Communications and Engagement Plan 2012/2014

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1 Making it happen Communications and Engagement Plan 2012/2014

2 Document Information Document location : This document is only valid on the day it was printed. N:/Governance/Authorisation/ Communications and Engagement Strategy Authorship: This document has been prepared by: Name Designation Organisation Debbie Jackson Assistant Director of Derbyshire City and Derby City PCT Cluster Communications Suzanne Pickering Governance Lead NHSNDCCG Revision history: The current version of this document supersedes all previous versions. Revision date Summary of changes 04/06/12 Initial Draft July 12 V1 07/08/12 Updated Draft 7 th August 12 V2 15/08/12 Updated version 15 th August 2012 V3 20/08/12 Updated version 20 th August 2012 V4 13/09/12 Updated version V5 16/09/12 Review by Chief Officer and final amendments V6 Approvals: This document requires the following approvals: Name Signature Date taken North Derbyshire CCG Governing Body 27/09/12 V5 Version Version Distribution: This document has been distributed to: Recipient Date of Issue Version Date for review: Date of review Name Designation and Organisation July 2013 Debbie Jackson Assistant Director of Communications Page 2 of 50

3 Contents Section Description Page One The purpose of this document What is a Communications and Engagement Plan Strategic intent Plans and framework 5 Two Our Clinical Commissioning Group Who we are Our Values Our Vision Our Mission Our Commitment to you Our Guiding Principles. 9 Three Communications and Engagement Objectives.. 11 Four Reputation Management.. 12 Five Stakeholder Mapping and Analysis Six Internal Communications Plan Target audience Objectives Channels 17 Seven Stakeholder Management Plan Target audience Objectives Channels 21 Eight Media management 24 Nine Crisis Communications Framework Introduction Objectives Target audiences Key messages and styles Actions 27 Appendix Description Page One Brand Development Outcome. 29 Two Stakeholder Map 33 Three Clinical Leader Top Tips 41 Four Newsletter 43 Five Corporate ID Guidelines 49 Page 3 of 50

4 Section One The Purpose of this document 1.1 What is a Communications and Engagement Plan? The purpose of this strategy is to set out NHS North Derbyshire CCG s (ND CCG) approach to communications and engagement with staff, member practices and stakeholders and provide a framework for all communications and engagement plans developed by the CCG. It is supported by a Patient and Public Engagement Plan which provides more detail and focus for the involvement of local people in the CCG s decision making processes. The plan also supports the implementation of both the Equality and Diversity Strategy and the CCG s organisational development plan. 1.2 Strategic Intent An organisation s strategic intent sets the general direction for communications. The strategic intent is based upon an assessment of any gap between how the organisation is seen (reputation) and how it wants to be seen (vision). The plan aims to bring these in line with each other, and sets out a process to manage the organisation s reputation, and affect the awareness, knowledge and behaviour of identified stakeholders. This process is reinforced by the engagement element of the plan. An organisation like a person - has three perspectives as illustrated below. The more integrated these are, the stronger and more credible the organisation. It is therefore vital that the CCG s vision is clear, and that it is consistently reflected through its activities, behaviour and communications. The strategic intent is arrived at by agreeing a vision for how you want to be seen. how you want to be seen how you see yourself how others see you Page 4 of 50

5 ND CCG has developed its vision through a series of meetings and surveys. These have enabled Governing Body and staff members to agree how they see the CCG and how they want the CCG to be seen. The detailed results can be found at Appendix One but some key themes can be identified as the key words emerging from discussions were: Innovative High quality Customer focused Responsive Successful Trustworthy The CCG is keen not to be seen as bureaucratic, nor just doing things the way they have always been done. As a relatively new organisation still in development, the CCG has limited intelligence on how it is seen by stakeholders, including the public. The 360 survey undertaken as part of the authorisation process should start to develop this intelligence, and this strategy needs to be revisited when the results of that are known. In the meantime, we can assume that awareness of the CCG is at a fairly low level, so our initial strategic intent is to move from this low level of awareness, and a positive reputation which reflects the vision of the CCG articulated above Plans and Frameworks This plan also sets out a number of actions and frameworks which will support implementation. In addition to these plans which are largely based on key groups, individual plans will need to be developed to address specific issues. These may include communications plans for campaigns such as flu immunisation or sun safety, for the launch or rollout of a new service, or for awareness raising of key NHS issues such as a change in the NHS Constitution. There will also be specific engagement plans for service change or redesign. Page 5 of 50

6 Section Two Our Clinical Commissioning Group 2.1 Who We Are The coalition Government white paper Equity and excellence: Liberating the NHS 1 set out the vision for the NHS of the future with patients and clinicians at the heart of commissioning decision making. To enable this vision Clinical Commissioning Groups within Derbyshire were established in shadow form during 2011, have evolved and developed since this time ready to take on statutory duties from April The core role of our CCG is to use the resources we have to commission (procure and contract for) health care which provides high quality, safe and effective care to meet the health needs of the population we serve. The Clinical Commissioning Group Governing Body is chaired by a GP and includes four additional GP s from each geographical area, two lay members, a nurse, a specialist doctor from outside the area, a representative from the County Council a Public Health Specialist, an Accountable Officer and a Chief Finance Officer. The constitution we have agreed with our member practices sets out how we will work within the following areas: The governing structure (including the Governing Body membership and subcommittees) The roles and responsibilities of the Governing Body members and member practices Standards of business conduct The NHS North Derbyshire Clinical Commissioning Group (NDCCG) comprises 38 member practices with a registered population of 288,000 and covers five geographical localities, Chesterfield, Dronfield, High Peak, North Dales and North East. 1 Equity and Excellence: Liberating the NHS. UK Department of Health (2010) pdf [accessed 6/9/12] Page 6 of 50

7 The list below details the commissioning responsibilities of our clinical commissioning group. This list has been determined by the Department of health 2 and shows the statutory responsibility of our organisation to commission the following health services for patients registered with our member practices and for patients unregistered; however present within our geographical area: 2 The Functions of Clinical Commissioning Groups. UK Department of Health (2012) [accessed 10/8/12] Page 7 of 50

8 2.2 Our Values Our values, as determined by our member practices, define our culture and will shape our decision making. They are; 2.3 Our Vision Our vision is to work in partnership to deliver a patient centred, clinically led, evidence based approach to service commissioning 2.4 Our Mission Our mission is to improve the health and wellbeing of our population by commissioning high quality services through effective use of our resources 2.5 Our commitment to you We will behave with integrity, energy and enthusiasm. Our drive is to deliver improvements through innovation and the empowerment of individuals; be that patient, partner or colleague. Page 8 of 50

9 2.6 Our Guiding Principles We actively seek feedback from our patients, our members, our partner colleagues and the general public both to help us plan services and monitor the performance of the services we commission. During the spring of 2012 we held a series of events across the North Derbyshire health community to discuss with our patients, staff and the general public both the changes taking place in the NHS, the current challenges we face and how we need to approach the difficult decisions we need to make. The feedback we received at these events has shaped our guiding principles and will be used as a basis to guide our decision making on behalf of our population. All services will be person-centred We will work in partnership with people needing care and their families and carers to provide care as close to the person s home as possible, and when appropriate support them to access the right care away from home. Care will be provided flexibly We will listen to and understand the person s complete needs and meet them by using all services and resources available. We will ensure that we will co-ordinate care across health, social care and voluntary services to ensure people receive the right care from the right service at the right time. Assumptions will be challenged We will have the courage to make changes for the better that will improve the patient experience and obtain the best value for money. We will embrace innovation and find new approaches to care based on sound evidence. We will commit to monitoring and publishing patient experience data to be accountable to those who use our services. People will be treated with dignity and respect We respect and value the people who use and work in health and social care services in Derbyshire and we will invest resources to support the health and well-being of our Page 9 of 50

10 communities. We will plan and deliver services partnership We will actively seek and listen to the views of people who use and work in health and social care in Derbyshire so that we can plan and deliver services in partnership and be accountable to them. Healthy lifestyles will be promoted We will support people to help them to make an informed choice about lifestyle and services and identify and provide extra support for those who need and want to make positive lifestyle changes. Page 10 of 50

11 Section Three Communications and Engagement Objectives The key communications and engagement objectives which support the CCG s vision and objectives are to: 1. Deliver a consistent and systematic approach to communicating and engaging with the public, patients, staff, clinicians and partners on an ongoing basis 2. Support staff and GP practices in identifying the appropriate opportunities, methods, tools and techniques for communicating and engaging with their target audience on an ongoing basis 3. Support effective delivery of the initiatives and related outcomes within the CCG s strategic and operational plans 4. Improve, monitor and manage the CCG s reputation with patients, the public and partners. The overarching communications and engagement plan will be supported by a range of targeted plans and frameworks, a number of which are presented later in this document. It is also supported by the Patient and Public Engagement Plan which provides more detail and focus for this area of work. However there will also be the need to develop specific plans for individual projects or issues e.g. winter, NHS 111 rollout, new service launches and consultations on service change. Page 11 of 50

12 Section Four Reputation Management Managing the CCG s reputation, and therefore the reputation of the NHS, is a key element of the communications strategy. According to the NHS Confederation the relative reputation of an organisation can have a significant impact on how successful it is and influences the organisation s ability to deliver high quality, safe and responsive patient care. Reputation can be defined as the combination of what you do, what you say and what others say about you. It is shaped by three elements, all of which influence what others say about you. Vision and values which drives what you do and how you behave Actions the manifestation of what you do Communications what you say MORI s Excellence Model 3 is a useful framework for thinking about relationships and reputation. The model sets out a hierarchy, starting with awareness (familiarity) and leading to advocacy. advocacy commitment satisfaction transaction trust (favourability) awareness (familiarity) 3 Peter Hutton, (1998) "From Awareness to Advocacy", Measuring Business Excellence, Vol. 2 Issue: 1, pp Page 12 of 50

13 The model suggests a cycle of success, i.e. as people move up the hierarchy, each level reinforces previous ones, so that advocates go on to develop awareness and trust amongst others at different levels. It is expected that the numbers of individuals/groups in each section of the pyramid decrease towards the top, as the rising stages also signify the increasing level of contact with the organisation. The model is supported by extensive evidence that familiarity is closely linked to favourability, i.e. that the more familiar people are with an organisation, the more likely they are to have a favourable attitude towards it. This model is applicable to all stakeholders and is useful for mapping the way in which different populations or groups could be expected to behave towards the CCG, and hopefully how they are moving up the pyramid. For example, members of the general public with minimal or no health issues are unlikely to reach the transaction stage and so therefore would only be targeted with the aim of raising their awareness and attempting to gain trust and favourability. A service user with complex needs, i.e. a patient with longterm conditions, has the potential to rise through the levels as they have increasing contact with the system and reach a minimum level of satisfaction, following contact with our commissioned services. There are clearly greater opportunities for increased satisfaction and advocacy through those who have increased contact with the system and the services. In the same way, this model can be applied to the relationships the CCG has with a commissioned service provider, or member of staff and therefore provides a model for relationship management with all stakeholders. Page 13 of 50

14 Section Five Stakeholder Mapping and Analysis Clearly, the Communications and Engagement Strategy needs to identify its target audiences or key stakeholders. Stakeholder mapping can be done in a variety of ways: geographically, group membership, interest in the CCG, demographics etc. Stakeholders may also be organisation, issue or event focused i.e. interested in the CCG per se; interested because of an issue which affects them, or interested because of a planned event. Once stakeholders have been mapped, there are a number of tools which can be used to analyse them to inform how and when to communicate with them. One of the most common is based on Mendelow s 1991 model 4 which focuses on stakeholders relative power and interest. As shown below, this suggests different approaches depending on where in the matrix stakeholders sit. high keep satisfied manage closely power minimal effort keep informed low interest high However, this model is not static. For example, while MPs have high power, for most of the time they will have limited interest in the CCG, so fall into the keep satisfied quadrant. However, if an issue arises which directly affects their constituents e.g. a service change in their area - they will swiftly move to being a key player. It is therefore important to review the stakeholder analysis as new issues arise or new plans are developed. 4 A. Mendelow, Proceedings of the Second International Conference on Information Systems, Cambridge, MA, 1991 Page 14 of 50

15 Key players can be further analysed in terms of how active and/or supportive they are, as shown below. This can help to identify who the CCG may want to enlist the advocates and who we may need to stimulate so that they become advocates the dormant. high opponents advocates Active apathetic dormant low Supportive high Seeking to understand stakeholders in this way makes our communications and engagement plans more robust and effective, and can save time and resources. A high level stakeholder map can be found at Appendix Two. This will be updated as required, and may need to be expanded for specific issues. Essentially our target audiences or key stakeholders are: Practices Staff and Governing Body members NHS organisations (local, regional and national) Local and national government Patients and the public The media (as a key communications channel for all other stakeholders). A database of contact details for all stakeholders has also been developed. This includes contacts for the diverse communities covered by NHS North Derbyshire CCG, as identified below. ND CCG serves a diverse population, from the busy towns of Chesterfield and Buxton to the rural villages of the Dales and High Peak. Chesterfield locality covers the largest town in north Derbyshire with a population of approximately 101,000 with a small ethnic population of about 3%, mostly Asian and Chinese. The health of people in Chesterfield is mixed compared with the England average. Deprivation is higher than average and life Page 15 of 50

16 expectancy for men is lower than the England average. Dronfield locality has a geographical area of 14 square kilometres and has a population of approximately 23,000 people. Dronfield s population has increased dramatically in post war years from 6,500 in 1945 to its current size. The population is generally older than the average across Derbyshire County, particularly across the 65+ age groups. North East locality covers a geographical area including Eckington, Killamarsh and Bolsover, with a registered population of 42,000 people. The population of this locality has a similar profile to the average in Derbyshire County with marginally older 65+ population and, in recent years, a small but growing Eastern European community. Dales locality covers the rural area north of the Dales from Matlock to Hope, representing a population of almost 50,000, from nine practices. High Peak is a very rural area that lies at the north western tip of Derbyshire. High Peak has an older population than average with a significant representation of people aged 45 and over. The ethnic composition is of 98.7% white. Page 16 of 50

17 Section Six Internal Communications Plan (Staff, Governing Body and Practices) 6.1 Target Audience CCGs are membership organisations in that all GP practices must align themselves to a CCG. Communications with constituent practices will need to ensure that clinicians, GPs and their staff feel that they are well informed, and involved in the CCG s business through genuine two-way communications. This Plan focuses on ND CCG member practices as well as the usual internal audiences of staff and Governing Body members. 6.2 Objectives This plan relates to our first, second and fourth key objectives on page 11 and the specific objectives of this part are to: Keep staff, Governing Body members and practices informed about the development of the CCG, its activities and other relevant issues affecting the organisation Engage staff, Governing Body members and practices in the development of the CCG Support staff, Governing Body members and practices to enable them to contribute to effective communications and engagement 6.3 Channels Web-based communications The CCG is developing a website which will initially have an internal focus, aimed at staff, Governing Body members and member practices. It will be visible to the wider public, but will have a password protected area which will act as an intranet for the CCG and member practices. Printed materials The CCG produces a quarterly newsletter for staff, Governing Body members and Page 17 of 50

18 practices. Events and meetings Staff time outs are held each quarter, as well as monthly full team meetings. Governing Body meetings are held every month in public and development sessions are held every other month. The Clinical Reference Group meets monthly and most Locality groups meet either monthly or six weekly. Activity Plan Activity Details Timescale Chief Officer s weekly An e-update is sent to all practices and staff Weekly update which includes key items of information and a selection of top clinical tips which are developed by GPs and secondary care colleagues. See Appendix Three Media training Media training is provided for senior staff and As required Governing members by the Communications Team ND CCG Newsletter E-newsletter to staff, stakeholders and practices Quarterly See appendix 4 Staff Time Out event Regular events which allow more time for discussion and development activity than team meetings Quarterly Locality Stakeholder Groups Patient Participation Groups (PPG s) Stakeholder engagement with locality stakeholder s and patients Practice PPGs contribute to the continuous improvement of services; ensuring practices are more responsive to the needs and wishes of patients. November 2012 Twice a year Monthly PPG Network in some CCG localities is in place and discusses issues that they wish to work on together or to learn from each other. Representatives from PPGs will be nominated to sit on the Stakeholder Forum for the CCG Quarterly Page 18 of 50

19 Activity Details Timescale Practice membership events Regular events to bring all member practices together and to hold the Governing Body to account. At least three times a year Practice QUEST sessions which focus on professional development training Locality QUEST sessions Website Available to the public with a member log in section for practices and CCG staff. Improvements are made on a regular basis as it develops further. Practice representation Five GP s on the Governing Body, five localities each with a clinical locality Lead. Clinical Reference Group represented by five GP Governing Body members and Locality Lead GP from each locality. Locality meetings Locality Meetings focus on locality plans, contract management and specific topic represented by GP s, practice managers, Review Communications Plan practice staff and patient representatives. Review progress and objectives and agree Communications Plan for 2013 Quarterly In place but developing Monthly Monthly January Page 19 of 50

20 Section Seven Stakeholder Management Plan 7.1 Target audience A stakeholder is any group or individual who can affect or is affected by the achievement of the organisation s purpose and objectives. (Freeman, 1984). For ND CCG these include staff, providers, NHS colleagues, politicians and other public representatives, community groups, patients and the public. A high level analysis of these groups can be found at Appendix Two and a detailed database has also been developed which breaks this down further. Some stakeholders are easy to communicate and engage with because they have a direct interest in the CCG and its achievements. However the CCG must also strive to include those who are easy to overlook. This may involve the translating of key documents and information, and the use of alternative communications channels such as social media to reach different groups. Public and patient engagement is a key area for the CCG and one which we want to ensure is at the forefront of our thinking. This Communications and Engagement Plan is therefore supported by a Patient and Public Engagement Plan which provides more detail and focus for this area of work. 7.2 Objectives As stated in Purpose of the Plan in part one above, our overarching strategic intent is to move from the current low level of awareness of the CCG towards the desired vision of the CCG. This means starting to raise awareness of the CCG with a view to building familiarity and trust in the CCG as set out in Reputation Management. This plan supports key objectives 1, 3 and 4 on page 11. The specific objectives for this part of the plan are to: Keep stakeholders informed about the development of the CCG, its activities and how this might affect them Ensure all stakeholders have the opportunity to engage with the CCG as appropriate Ensure that the communications and engagement needs of the different communities within the CCG are met through the use of appropriate communication channels and methods Page 20 of 50

21 7.3 Channels Web-based communications The website is currently a small scale site aimed primarily at staff and practices. Consideration needs to be given to how a more public facing site is developed following authorisation. In time Facebook and Twitter accounts may be set up, but the objectives and management of these needs to be clearly established. Practice-based communications Practices provide a massive opportunity to regularly communicate and engage with the CCG s largest stakeholder group their patients. The CCG therefore needs to work with practices to enlist their support in communication about the CCG through websites, practice leaflets, waiting room information and Practice Participation Groups. Media relations ND CCG is committed to developing good working relationships with key local media contacts and journalists to ensure that its views are accurately reported and represented and ensure a balance of positive coverage. Printed materials The CCG does not currently produce a public facing newsletter. However, opportunities should be explored for providing copy for other organisations' newsletters for example parish councils, voluntary sector organisations and community newspapers. Provider and partner communications Increasingly, the CCG s core business and decisions made will be of interest to providers and partners. We will look at options for communicating key areas of work through existing meetings, and determine what additional communications may need to be developed. Paid for advertising Advertising will be used where there are clear objectives and where evidence shows the media to be used has effective reach with target audiences. Community and patient groups These provide opportunities to engage with existing, well-established groups. A database Page 21 of 50

22 of local groups is being developed, including those which are harder to reach. Details of the various channels used to engage with our public and patients are provided in the accompanying Public and Patient Engagement Plan. Activity Plan Activity Channel details Timescale Chief Officer s weekly An e-update is sent to all practices and staff which Weekly update includes key items of information and a selection of top clinical tips which are developed by GPs and secondary care colleagues. (See sample of top tips in Appendix Three) Regular programme of Chief Officer and Clinical Leader to meet with November media releases Public Governing Body meetings local media editors and regular releases issued Meetings held in public every month 2012 Monthly Review results of 360 survey Website 21 st Century Health and Social Care Programme Membership of Health and Wellbeing Boards Maintain database of contacts Campaign programme Practice Participation Groups Stakeholder Event The 360 survey should provide some useful insight into the current reputation of the CCG. The Communications Plan will be reviewed in the light of the results Available to the public with a member log in section for practices and CCG staff. Improvements are made on a regular basis as it develops further Major engagement initiative around integrated care across north Derbyshire which will involve a wide range of stakeholders and the public Regular communications with partners via the clinical leadership on the H&WB A comprehensive database of contact details for key stakeholders, including the seldom heard groups, is being developed A full programme of public campaigns is being undertaken including flu immunisation, and winter wise. Where appropriate campaigns will follow social marketing principles and processes. Support to PPGs and regular meetings Involves a wide range of stakeholders from statutory, community and voluntary sectors. Others have invited the general public to help them to understand the role of the CCG and to engage them in its aims and objectives. October 2012 Ongoing in place Summer 2012 onwards Ongoing - in place Ongoing - in place Ongoing - in place Ongoing Three times a year Page 22 of 50

23 Stakeholder Forum In development Bi monthly or quarterly Develop use of Set up a page which links to the health community TBC Facebook Facebook page Public Launch An official launch the CCG. Public, stakeholders and media invited and interviews given. TBC NHS Provider Briefings E mail newsletters and articles for provider TBC intranets to keep provider staff informed of developments. Website Podcasts Interviews and features to keep the public informed. TBC Page 23 of 50

24 Section Eight Media Management The media has a vital role to play in influencing the reputation of the CCG. The CCG will need to develop good working relationships with key local media contacts and journalists to ensure that its views are accurately reported and represented and ensure a balance of positive coverage. Media relations also act as a tool to support the engagement with patients and public, ensuring they have access to correct information about local health care through all relevant channels. The Communications Team will support the CCG as follows: Media monitoring and reporting Monitoring press clippings relating to the ND CCG patch and providing regular reports and responding as appropriate. Publicity and Rebuttal Building and maintaining a good reputation with patients and the public. We will proactively target local and regional media to promote new services, quash negative rumours and communicate information on the development of the CCG. Press enquiries The Communications Team will field and log daily press enquiries. Appropriate responses will be drafted and spokespeople briefed for interview. Building relations with media Maintaining a good relationship with key journalists will ensure a two way flow of accurate information is maintained. The CCG Clinical Leader has already been featured in a number of pieces in the Derbyshire Times. An extensive database for media relations has been developed and will continue to be monitored and amended to reflect any changes to media. Page 24 of 50

25 Media Training A number of Governing Body members and senior staff have already undertaken training for media interviews and this will continue to be provided as a service to the CCG as required. Media Activity Plan A Media Activity Plan is continually updated as new stories emerge from the CCG, and to take advantage of national stories which can be given a local focus. Social Media The continuing growth of the internet, and particularly the use of social media, means that the CCG cannot rely solely on traditional print and broadcast media to manage its reputation. However, effective involvement in social media sites is time-consuming, and the CCG needs to be clear of the objectives of such involvement. This is something which the Communications Team will work with the CCG on following authorisation. Page 25 of 50

26 Section Nine Crisis Communications Framework 9.1 Introduction A crisis can be defined as a serious incident affecting, for example, human safety, the environment, and/or service or corporate reputation - and which has either received or been threatened by adverse publicity. In terms of management time and resources, communicating with the many outside audiences - especially the media - can involve as much time and effort as the crisis itself. And it is often the publicity that will cause ongoing problems, not the damage from the actual crisis. 9.2 Objectives Specific objectives will need to be identified depending on the nature of the crisis. However, the essential objectives are too: Establish a communications response as soon as possible Take control of as much of the communications as possible Ensure all communications are accurate and timely Prepare for the ongoing communications. 9.3 Target audiences These will change depending on the circumstances of the incident, but are likely to include the following groups of people: Patients/public involved in the incident The wider public Staff involved in the incident Other staff Partner organisations NHS Midlands and East The media local and national Page 26 of 50

27 9.4 Key messages and styles Consider communicating some or all of these core messages in a crisis: Details: as much information about the incident as possible. Human Face: we care - sympathy, concern, understanding; maybe regret; possibly even sorry. Reassurance: No further risk; what to do if worried; one in a million; etc. What We Are Doing About It: especially a thorough (independent) investigation. Track Record: independent assessments of how good you are. Further Information: when and where further information will be available. Numbers for information hotline or helpline. Your own side of the story may be open to cynicism, so include evidence to support this from others. 9.5 Actions The basic actions required in dealing with crisis communications are as follows: Ensure communications input/link to Major Incident and/or Business Continuity Team or incident team Decide on communications response and approach Identify the audiences Decide on the key messages Agree/release a holding statement Agree spokesperson and brief them Continue to provide information and reassurance Start to think longer term as soon as you can. The following questions are useful when assessing the crisis and formulating the communications response: What precisely has happened? Do we all have the same understanding of the situation? Is there a more fundamental problem? Could this become a broader issue? Is there more to come? What is the worst case? Prepare for it just in case. What are the audiences likely to make of it? Step outside the crisis and imagine what it s like looking in from the outside - for the worried local community; the staff Page 27 of 50

28 who are only just learning what s happened; the opportunist politician; the official; the other audiences - especially the media? What are the likely time scales? How long before the various media start going to bed with the story? How long is the crisis likely to run? What is actually at stake? Are we panicking unnecessarily? Can we involve any allies? Would our messages come better and more credibly from someone else? Who else is (culpably) involved? If someone else is at fault, how can you make this clear without you appearing to try to pass the buck? Can the spotlight be transferred? Are there other positive stories - human interest stories, for example, such as the heroism of the staff? Can the crisis be contained? Or can you narrow the issue down to a single location, venue or event? All communications should involve support from experts in Communications. Should the incident be a major disaster such as a terrorist attack or explosion the police or other appropriate emergency service will take the lead, following multi-agency major incident protocols. A lessons learned exercise should be undertaken after the event to inform future crisis communications planning. Page 28 of 50

29 Appendix One Brand Development Outcome Brand Marks and Spencer John Lewis Honda Levis J & J Amazon Co-Op Aston Martin Virgin Body Shop Waitrose Boots Pizza Express Apple Dyson What they stand for and why you admire them Best Excellent Customer Service / Exceed Customer Expectations Quality - although??? Good for employees They can make mistakes but retain credibility Quality Best Excellent Customer Service / Exceed Customer Expectations / Initiative and different quality Owned by employees Customer focused, quality, inclusive Good products, high quality, reliable Quality rules of the organisation, membership model Membership, Quality, customer services Membership, Culture and business model They are considered high quality but at a fair price High engineering standards, efficient, reliability Standard product you can trust, hard wearing Family Business Simplicity / value / customer service Corporate tax dodgers Efficient, Choice, Informative, Cost effective Fair Trade Community and Membership scheme Ethical and Local Aspirational, Quality, Best Innovative, energetic yet corporate Quality but also Branson s way of working supports out attitude as CCG e.g. his book screw it, let s do it Walk the talk Ethical, simply says what it is Good quality products, good service. Reliable Good products, ethical, good service, reliable, accessible, customer focused Fresh produce visibly produced open kitchen Innovation, challenge status quo Innovation and delivering what customers want, creating demand Technologically at top of ipad / ipod They produce products that people covet Innovation, challenge status quo Page 29 of 50

30 Brand McDonalds Oxfam Gucci Patagomia VW, BMW & Audi Tesco Thompson / 1 st Choice ASDA What they stand for and why you admire them Same offering each time, consistency of quality Ethos Quality product. Great reputation Technically good and aware, competent. Products that perform well and last a lifetime Reliability, quality Reliable, Accessible Trusted, not fold or collapse, staying power / risk Consistently supermarket of the year and first to do you said, we did How you would like the CCG to be perceived? Insightful Small Respectful Visionary Approachable Complex Modern Modest Holistic Exciting Caring Clear Progressive Confident Simple Fascinating Understanding Durable Safe Aspirational Sturdy Genuine Proud Formal Team spirited Inspirational Conservative Heritage Ethical Trustworthy Feminine Honest Natural Masculine Green Knowledgeable Process driven Young Wise Evidence based Old Sexy Passionate Independent Dynamic Entrepreneurial Flexible Cool Pioneering Integrity Fashionable Innovative Intuitive Fresh Exclusive Focused Contemporary Quality Open minded Love a challenge Powerful Service Energetic minded Reliable Customer Positive focused Solidity Accessible Optimistic Systematic Strong Informal Page 30 of 50

31 Technical Responsive Value for money Successful Big Human Transparent Responsible What is the ND CCG NOT about? Fire fighting, following others Just doing enough We are not uncaring We are not about stopping care Empire Building Change for changes sake Not about restricting access Not about making decisions without asking your opinion Not about recreating the old system Not about being distant from our public Delivering the same old services We are not the same as a PCT (!) Self-interest individually or organisationally Status Quo A paternalistic model Doing things in the same way as we have always done Accepting poor standards because that s what we have always had Doing it our way, wasting money and resources Working in isolation without input from patients / public and clinicians We are not a box ticking organisation We are not an old PCT rehashed We are not looking for individual glory (!) Not putting patients at the heart of decision making We are not ineffective We are not driven only by self motivation We are not about making unnecessary changes Making false promises Not about rationing healthcare / choice Not about providing a poor quality service Not about using resources to build empires Not about divided teams as directorates Not about a bureaucratic PCT Top Down approach Bureaucratic North Derbyshire does not revolve around the CCG Breaking away from difficult decisions Bureaucracy Accepting the status quo Being critical. Pointing the finger We are not focused just on what s best for our ND patients, we want to improve the quality and service for all Derbyshire Delivering change at any cost, must be achievable by staff and others and wellbeing is important We are not just going to talk and plan and not do We are not a group of disparate people Page 31 of 50

32 What is the essence of the CCG? Passionate, inspirational, patient focused and providing quality care. Passionate about putting patients at the heart of.. Responsive Integrity / Trustworthy / caring Trustworthy and caring Here for you Customer focused and ethical Visionary Responsive Pioneering Customer / person focused, transparent and innovative Progressive Passionate believing it Quality Innovative, customer focused, safe or inclusive A different organisation that will be responsive to the needs to both staff and public Page 32 of 50

33 Appendix Two Stakeholder Map The high level stakeholder map below identifies key groups, provides some analysis of those groups, and suggests their position on Mendelow s matrix. Group Analysis Stakeholders Matrix position Practices Characteristics: CCG members Increasing influence Support to deliver initiatives Work together to manage financial challenge Needs and interest: To develop as provider organisations To contribute to strategic direction and priorities To identify key challenges To work together Potential: Influence direction of travel Facilitates joint working Ambassadors of the CCG Risks: May pursue conflicting direction of travel Mixed messages for staff and patients Member practices in North Derbyshire Manage closely Page 33 of 50

34 Group Analysis Stakeholders Matrix position Staff and Governing Body Staff (cluster/ccg) Manage closely Characteristics: Commission services Manage transition and day to day business Wide and varied influence over other groups, including patients Needs and interests: Regular information to enable them to do their job effectively Understand what is expected of them Understand what they can expect from the organisation Need to be valued Potential: Ambassadors of the organisations Committed to achieving the vision Risk: Undervalued, de-motivated Reluctant to change Critical of the organisation in public The Governing Body Staff side representatives Page 34 of 50

35 Group Analysis Stakeholders Matrix position Patients and public Existing patients Characteristics: Central to everything we do Receiving a service Tax payers Have wide and varied influence Need and interest: A good patient experience/customer service Information at a potentially vulnerable time and to support informed decisions about health and wellbeing Knowledge and information about where to get help when needed Assurance that they will get the care they need when they need it Information about how the money is being spent Opportunity to feed back and feel listened to Opportunity to engage in the design/redesign of services Potential: Help us to achieve our vision Valuable feedback Ambassadors share good experiences Help to shape services based on first hand experience Risks: Complaints and negative feedback through MPs, media etc. CCG fails to listen potentially continue to make same mistakes Accuse of not delivering/wasting public money Disengage from health services General public Communities of interest ( BME, seldom heard, people with disabilities, children and young people, older people, users of mental health services, homeless, immigrants) Community groups LINk/Healthwatch Keep informed manage closely for specific issues Page 35 of 50

36 Group Analysis Stakeholders Matrix position Partners in new NHS Manage closely Characteristics: Future commissioners Increasing influence Support to deliver initiatives Work together to manage financial challenge Needs and interest: To develop as organisations To agree a strategic direction and priorities To identify key challenges To work together on transition Potential: Influence direction of travel Develop through transition to effectively take on PCT functions Clinical and elected member support for change Facilitates joint working Risks: May pursue conflicting direction of travel Failure to develop sufficiently as organisations Mixed messages for staff and patients Clinical Commissioning Groups Health and Wellbeing Boards NHS Commissioning Board NHS CB Local Area Team Commissioning Support Units Page 36 of 50

37 Group Analysis Stakeholders Matrix position Providers Characteristics: Acute, mental Manage Provide services health and closely Work alongside to deliver services community Support to deliver initiatives Foundation/Trusts Work together to manage financial and other NHS challenge organisations Needs and interests: To know where we are going /our Independent strategic direction contractors To understand how they can fit into GPs, the strategic direction Dentists, To have an overview of our priorities Ophthalmologists, and challenges Pharmacists To understand our position on Local professional specific issues that impact on them committees e.g. GP opening hours and urgent (LMC, LOC, LDC, care LPC) To understand our short, medium and long term intentions Local authority To influence our direction of travel Independent with specialist knowledge and providers experience Potential: Third sector Supportive of direction of travel providers makes it easier to take forward More co-ordinated approach patients only see one NHS Facilitates joint working Better proposals with more contributions from front line staff and patients Risks: May pursue conflicting direction of travel/projects Mixed messages for staff and patients Less likely to work in partnership May block proposals Confusion for patients and public Poor joined up working Page 37 of 50

38 Group Analysis Stakeholders Matrix position Political (local) County Councillors Characteristics: Protecting the interests of constituents/local population Supporting political beliefs Striving to see improvements Key opinion formers Highly influential Need and interest: Understanding of the strategic direction of the organisation Regular updates and briefings on key issues or hot topics Involvement in issues and hot topics at an early stage to ensure they have a full picture Assurance around improvement Assurance around patient experience Assurance re response to constituents issues and concerns Awareness and involvement in achievements Potential: Able to influence publically if supports a project/issue Able to influence politically Frequent contact with constituents and media able to act as ambassador/spokesperson in some areas An independent spokesperson Can contribute to discussions and developments from wide breadth of background/contacts Risk: Very high profile if not in the loop or in agreement with a project Able to raise issues in Parliament First port of call for media for comment on issues and challenges Able to refer to review panels if don t feel a process has been followed correctly (OSC) delaying process District and Borough Councillors Parish Councillors Members of Parliament Improvement and Scrutiny Committee(ISC) Health and Wellbeing Board Keep informed manage closely for specific issues Page 38 of 50

39 Group Analysis Stakeholders Matrix position Government Characteristics: Set policy and drivers Set performance targets and standards Need and interest: Assurance of improvement NHS Commissioning Board Department of Health Keep satisfied keep informed on specific issues Assurance of meeting targets and legislation Care Quality To know when things are causing Commission concern Heads up on key/controversial Monitor issues Potential: Supportive and flexible in making things work Sharing best practice Championing innovative work Light touch approach/left to get on with the job Risk: Concerned over lack of assurance so intervene more Raise concerns in public Put intervention measures in place Demand more assurance Impose or prevent change Page 39 of 50

40 Group Analysis Stakeholders Matrix position Media Characteristics: Local print and Keep Present a high profile view of issues broadcast informed of interest to local population manage Can be seen to dwell on the Regional print closely for negatives to make a good story and broadcast specific Excellent mechanism for getting issues messages out to general public and Information patients websites BBC has public service responsibility (community information, Pre-recorded Communicating in a crisis etc.) video stations in Need and interest: GP Human interest stories Surgeries Prompt response to queries Information about things that improve things for local people New information that has not been covered elsewhere Contact with real people staff and patients Potential: Excellent mechanism for getting information to patients and the public and other key stakeholders Recognition for staff and patients Ability to discuss issues and present a balanced argument Accurate and timely information leads to better quality coverage Risks: Story is blown out of proportion Damages the reputation of the organisation Does not provide a complete picture of an issue or incident Use of FOI to fish for stories Page 40 of 50

41 Appendix Three Clinical Leaders Top Tips Clinical Top Tips Week Commencing 11 th March 2012 Consultant suggestions regarding general management of patients: 1. Discuss with the patients whether they actually want surgery before deciding whether to refer or not. Consultants across many surgical specialities come across patients who are only too happy to be discharged without surgical intervention! 2. Refer for surgery when patient ready, not when patient wishes to defer surgery for 3m. 3. Tumour markers: This are often being used by some GPs as a screening test. They are generally not effective for either screening, case finding nor diagnosis, but for monitoring or other research purposes. CA125: Use only as per NICE guidance where Ca. Ovary suspected Use of CEA, Ca19.9 et al in newly referred patients with no diagnosis make further investigation difficult to avoid, and explanation to patients difficult. Please do not use. Only PSA is specific enough to direct referral. Restrict PSA testing to men with: - o Abnormal feeling prostate glands o Who request screening after counselling o A patient with a likely underlying malignancy with no obvious primary focus. 4. Consider inviting a Specialist to shadow a day in General Practice: There s a lot to learn both ways! Clinical Top Tips Week Commencing 1 st April 2012 Respiratory medicine: 1. Antibiotics for exacerbations of asthma no evidence! 2. All bed-bound patients in nursing homes should have a RightCare management plan Re. possible pneumonia to avoid admission whenever possible. 3. Send sputum for exacerbations of bronchiectasis: Use10-14 day antibiotics courses in bronchiectasis. Geriatrics: 1. Every "take" one or two patients are admitted from nursing homes where active hospital Page 41 of 50

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