forums, outreach work and events, young peoples groups etc. Patient and Service User Satisfaction Proactively monitor patient and service user satisfaction levels. LINK Effective relationship with LINK, considering issues they raise and commissioning work where appropriate. Patients Panel Group of interested volunteers who are able to participate on an informed basis. Contirbute to day to day NHS activity, inspections, visits, meetings, tender evaluations, reviewing policies. PPI Champions and advocates, role in induction of other volunteers. Health Insight Panel Database of people registering particular interest in health issues. Opportunity to perticipate and be involved by atttending focus groups, completing questionnaires etc. Categorised by interest groups eg.stroke, long term conditions, diabetes etc as well as giving opinions in general NHS services. Worcestershire Viewpoint Panel of 6,000 Worcestershire residents Joint initiative with County and District Councils, Fire and Police. Regular questionnaires reviewing trends, opinions, perceptions and satisfaction needs. 40 Community Engagement & Communications Strategy

41 The Health Insight Panel is a group of people who have agreed to spend time commenting on documents, providing input and their views by sitting on focus groups, attending meetings or completing questionnaires. Patients Panel members are the volunteers who are more actively involved on a day to day basis. These volunteers commit a large amount of time and effort into ensuring that the needs of the patient and public are at the heart of the health care services commissioned for the people of Worcestershire. The Health Insight Panel continues to grow with new members registering every week and the aim is to increase the membership from 200 to 500 by the end of The PPI Sub Committee is a formal Sub Committee of the NHS Worcestershire Board and has a remit to cover involvement and consultation activities from a provider and commissioning perspective. Regular progress reports and issues are raised with the Board. The main aims of the Sub Committee are to ensure that: NHS Worcestershire involves patients and the public in a planned and proactive way Involvement and consultation activity is integrated with other local partners wherever possible NHS Worcestershire meets its legal duty to involve as outlined in Section 242 of the NHS Act The membership of the sub committee consists of: the voluntary sector, Worcestershire County Councillors and cabinet members, representatives from the community hospitals League of Friends, Local Involvement Network, Expert Patient Programme and Patient Panel members. The meetings are held quarterly and it is anticipated that the group will facilitate a flow of information to and from the wider community. Community Engagement Team Community engagement activity has grown considerably this year. This has been influenced by the expansion and re-organisation of the Communications and Community Engagement Team. The reorganisation has separated the Patient Advice Liaison Service and community engagement roles. A new post of Community Engagement Manager was created and Sonia Spurr was appointed in May. She is supported by a Community Engagement Officer, Helen Perry, who started in September. This increase in capacity gives a clear indication of NHS Worcestershire s commitment to PPI and enables the team to support panel members to have a greater influence in the reviewing, redesigning and commissioning of services. This also allows time for the recruitment new members to the Health Insight Panel to undertake PPI roles. The benefits of this increase in resources will be truly felt in 2010 when work started over the last 12 months comes to fruition and is able to have an even greater impact on the care pathway and commissioning cycles. Community Engagement & Communications Strategy 41

42 SECTION 2: 2009 Activity Report 2.1 Knowing our PPI representatives and creating a real sense of involvement This year we have worked on expanding the membership of all our panels and involving an increased number of our members in projects that reflect their interests, knowledge and level of expertise. We take care to speak to our volunteers to discover what they are most interested in and how they would like to be involved in the work of the organisation. In September we launched our PPI newsletter that we called Having Your Say. This has been well received by panel members, voluntary organisations and key stakeholders. The newsletter has detailed reports of PPI activity, the impact that it has had on the services and opportunities for further involvement. Having your say October 2009 Hello and welcome to the first issue of NHS Worcestershire s Health Insight Panel newsletter. This is our latest attempt to assist the process of getting patients and members of the public involved in decision making and I hope very much that it will add value and that you will find it interesting and useful. We will try to produce it bi-monthly and the aim will be to make sure we are describing and highlighting the opportunities that are out there to get involved in your local NHS. I hope that you enjoy the newsletter and thanks for your ongoing support and interest. Patients benefit from increased nursing care Productive Ward Programme is about releasing time to care, enabling healthcare staff to spend more time directly caring for patients. Pam Mace and Gordon Prescott are patient representatives who both sit on the Productive Ward Board and their input has proved invaluable to the project. The main focus is on improving patient experience, something which Pam and Gordon have been able to advise on first hand and their thoughts and ideas have really allowed the Trust to reflect on the best ways of effectively implementing changes that will enhance patients stay. Both Pam and Gordon have been really positive in their feedback to the Board surrounding some of the project s achievements to date, and as the momentum of Productive Ward continues to increase their contribution will remain imperative to its success. Pam has said I am proud to be involved in the Productive Ward Project and to see the improvements it has made to patient care. My input has been valued by the staff involved and I feel part of the project. Simon Trickett - Head of Communications and Community Engagement Improving Stroke Services in Worcestershire In its 5 year strategy Investing in Health for Worcestershire, NHS Worcestershire identified Stroke Services as a priority for improvement. In order to inform discussions and plans for improvement the views of stroke patients and their carers were sought during April & May 09. Members of the Clinical Development and Community Engagement team attended Community Stroke Support Groups in the following areas: Bewdley Worcester Bromsgrove Evesham In excess of 80 people attended the four sessions overall. A combination of stroke survivors, their carers, and Stroke Association Co-ordinators, were asked for their views on: Specialist clinics for minor strokes/transient Ischemic Attacks, where and when they should be available Creating stroke specialist in-patient rehabilitation centre(s) Investment in a Community Specialist Rehabilitation Service for patients to receive intensive support in their own homes Long term support after a stroke Having your say December 2009 Merry Christmas and a Happy New Year We would like to say Thank you for all your support and commitment during We look forward to continuing to work with you all in Patients and Carers have their say on Renal Services In October four volunteers met with commissioners for the first time to discuss Renal services in the county and to influence the service specification so that services in the future can better meet the needs of patients and carers. Celebrating a Year in the Life of Malvern 2010 Time Capsule Project We wanted to involve young people in the development of the New Malvern Community Hospital, and at the suggestion of a local resident, have arranged to bury a time capsule on the hospital site that captures the lives of young people in Malvern in 2009/10. The time capsule will be opened in 2048 on the 100th anniversary of the NHS. The project was launched on 19th October in Malvern Theatre and was attended by a range of local organisations, schools and local residents. These organisations will be working on projects in the coming year to submit mementoes for the time capsule. The items submitted will be on public display in autumn 2010 at a venue in Malvern. We also have a group of young people supporting the project by becoming young documenters, they will be out and about over the coming months Several issues were raised, including the provision of food for patients whilst having dialysis. The commissioners are currently reviewing the existing service specification and considering changes for the future arrangements to ensure all patients are offered food during their treatment. recording local events in and around Malvern, we look forward to seeing the finished product. The items in the capsule will give a flavour of what life is like for children and young people in the area the hospital serves and will allow residents, when the capsule is opened, to reflect on the changes that have occurred in the lifetime of the new Malvern Community Hospital. Pictured: Children getting involved in the time capsule project Pictured: Having your say newsletter We feel this is a great way of staying in contact with our Panel members and encouraging their participation by showcasing the difference that patient and public involvement has been able to have on service design and delivery. We are working closely with patients on content and plan to publish the newsletter every 2 months. NHS Worcestershire has joined forces to develop a joint Citizens Panel - Worcestershire View Point. The panel is supported by; the County Council, five District Councils, Herefordshire and Worcestershire Fire and Rescue and NHS Worcestershire. It is hoped that this panel will have a 42 Community Engagement & Communications Strategy

43 membership of 6000 residents and will enable a larger number of people in Worcestershire to comment on the reputation of NHS Worcestershire and on the services it commissioned. The first survey being carried out is similar to the recent local government Place Survey and will include questions relating to NHS Worcestershire and the services we commission. The first survey will be conducted in November 2009 and will be repeated every 6 months. 2.2 Panel members induction and ongoing support A structured induction programme with supporting materials is being developed, driven by PPI volunteers for PPI volunteers. The PPI representatives have given the Community Engagement Team clear guidance on the content of the induction and the support members require to be effective in their role. You said: PPI representatives felt that new members should be supported more effectively, so they felt more confident in their new roles. We did: An induction programme has been designed, introducing new volunteers to each other for peer support, the NHS team, opportunities available to them and corporate policies and procedures. This will be launched in February Staff development raising the profile of PPI within NHS Worcestershire In 2009 we have been working to develop opportunities for volunteers to be more effective in the work of the organisation and for NHS staff to be aware of the importance of PPI. By increasing people s knowledge we are ensuring that engagement is embedded into the everyday work of the organisation and is not just seen as a tick box exercise. The emphasis is very much something that is integral to the process when reviewing, designing and commissioning services. We are working with all our health partners in Worcestershire and Herefordshire to deliver Learning to Listen and Engage Workforce Development for Patient and Public Engagement. This is a programme of projects to improve the skills and capability of managers and frontline staff in involving public and patients in service improvement. It comprised of a gap analysis to identify staff knowledge and current levels of activity in relation to patient and public involvement, an internal communication campaign and the development of a training programme. The aim of the training programme is to raise awareness of the importance and benefits of involving patient and public in health care service review and design and to increase staff skills and confidence in engaging with patients and service users. The training sessions will be attended by staff and service users from across all the health organisations and it is hoped that this will lead to the recruitment of a range of people, both staff and service users who will also be trained as facilitators for delivering Patient and Public Awareness Raising sessions from 2010 onwards. The training programme starts in January Community Engagement & Communications Strategy 43

44 It has been funded by the Herefordshire and Worcestershire Locality Board, and is managed by a Steering Group comprised of representatives from the six health organisations, the Local Involvement Network and service user representatives from both counties. 2.4 Listening and responding Phlebotomy Services During 2008 problems including waiting times for Phlebotomy services at the Kidderminster Treatment Centre were featured in the local press. Two local PPI representatives undertook a survey of service users to understand the issues and find solutions. They made several recommendations including; phlebotomy services to be provided at G.P practices, an appointment system and a review of the location of the service and its waiting room. These recommendations were accepted by NHS Worcestershire and are being delivered this year. Waiting times have decreased and more patients are attending their G.P practices for a blood test. You said: Improve waiting times and conditions at the drop-in phlebotomy sessions in Kidderminster Treatment Centre. We did: Encouraged GP s to do their own testing so reducing the number of referrals and waiting times. Planned to introduce a choose and book system for appointments. 44 Community Engagement & Communications Strategy

45 Falls Prevention Falls Prevention is one of the Strategic Priorities set out in NHS Worcestershire s 5 Year Strategic Plan. A review of the current Falls Pathway process has been undertaken in Redditch. A focus group - that comprised of people who had suffered from a fall, their carers and local community groups with an interest in older people s health - met to review the information that is currently available to raise awareness on how to prevent falls. They considered whether the information, is accessible, in a user friendly format and likely to change behaviour resulting in reductions in numbers of falls. They also considered exercise, as this is an important factor in preventing falls. Healthcare staff were keen to understand how they could motivate people to attend exercise classes specifically aimed at people at risk of falling and the barriers that may prevent people attending. You said: Help people at risk of injury or hospitalisation from falls. We did: Set up a programme that helps identify people who are at risk of falling and offers them the opportunity to attend a programme of exercises to improve their balance and postural stability, leading to a reduction in the risk of those attending falling. Stroke Rehabilitation Service A survey was undertaken in April 2009 to review Worcestershire stroke survivor s experiences of support after they leave hospital. The survey is aimed at ensuring service users have a voice in current service planning and will be repeated at regular intervals to measure the impact of current service developments. The results of this survey indicated that: Only 46.8% respondents rated the care they received for their stroke as good, very good or excellent Local service users experienced low levels of satisfaction in several key areas of care and support, notably: Support with speaking difficulties and mobility Information Relating to secondary prevention, including diet and exercise Information about stroke, what it is, what to expect etc Information about national and local support groups, websites etc Access to advice about benefits Support for emotional difficulties following stroke Lack of or untimely follow up after TIA. Community Engagement & Communications Strategy 45

46 WHEN STROKE STRIKES, ACT F.A.S.T. nhs.uk/actfast Client Name: DLKW Account Name: Stroke Select Publication: - Size: 420x297 File Name: 62508DL26a0302_A3 Prev File: - Fonts: Tasse Pictured: FAST campaign poster The feedback endorsed the actions already undertaken by the County s Stroke Care Planning Group, which includes commissioning the Community Stroke Rehabilitation Service and the Family & Carer Support Service. You said: You wanted more support after discharge home from hospital and dedicated stroke unit beds. We did: Have expanded the Family and Care Support Service so it is available countywide. Transient Ischemic Attacks (TIA) Evidence shows that treating a TIA within 24 hours appropriately can reduce the likelihood of having a stroke. NHS Worcestershire is committed to providing TIA clinics for assessment and treatment within the 24 hours window but for this to happen the clinics need to take place at a variety of health care setting across the county. This may involve people having to travel up to 30 miles to be seen at relatively short notice. In a series of focus groups with stroke survivors and their carers we asked what their thoughts were regarding having to travel to a TIA Clinic. They all responded positively to this service being available but expressed some concerns regarding transport and being able to attend the appointment easily. 46 Community Engagement & Communications Strategy

47 You said: Some people would find it difficult to arrange transport at short notice to get to the other side of the county to attend an appointment. We did: Met with the Worcestershire Community Transport Partnership to see how we can arrange for community transport to be available take a patient and their carer to a TIA clinic appointment at short notice. Maternity Services The Maternity Services Forum is attended by diverse range of stakeholders but is primarily driven by service users and includes some members from the National Childbirth Trust. The aim of the Forum is to evaluate and ensure local maternity services are provided in accordance with need and adhere to the requirements of Maternity Matters. Members of the Forum are actively involved in the working group regarding the development and provision of a Midwife Led Unit at Worcester Royal Hospital, a project they support fully. They have also been involved in Birth Environment Audits on both sites and made recommendations for changes to ensure that the patient experience is as positive and comfortable as possible. The focus of the their work is currently devising a survey to monitor the experience of mothers who have given birth in the last 12 months on a range of maternity and community services. It was agreed that it should be based on a national survey conducted in 2007 so that we are able to compare the results. The survey will be undertaken in spring 2010 and will be available in a range of formats to ensure that we access a wide range of women s views and experiences from across the county. Children s Centre staff are involved in the project and will be supporting people to complete the survey. You said: Maternity services in the county needed investment. More people wanted the opportunity to give birth locally if possible. We did: We developed a new Improving Maternity and Children s Services for Worcestershire Strategy that includes provision and investment in local facilities such as increased capacity at Alexandra Hospital Redditch and a new midwife-led unit at Worcester. Community Engagement & Communications Strategy 47

48 Paediatric Palliative Care Services Improving outcomes and experiences for children, young people and their families living with lifelimiting and life-threatening conditions was the focus of Better Care Better Lives (Department of Health Feb 2008). In the West Midlands the SHA facilitated a mapping event to identify paediatric palliative care services regionally and to identify gaps in service provision. In order to gain further details of the needs of the service a small focus group was developed of parents/carers whose children have received palliative care services from the Orchard Service. The finding of the mapping event were presented to the group and they identified the following as being areas of concern regarding the service they had received: Difficulty accessing equipment Lack of bathing aids Wheelchairs not available for short term use for cancer patients Collection and delivery of equipment Obtaining appointments for ongoing treatment/needs with Occupational Therapist and Continence Service Lack of telephone advice from Orchard Service out of hours Lack of emotional support for family Lack of holiday play scheme places for children with very complex health needs Lack of or reduction of physiotherapy service especially during school holidays. To ensure that the views of a wide range of parents are considered, this information is to be shared with the parents/carers of all the children accessing the Orchard Service and determine if there is agreement regarding the areas that are in need of developing. Further consultation will then be undertaken with the focus group before final decisions are made on service developments. You said: We would like to be able to access wheelchairs for short term use when our children are having chemotherapy. We did: Made contact with the British Red Cross to discuss increasing the capacity of their Community Equipment Service and to develop a publicity campaign to ensure people are aware of the service. Spinal Services During June 2009 a review of the provision of spinal services to Worcestershire residents was undertaken, this included sending a survey to patients who had received treatment in the spinal services care pathway with two health care providers and discussions with GPs to establish their experience when referring to these services. The number of responses to the survey was small but statistically significant. The following are the key recommendations to take forward to improving the patients experience in the whole spinal services care pathway: Ensure that the role of this service is establish with the providers and whether more needs to be done to improve its effectiveness Improve the speed at which patients are reviewed, diagnosed and treated 48 Community Engagement & Communications Strategy

49 Ensure the Consultant has all the relevant patient records and test results to prevent unnecessary delays and recurrent visits for consultation Develop criteria s that would quickly assess the need for urgent treatment (ensure urgent treatment is classified clearly) Communications need to be improved ensure patients know at every stage what s happening to them and if they are going to be waiting longer than anticipated let them know. Improve administration responses to patients wanting to find out about their care i.e. ensure they are given appropriate contact details and there is someone at the other end of the line to answer their queries. Consider customer care training for administrative staff Ensure patients are provided as much information as possible on their after care on discharge Consider the issues raised by GP s for a more wider debate with the Providers speediness of service; clear pathways; role of OPS; communications; MAU and SAU s; referral management and a local service The findings from the review were presented to the health care providers in November There will be further meetings to establish how the above will addressed. You said: We don t want our scans to go missing and to not be available when we attend consultants appointments. We did: Arranged for all scans to be sent electronically to consultants. 2.5 Influencing decisions NHS Worcestershire has been undertaking a detailed review of health services in Evesham as part of its commitment to improve health services across the whole county. A Steering Group comprising of a variety of stakeholders including local GPs, Wychavon District Councillors and officers, NHS Worcestershire staff, Evesham Community Hospital staff and Evesham Hospital League of Friends members was been formed as part of the consultation process. Pictured: Developing Healthcare Services for Evesham Community Engagement & Communications Strategy 49

50 The initial findings from a health needs assessment and a review of potential options for future delivery of services was collated along with other relevant information in a consultation document that was distributed to every household in the District. You said: Lots of feedback to the consultation document was received with a desire for more care to be available out of hospital and closer to home being a key theme We did: The NHS Worcestershire Board will receive a final report on the project in early 2010 but the care closer to home will be a key theme of any recommendations and future planning Renal Strategy and Service Specification We have been developing a new Renal Strategy and as part of that process wanted to provide an opportunity for service users and carers to contribute to discussions on the draft renal strategy and service specification. A group of PPI representatives - either Chronic Kidney Disease sufferers or their carers - is now meeting regularly to share their experiences of the renal service and to ensure that patient needs are at the heart of the new strategy. The group raised a number of areas to consider improving the patient experience, these included: The care pathway for patients who decide they do not wish to continue with dialysis, the current End of Life Care provision for renal patients is limited The dietary needs of patients needs when having dialysis, as in some centres there is not enough, or in some cases, no food being provided They also raised the issue of the collection of rubbish from the homes of patients who undertake home dialysis with some district councils refusing to take away the rubbish they produce. You said: Patients didn t feel as though they got fed appropriately at some centres when they were having their dialysis We did: Are currently reviewing the service specification to try to address this. 50 Community Engagement & Communications Strategy

51 New Malvern Community Hospital The New Community Hospital in Malvern has been high on our agenda this year as funding was finally approved and construction started on site. Planning for the final design was hugely influenced by patient input and considerable changes where made to the building layout and car parking provisions as a result of feedback during the consultation phase. Pictured: Plans for Malvern Community Hospital The League of Friends have been very involved raising money to improve facilities and increasing awareness of the project amongst the local community. We did however specifically want to improve engagement with young people, whose opinions are obviously critical as they shall be using the hospital for many years to come. A Time Capsule project was launched in October as a result of an idea from a local volunteer. Schools, organisations and individuals have been invited to submit items that represent life in Malvern in 2010 into the capsule which will be buried on site with a plan to open it in 40 years time. You said: Create more parking at the new site. We did: Negotiated with the planning authority and changed the planning application to successfully achieve this. You said: Involve Young People in the New Hospital through an innovative project a Time Capsule. We did: We have developed the idea, put staff resources into making this unusual piece of engagement happen and have launched the project. Community Engagement & Communications Strategy 51

52 Strategic Plan Investing in Health for Worcestershire During 2009 NHS Worcestershire continued the development of a 5 year strategy as part of the World Class Commissioning process. Engaging the local population in this was a really important objective and in May a public friendly summary version of the document was produced and widely distributed. This document included a series of set questions, as well as an opportunity for people to submit general comments and allowed a period of 12 weeks for consultation. Results were collated and then considered as part of the re-writing of the plan in November Pictured: Investing in Health for Worcestershire: A Draft five year strategy: 2008 to 2013 Investing in Health for Worcestershire A draft five year strategy: 2008 to 2013 March You said: Investing for Health 5 year Strategy public consultation main feedback: 85% of people agreed with the proposed vision 90% agreed with the suggested core values for NHS Worcestershire 85% were supportive of the key priority areas and the majority thought that these would make a positive difference to healthcare in Worcestershire Other comments and suggestions included support for: Improving joined up working between health care providers and health and social care providers. More support for the elderly and carers Improving car parking Extending screening services. Making services easier to understand for those with learning difficulties, sensory problems. Providing more local services. More health education particularly sexual health in schools. We did: Took this feedback into account and reflected it in the new version of the Strategy 52 Community Engagement & Communications Strategy

53 Radiotherapy Services The Radiotherapy Stakeholder Reference Group have met twice during The group comprises of health professionals, voluntary sector, cancer network staff and PPI reps. The aim of the group is to review the provision of radiotherapy services currently available and to comment on the development of a locally accessible radiotherapy for the people of Worcestershire, an objective that NHS Worcestershire has been working towards in recent years. In collaboration with other NHS organisations and with all its stakeholder groups, NHS Worcestershire has been considering how best to commission a safe and sustainable radiotherapy service in Worcestershire and this group has been a way of involving patients and the public in this process. There was a consensus in the group that the needs of the whole of the Worcestershire population should be taken into consideration, the group did not want solutions to be based on geographical areas of the county. Also the group felt that transport issues and designated car parking should be incorporated into any service specification. The issues raised by the group are now being considered by NHS Worcestershire and the group with meet again early in You said: Create opportunities through commissioning for patients to be able to access radiotherapy services locally within Worcestershire We did: Agreed funding for a new linear accelerator at Worcester and agreed to review our whole approach to Cancer Strategy to identify other services that can be delivered safely more locally Community Engagement & Communications Strategy 53

54 GP Premises Developments Increasing pressure on finances mean that NHS Worcestershire has to be very clear about the views of local stakeholders when developing or investing in services. A policy has been developed and approved this year that ensures the views of a variety of stakeholders are taken into consideration when a business case is submitted to NHS Worcestershire for the development of a GP s premises. The protocol includes suggestions for ways of including a variety of stakeholders from local Councillors to patients in the development of plans, and outlines specific information that NHS Worcestershire would expect to see as part of a business case. The process for submitting a business case now includes a specific section on how members of the public and stakeholders should be involved with developing proposals. You said: Listen to patients when deciding how to develop GP premises We did: We consulted and implemented a new protocol for consultation that GPs and developers have to take into account and address when preparing business cases 18 week Survey Action Plan The 18 week target has been a very high profile issue nationally with significant resources being invested in ensuring that the waiting time for patients from referral to treatment does now exceed 18 weeks. From the start of 2009 virtually all patients can be seen, diagnosed and for their treatment to have started within 18 weeks of their initial referral. Ipsos MORI were engaged by the 17 West Midlands PCTs to undertake a research study that assess this and what impact the overall drive to improve performance in this area has had. The fieldwork for the research was undertaken between the 24th November 2008 and 2nd January 2009 with each PCT area targeting a sample of 1,500 patients. All of the target sample had been referred by their GP to an NHS healthcare provider within the previous 20 weeks so in theory would be well placed to comment on their experience. Elements of the questionnaire itself were designed to be consistent with the Healthcare Commission Inpatient Survey and The National Patient Choice Survey to enable some comparisons of performance to be made. The Department of Health had also previously undertaken an 18 Week Pilot Study in March 2008 and this was also taken into account. In Worcestershire the PCT worked with the Acute Hospitals Trust to identify these patients and to distribute the questionnaires. Overall, Worcestershire performed fairly well when compared to other PCTs within the West Midlands: Survey response rate, 31% Worcestershire performed significantly better than the regional average Overall patient satisfaction, 62% Worcestershire performed significantly better than the regional average (3rd best overall) Satisfaction with waiting time, 81% Worcestershire performed significantly better than the regional average (2nd best overall) 54 Community Engagement & Communications Strategy

55 Appointment cancellations, 72% Worcestershire performed significantly better than the national average (1st overall) Patients dealt with dignity and respect, 89% Worcestershire performed significantly better than the regional average (2nd best overall). Using the survey outcomes in addition to our own knowledge of areas of weakness, the Worcestershire Health Economy has jointly agreed an action plan to improve patients experience of 18-weeks. The outcomes from the action plan have been: Undertaking a survey of 1000 people who had been referred for an outpatient appointment at Worcestershire Acute Hospital Trust by their GP regarding their experience of the Choose and Book system and to ascertain the level of choice that patients are being offered The data received from the survey will be analysis in January 2010 The Service Level Agreement for Local Enhanced Service (LES) for Utilization of Choose and Book 2009/10 included 5 practice models for the Choose and Book process A publicity campaign has been commenced regarding Choose and Book, including use of local media, bus advertising, development of poster and leaflets for distribution to GP practices, pharmacists, Community Hospitals and the Acute Hospital Trust Posters and leaflets regarding the Setting new standard for your care - 18 weeks have been produced and cover what this means to the patient and how their actions can prevent delays in receiving their treatment within the 18 week period. They have been distributed to GP practices, pharmacists, Community Hospitals and the Acute Hospital Trust. Dementia Services Service Users are represented on the Care Planning Partnership group the Dementia Stakeholder Group, this is through voluntary organisations and community groups attendance especially the Alzheimer s society and Als Way. Service users have been involved through again the Alzheimer s Society carers support groups being involved in the countywide Dementia Service Mapping exercise. We are planning to take out into the county a consultation of the dementia service mapping and strategy in the new year to which service users will be encouraged to make comment, we will also be presenting dementia at our MH Service Users and Consultative forums and groups. Aspergers Service Service users have lobbied Social Care and NHS Worcestershire for the last 10 years to invest in an Aspergers Service. Service user organisation WAASP have worked hard to raise awareness of this issue and in addition to this we also received a number of letters from parents and carers. As a result of this feedback, and advice from it s commissioning team, NHS Worcestershire has invested in the development of a new Aspergers Service. This investment is being managed by a Multi Agency Stakeholder Group that includes three service users and representatives from Autism West Midlands along with officers from our Public Health and Clinical Development teams and the Joint Commissioning Unit. The first part of the work of the group is to review service needs and develop a service specification. The group has met four times and aims to have a specification in place for consultation again with our consultative forums in February with a launch date for the new service in Summer Service users have been instrumental in lobbying and securing investment and in designing the service, to best practice models from around the country. Community Engagement & Communications Strategy 55

56 Buying new services We have made a conscious effort to make sure we involve patients in large procurement exercises that we have undertaken in the last year. During the last year the best examples of this were in the selection of a new out of hours primary care provider and an organisation to operate the new GP-led health centre in Worcester. On both occasions patient representatives played a full part in the process and were able to quiz companies tendering for these contracts about their intentions, the quality of service they were offering and in particular how they would ensure ongoing patient and public involvement. We have also recently selected new contractors to provide health trainer services in some of our areas of highest need in the county. This process was also able to consider the results of a survey of 70 people who had been part of an initial pilot study into the benefits of the health trainer concept. Carers Strategy Our Joint Commissioning team are leading on some work to develop a new Carers Strategy and this has included considerable engagement and listening on our behalf. The voice of Carers within the county is strong and representatives have been able to have a major impact on the development of the new Strategy. Input from PPI has shaped the following commissioning decisions as part of the new Carers Strategy: Re-procurement of flexible breaks service Choice and control review Funding for GP engagement Countywide information, advice and support service Training programme for carers. Dentistry Regular surveys are undertaken to assess the public s opinion of local health services and in particular the areas which require improvement. Consistently the top priority for investment in Worcestershire is NHS Dentistry. The latest telephone survey that was undertaken on our behalf showed that nearly one in five residents wanted to see more NHS dentistry places being made available so we have responded with significant investment of over 3 million across the county. Smile! There are NHS dental places available in Worcestershire for the whole family To find out where, call NHS Worcestershire Dental Helpline on or visit: NHS Worcestershire Dental Helpline, NHS Worcestershire, Wildwood, Wildwood Drive, Worcester, WR5 2LG 56 Community Engagement & Communications Strategy

57 Diabetes Network To inform the work of the Diabetes Network a Patient and Public Involvement Sub Group has been developed. The group has a membership of charitable organisations, patient and public representatives, clinical staff and clinical development staff. The aim of the group is to: To ensure patient participation and consultation of new developments To engage voluntary sector organisations (such as Diabetes UK) and foster productive working relationships with diabetes teams across the health economy To work across service boundaries in the local health economy To invite appropriate representatives to give updates on developments and provisions of diabetes services To ensure that relevant input is given to structured education programmes and self care For all parts of the county to have diabetes centres. The group meets on a quarterly basis and has been involved in organising awareness raising events, developing a newsletter, consider developments in treatment from a patient perspective, considered PALS issues regarding diabetes, attended community events and commented on areas such as vascular checks. The information and the experience that the group bring to the Diabetes Network is considered imperative to ensuring the effectiveness and continued improvement of diabetes services throughout Worcestershire. End of Life Care NHS Worcestershire worked together with Marie Curie Cancer Care during 2009 to gain an insight into carers experiences of their loved ones receiving palliative care services and how they could be improved. We wanted to understand what carers experiences were of caring for a loved one at the end of their life and to ascertain how services could be improved to support them more appropriately. Those taking part in the project were interviewed or attended a focus group to share their experiences. Information shared was then collated into a report and has been shared with service providers to enable them to review their service provision. The report was then put together with recommendations from over 300 GPs, nurses, therapists, nurse specialists, hospice staff, social care staff and managers, to inform the action plan for the next phase of the project. This has led to the development of End of Life Services being over seen by the End of Life Executive Board and eight groups being developed to support the strategic and service development work: 1. Network Board 2. Project Group 3. GP Group 4. Support for Carers Group 5. Community Carers Group 6. Specialist Palliative Care Group 7. Education and Workforce Group 8. Worcestershire Hospitals Strategy Group This indicates the commitment of the organisation, the staff and key stakeholders to the development of high quality end of life care services. Community Engagement & Communications Strategy 57

58 The experiences of the patients and their carers have influenced service provision, with the project already achieving: Provision of evidence to support a business case to double the number of Admiral Nurses, who support the carers of those patients with dementia Implemented training for over 300 GPs across the county to update them on symptom control and end of life care pathways Improve access to equipment and specialist palliative care drugs for patients cared for at home. 2.6 Involving Community Groups including LINK Community and voluntary groups are key stakeholders and we are keen to engage and work with them as effectively as possible. During 2009 we have linked with a wide range of organisations, including: Bromsgrove and Redditch Network Worcestershire Associations of Carers Sight Concern Worcestershire (formerly Worcester Association for the Blind), The Stroke Association Worcestershire Association of Voluntary Organisations in Community Care Worcestershire Infrastructure Consortium Odel Centre, Kidderminster Deaf Direct Haybridge High School Pershore High School Worcestershire Association of Services Users Wychavon Older Peoples Organisations Network Parent Voice Steering Group Older People Voluntary Social Services Network St Richards Hospice Marie Curie Cancer Care. We are actively seeking voluntary organisation representation on care pathway and commissioning groups. Examples of representation we currently have from voluntary organisations are: Diabetes UK are represented on the Diabetes PPI sub committee as are the local Diabetes Support Group (which reports to the Diabetes Network Board, NHS Worcestershire) Marie Curie Cancer Care are represented on the Worcestershire Palliative and End of Life Care Network and at the July meeting presented their findings and recommendations for the End of Life Care Pathway The Chief Officer from Sight Concern is a member of the Opthalmic Commissioning Group, her input has been invaluable and has allowed the group to consider the needs of patients from a different perspective. Local Involvement Network The Worcestershire Local Involvement Network (LINk) is now in its second year and we have been working together on several initiatives. They have done two reports from visits to the out of hours primary care services and we are working with them to consider and implement their recommendations. At a recent away day they organised we ran a workshop on how to use the local 58 Community Engagement & Communications Strategy

59 media to raise their profile. The LINk have also been very active in lobbying for head and neck cancer services to remain in Worcestershire and their views have been taken into account as a long term solution is sought. Ann Montague-Smith, Chair of the Worcestershire LINk said: NHS Worcestershire work with Worcestershire LINk on a regular basis. A representative attends the LINk meetings once a month where there is an opportunity to provide the wider LINk membership with information and give updates. NHS Worcestershire engages with the LINk and provides us with the opportunity to discuss local provision with commissioners. The LINk has also received training from Simon Trickett on working successfully with the media. The community engagement team readily share information and best practice with the LINk and provide support in doing this with other Worcestershire organisations. NHS Worcestershire has also attended a number of LINk events including the Launch and AGM in April Equality Impact Involving Everyone We are very aware of the need to ensure our services are accessible and this also applies to our communications and engagement activity. All staff receive equality and diversity training and there are clear policies and resources in place to ensure equality considerations inform all decision making. A framework agreement with Applied Language Solutions provides a service that translates information into appropriate formats and languages on request and we supplement this where necessary with targeted communications material such as the Choose Well guide that was translated into polish. Pictured (right): Unwell? Choose Well Polish leaflet Źle się czujesz? Wybierz dobrze. U C w Poradnik pacjenta na temat wyboru odpowiedniej placówki opieki zdrowotnej we właściwym momencie. Unwell? Choose well. Community Engagement & Communications Strategy 59

60 You said: provide information in polish language for people wanting to access NHS services who don t have English as their first language. We did: produced a basic guide to services in polish and a version of the Choose Well literature that was distributed widely through community groups. We accept that there is a need to undertake outreach work in the community to make sure we are listening effectively to seldom heard groups. As part of this we have made good links with groups such as Sight Concern Worcestershire, Deaf Direct and others. Their views on general services are of obvious importance but it has also proven beneficial to get groups such as Sight Concern Worcestershire involved in commissioning considerations around services that have a direct impact on their members. You said: Sight Concern Worcestershire expressed some observations about services for partially sighted people We did: We invited a representative from Sight Concern Worcestershire to sit on the Ophthalmology Commissioning Group During 2009 a series of Equality and Diversity Seminars were held around the county to enable the health economy as a whole to gain an insight into the issues that people face when trying to access health care services. The seminars began with formal presentations from the Trusts, broadly around whom we are, what we do and the equality and human rights strands. The events were led by the Equality & Diversity Leads from each of the partner organisations The seminars then moved to break out group sessions with specific reference to equality themes of: Race & Religion/Belief Age Disability Gender & Sexual Orientation. Attendees self-nominated, which group sessions, they were interested or concerned with under the particular themes. All themes generated much debate and it was clear that more time would be required to allow participants opportunity to fully express themselves. This is in line with the Single Health Equality Partnership agenda to enable meaningful debate from localised and minority perspectives in order to meet specified needs. 60 Community Engagement & Communications Strategy

61 Seldom Heard Groups During 2009 we have made successful links with a range of groups to ensure that we access a wide view point, a number of groups have agreed to be consultative groups for us on a generic issues relating to health care services. This includes: Asian Elders Male and Female in Worcester City The Chinese Society Communication and Stroke Support Groups Haybridge High School, Hagley 6th Form YMCA, Redditch - Childrens Centre, Homelessness Redditch Older Peoples Forum Pathfinder Project Oldington and Foley Park Project Deaf Forum Redditch and Bromsgrove Worcester Afro Caribbean Association Odel Centre for Adults with Learning Difficulties Sight Concern (Previously Worcestershire Association for the Blind). We have the facility in place to have information translated into a range of languages and formats. All staff are able to access the service of a translation service for consultations and Deaf Direct are able to offer the services of a British Sign Language Interpreter. We have developed a working relationship with Deaf Direct who are offering awareness raising sessions with GP practice staff in the needs of a patient who is hearing impaired and how best to support them. 2.8 Promoting Independence, health, wellbeing and personalisation We are currently working on the next issue of our annual Well Being Magazine that will be delivered to households across the county in January This has been well received by local residents and is cited nationally as best practice. The magazine includes: Health advice Public Health messages Details of how we spend the budget Updates on service provision Details of how members of the public can become involved with the organisation. Your Health, Your Way - an introduction A local Your health, your way, website area is currently being developed by NHS Worcestershire, it will provide people with long term conditions the information they need about the choices, which should be available to them locally, to enable them to self care in partnership with health and social care professionals. This is about providing information to people on choices they can consider in order to fully engage in discussions about their care. Community Engagement & Communications Strategy 61

62 Pictured: Self care web page Self care web pages have been identified nationally as best practice and ours will contain information on the following conditions: Cancer Cardiovascular Disease Falls Chronis Obstructive Pulmonary Disease Diabetes Neurological conditions Stroke Musculoskeletal. This area of work has involved engaging with patients with Diabetes to ensure that we consider their experiences of receiving information to enable them to manage their condition effectively. Gaining the views and experiences of patients will inform the process of developing information prescriptions ensuring that the information is as useful and relevant as possible. 62 Community Engagement & Communications Strategy

63 Dental Services A dental campaign has been ongoing during 2009 to change people s perception that there are few NHS dental places available in Worcestershire and encourage them to contact the Dental Helpline on or findadentist@worcestershire.nhs.uk to find an NHS dentist in their area. It was important that the public we made aware that there are dental places available near to their home and that there is a set, reasonably priced, price structure for treatment. The key aim of the campaign has been to increase the number of patients who have accessed NHS dentistry at least once in the preceding two years. The number calls to the Dental Helpline have increase with 3303 calls having been received between July 2009 and early December 2009 an increase of phone calls per month prior to the campaign. This has led to more people being registered with an NHS dentist in Worcestershire. Public Health Campaigns There has been a variety of Public Health Campaigns during 2009 including Alcohol Awareness, Switch it Off, smoking cessation and National Obesity Week. Smoking cessation is an ongoing priority as it is proven to have such a considerable impact on wider health. One of the key social marketing initiatives this year has been the launch of a free phone number for people interested in stopping smoking to call where they can get details of the wide range of groups and providers of this service. This range of providers has been considerably increased during 2009 with our move to a tariff based system. National Obesity week is an annual health event which aims to increase awareness of the growing problem of obesity. 25% of people across Worcestershire are estimated to be obese (BMI of 30 or over). This year the approach was about being positive to stop talking about obesity and to start talking about health and healthy weight. The aim of the events were to encourage the public to check their weight, to see if they are within a healthy weight and provide the information to support becoming healthier. This process was not to solely look at weight and BMI (although they provide a good trigger to talk about health risks), rather health and local support to help people to take small steps to make lasting changes for a healthier lifestyle. Public Health and Communications worked together this year to deliver a week with public facing events to raise awareness locally. During National Obesity week there were three main public facing events, each allowing face-to-face interaction with the local population and was successful in the key objective of creating awareness and prompting the local population to think about their weight. It was also successful in promoting NHS Worcestershire and Worcestershire PCT services. Through face to face conversation we were able to feed back to the public the local support available to help them become healthier and with a targeted approach to their individual needs. Another strength of the events was providing the public with time to talk through healthy lifestyle issues which they voiced they wouldn t have the time to with their GP. All NHS Worcestershire and Worcestershire Mental Health Partnership Trust staff were urged to switch off unnecessary electrical appliances during Switch It Off Week, which started on Monday, November 9. Community Engagement & Communications Strategy 63

64 The Trusts supported the energy saving campaign, which covers Worcestershire, Coventry and Warwickshire, with the aim of showing staffing how much energy and money can be saved when we turn off unused lights and electrical appliances, including those left on standby. The Carbon Trust estimates over 10 per cent energy savings can be made if equipment and lights are turned off, equating to nearly 100,000 across the two Trusts each year. To help remind staff about saving energy, information stands were placec at Evesham Community Hospital, the Princess of Wales Community Hospital in Bromsgrove and Prospect View Medical Centre in Malvern during the week. NHS Worcestershire s Non-Executive Director Peter Pinfield and Colin Phillips, Non-Executive Director at the Mental Health Trust visited staff at their Isaac Maddox House offices in Worcester to raise the profile of the campaign. The two Trusts monitored how much energy they save during the week by taking meter readings before and afterwards. 64 Community Engagement & Communications Strategy