Better communication, better engagement, better health Integrated communication and engagement strategy for Trafford s Pathfinder Clinical

Transcription

1 Better communication, better engagement, better health Integrated communication and engagement strategy for Trafford s Pathfinder Clinical Commissioning Group

2 Contents Page 3 Page 4 Page 7 Page 9 Page 12 Page 13 Page 16 Page 17 Page 26 Page 31 Page 32 Page 33 Chapter 1: Introduction Chapter 2: Context and background Chapter 3: Involving all stakeholders in CCG development Chapter 4: Strategic communication and engagement approach Chapter 5: Communication and engagement objectives Chapter 6: Stakeholder mapping Chapter 7: Messaging Chapter 8: Engagement Chapter 9: Communication Chapter 10: Integrated campaigns Chapter 11: Evaluation and evidence Appendices: Appendix A Primary care briefing Appendix B Trafford Talks Health magazine Appendix C Trafford CCG website Appendix D Detailed list of stakeholders 2

3 Chapter 1: Introduction 1.1 The NHS was created more than 60 years ago to ensure that people are able to receive healthcare based on need and not ability to pay. The NHS is one of the most trusted brands in the world, and there are high expectations of any organisations which carry, and are therefore guardians of, its name and reputation. This could be seen as even more key for Trafford organisations due to its heritage as the birthplace of the NHS. 1.2 There is a wide range of evidence to support the significant contribution that effective communication can make to improving organisational effectiveness and performance. According to a study by Capgemini Ernst & Young in 2003, between 80 to 85% of the market value of the top 500 US companies was comprised of intangible assets such as reputation. And when looking at the impact of reputation on customer loyalty, a study of the US airline industry by M. Graham and P. Bansdal in 2007 found that for each one-point increase in an airline s reputation, consumers were willing to pay $18 more for a plane ticket. In short, there is much evidence that reputation is a key contributor to the health and performance of businesses. 1.3 The evidence that communication makes a vital contribution to organisations applies to public services as well as to businesses. Over the years, the survey research organisation Ipsos MORI has developed a substantial amount of data related to the overall performance of local public services and their communication effectiveness. 1.4 Within the NHS, it found that better-performing trusts committed more resources to communication, were more likely to have marketing strategies in place, and had communication teams that were more influential. It also found that staff in trusts rated as excellent were significantly more likely to understand their roles than those in weak-performing ones Trafford s clinical commissioning group needs to carry out meaningful communication and engagement on an ongoing and long-term basis, as this is vital for developing a sustainable and effective future for it as an emerging NHS commissioning organisation. 1.6 This document provides a strategic framework and blueprint for how Trafford s Clinical Commissioning Group (and the emergent authorised NHS organisation in 2013), can use effective communication and engagement with all its stakeholders to help deliver its strategic mission, values and aims. 1.7 Best practice in communication and engagement is reflected throughout the strategy, taking an integrated approach to delivering patient and public involvement, stakeholder relations, reputation and crisis management, PR, media relations, internal communications, online communications, events and marketing. 1 The Communicating Organisation, 17 December 2009, Department of Health 3

4 Chapter 2: Context and background 2.1 Trafford s Pathfinder Clinical Commissioning Group GP commissioning in Trafford started with two GP practice based commissioning (PBC) clusters that matched the then Trafford North and Trafford South primary care trust footprints Trafford North and Trafford South merged to become Trafford Primary Care Trust (NHS Trafford) on 1 October 2006, and in September 2010, the two Practice-Based Commissioning areas came together to form a shadow board for GP commissioning in the borough: Trafford Commissioning Consortium. The Consortium, which featured membership from almost all of Trafford s GP practices, was awarded pathfinder status by the Government in December On 1 April 2012 a shadow committee was formed for a Trafford Pathfinder Clinical Commissioning Group (CCG). This committee will steer the CCG through the authorisation process for it to become a statutory NHS commissioning organisation when primary care trusts are abolished on 1 April The committee will become the governing body of this organisation and the member practices will form the GP Council The CCG s commissioning responsibilities will differ to that of primary care trusts in that it will hold less of the local commissioning budget and commission less activity overall, however, the principles of good communication and engagement will still need to be held by the CCG as it will still be responsible for commissioning key services, such as secondary and community healthcare Its responsibilities with respect to communication and engagement are outlined as functions as follows: I. To secure public involvement in the planning of commissioning arrangements and in developing, considering and making decisions on any proposals for changes in commissioning arrangements that would have an impact on service delivery or the range of health services available. II. To co-operate with relevant local authorities and participate in their health and wellbeing boards and other NHS bodies. III. Act with a view to securing that health services are provided in a way that promotes the NHS Constitution, and promote awareness of the NHS Constitution amongst patients, staff and the public. IV. Promote the involvement of individual patients, their carers and representatives where relevant, in decisions relating to the prevention or diagnosis of illness in them or their care and treatment. V. Act with a view to enabling patients to make choices about aspects of health services provided to them. 4

5 VI. To consult patients and the public in developing, or making significant revisions to, the commissioning plan. To ensure that any published commissioning plans (including revised plans) include a summary of views expressed during consultation and an explanation of how the CCG too account of these views. VII. To involve each relevant health and wellbeing board in preparing or making significant revisions to the commissioning plan, consult with them on whether the draft plan takes proper account of each relevant JHWS, and ensure that any published commissioning plans (including revised plans) include a statement of their final opinion. VIII. To publish and annual report on how the CCG discharged its functions in the previous financial year, with particular reference to how it discharged its duties in relation to quality improvement, reducing inequalities and public involvement, and contributed to the delivery of joint health and wellbeing strategies (on which the relevant health and wellbeing boards must be consulted. IX. To hold a meeting to present the annual report to the public. X. To have a published constitution that sets out the arrangements made by the CCG for the discharge of functions and: 2.2 Engagement a) How the CCG will make decisions, how it will deal with conflicts and potential conflicts of interest of members, employees, governing body members and members of CCG or governing body committees and sub-committees, how it will ensure transparency for its decisions and how it will ensure effective participation of all its members. b) Public involvement in planning commissioning arrangements, and in proposals and decisions concerning changes to those arrangements that would have an impact on services delivered, and a statement of the principles, which the CCG will follow in implementing the arrangements Engagement is not just about talking to people. Real engagement is about fully involving patients, the public, local communities and wider stakeholders in decision-making processes. Engagement does not just mean consultation. Consultation is a type of engagement, as the function of engagement reaches far wider in ensuring that people s views are taken into account during healthcare commissioning at every step of the way. Good commissioning needs patients and the public at its heart. 3 2 The functions of clinical commissioning groups, 12 June 2012, Department of Health 3 Better health, better experience, better engagement, August 2001, Department of Health 5

6 2.3 Communication Good communications is two-way symmetric, in that it relies on honest, open communications that fosters mutual understanding. 4 Doing communications well is not just about ensuring there is a system in place for dealing with journalists, or providing a function for producing leaflets. Good communications should be an intrinsic part of every organisation, from the way staff are treated by their managers to fostering an open and transparent culture. 4 Managing Public Relations, 1984, James Grunig and Todd Hunt 6

7 Chapter 3: Involving all stakeholders in CCG development 3.1 Clinical leadership is key in Trafford, which can be evidenced by the CCG s organisational structure and focus on commissioning integrated care that is clinically-led and patient-centred. 3.2 GP leads and commissioning managers regularly visit practices in Trafford to discuss performance and key issues. 3.3 All this builds on work that began in 2008, where a clinical congress took place in Trafford. The congress was designed and developed with the input of clinicians, and was attended by health professionals and patient representatives from across the borough. Delegates discussed service development resulting in a powerful mandate from the clinical community to begin to develop detailed plans to introduce integrated services in Trafford. 3.4 Future direction for health service commissioning and provision in Trafford was set following a programme of engagement with clinicians, key partners and stakeholders, patients and members of the public. This engagement was carried out through: I. Strategic partner engagement events focused on enabling key partner organisations to identify the potential priority areas for Trafford and then to shortlist those priorities in to key areas for delivery. II. Public focus groups across the borough of Trafford targeting the general public, seldom heard groups, young people, carers, service users and unemployed residents. The focus groups were designed to develop a broad understanding by a range of representative groups of the key local health issues, barriers, issues and areas of good practice recognised by the population, to identify high priority areas. III. Citizen workshop events to provide a platform for much deeper debate and give a richer picture about general attitudes, including the public perception on the vision and priorities. IV. Presentations where lead clinicians and commissioning managers have attended a variety of external forums, including local Overview and Scrutiny Committees. V. Active clinical participation in project workstreams involving lead clinicians. 3.5 This involvement activity has resulted in a strategic planning process that has secured ownership across the CCG, and the production of a series of plans that have broad ownership and support both across the organisation and within the wider economy. 3.6 Trafford s GP community was fully involved in developing the CCG s mission, values and aims (outlined in section 7.2 on page 16), and did this by undertaking two workshops in October and November

8 3.7 The first workshop was attended by a number of influential GPs, practice managers, practice nurses and commissioning managers, and presented the attendees with a series of key decision areas to facilitate a discussion on the purpose, vision and key governance principles of the emerging CCG. 3.8 The second workshop was attended by the same delegates as the first session, and was designed to engage the attendees in defining the mission, values and aims of the developing CCG, and also to identify organisational development needs. 3.9 The outcome of the workshops were developed further following presentation to the CCG s executive committee and Trafford s GP community and CCG practice membership. 8

9 Chapter 4: Strategic communication and engagement approach 4.1 As the CCG will only evolve into existence as an NHS commissioning organisation if it is authorised, the strategy has been developed for the 2012/13 authorisation year. However, the strategy also provides a framework for successful communication and engagement to be delivered to support the CCG s integrated plan and organisational development plan beyond authorisation through to 2013/ The engagement and communications objectives have been mapped to the domains that will be used to provide evidence for authorisation as part of the engagement and partnerships workstream. 4.3 Domain description, criteria and thresholds This domain (2), entitled, meaningful engagement with patients, carers and their communities, states that: CCGs need to be able to show how they will ensure inclusion of patients, public, communities of interest and geography, health and wellbeing boards and local authorities in everything they do, especially their commissioning decisions. They should include mechanisms for gaining a broad range of views then analysing and acting on these. It should be evident how the views of individual patients from the consulting room are translated into commissioning decisions and how the voice of each practice population will be sought and acted on The table detailing the criteria and thresholds is referenced as follows. 2.1 CRITERIA: Ensure inclusion of patients, carers, public, communities of interest and geography, health and wellbeing boards, local authorities and other stakeholders TRESHOLD: Constituent communities and groups within the population served by the CCG identified A EVIDENCE: CCG has mapped and analysed constituent communities and groups B 2.1.1C EVIDENCE: Analysis of the health needs of constituent communities and groups is reflected in CCG integrated plan. EVIDENCE: CCG has outline plans in place to communicate and engage with strategic partners and diverse groups and communities THRESHOLD: Engaged in health and wellbeing boards, the refresh of JSNAs and the development of the JHWS A EVIDENCE: CCG has engaged local authority/ties in establishing its geographic area B 2.1.2C EVIDENCE: CCG is engaged in shadow health and wellbeing board, is participating in refresh of JSNAs and in development of the JHWS. EVIDENCE: CCG integrated plan aligns with JHWS and enables integrated commissioning, depending on local time frames. 2.2 CRITERIA: Analysing and acting on information from engagement to translate into priorities for improvement. 2.2 THRESHOLD: Plans, processes and resources are in place to measure and use insight from patients, carers, partners and stakeholders to improve services 5 Developing clinical commissioning groups towards authorisation, Department of Health 9

10 2.2.A 2.2.B EVIDENCE: Arrangements in place to ensure appropriate on-going patient and public involvement in CCG decision-making. EVIDENCE: Systems and processes for monitoring and acting on patient feedback, and particularly in identifying quality including safety issues. 2.3 CRITERIA: Voice of each practice population to be sought and acted on. 2.3 THRESHOLD: Arrangements in place for patient views to be sought at practice level to inform and receive feedback from CCG priority setting. 2.3A EVIDENCE: Accountability between CCG and member practices is reflected in its constitution and in any broader governance arrangements. 2.3B EVIDENCE: Examples of CCG engaging different groups and communities through a range of communications channels in the development of its vision, plan, or in broader CCG decisionmaking processes. 2.4 CRITERIA: Views of individual patients are reflected in shared decision making and translated into commissioning decisions THRESHOLD: Arrangements in place to promote the involvement of patients and carers in decisions about their own care and treatment, including exercising choice A 2.4.1B EVIDENCE: CCG understands its statutory duties in relation to enabling patients to make choices and to promote the involvement of patients, carers and relatives in decisions about their care and treatment. EVIDENCE: Systems in place to convert insights about patient choice/s in practice consultations into plans and decision-making THRESHOLD: Plans in place to manage and respond to concerns raised about its own operations or the services it commissions, to monitor patient/ public perceptions of its responsiveness as a NHS organisation, and to learn from concerns raised to improve its performance A CRITERIA: Arrangements for handling complaints raised with the CCG are compliant with the statutory framework for complaints handling. Arrangements for handling concerns raised with the CCG deliver equivalent outcomes B CRITERIA: Arrangements for handling concerns and complaints raised with the CCG, and actions taken as a result, are clearly communicated to the public C CRITERIA: Clear line of accountability for patient safety including regular reporting to the National Reporting and Learning System Other authorisation domains that are also taken into account as part of this strategy: I. 1.1 Clear articulation of mission, values and aims II. 1.2 Clinical engagement member practices involved in decision-making III Demonstration of communicating vision and priorities to stakeholders, patients and the public IV Engagement with LINks, Healthwatch, patient groups etc V Commitment to promote constitution, including performance VI Demonstrate how other stakeholders understand and are aware of CCG priorities, plans and transparency / Member practices understand their local plan and priorities and receive timely information to inform their involvement of planning and delivery The potential to take the CCG beyond the authorisation process in terms of communication and engagement is also addressed as part of this strategy. The strategy will provide an overarching framework against which individual campaigns and tactical delivery plans will be implemented to support the CCG 10

11 in gaining authorisation by ensuring that it can effectively engage and communicate with all its stakeholders It is acknowledged that this strategy framework may need to change as stakeholders are given the opportunity to provide feedback on how they want to interact with the organisation It is also recognised that communication and engagement have some specific and in some cases, statutory functions, so further on in this document, the two areas are dealt with individually. However, as it is essential that communications is able to support engagement in its activities, and vice versa, the delivery will be fully integrated All activity will be carried out with a stakeholder management approach to ensure that types of audiences are dealt with in appropriate ways. 11

12 Chapter 5: Communication and engagement objectives 5.1 The following objectives have been put together, which are also mapped to the appropriate authorisation domains. Objective Establish and maintain effective mechanisms for patient and public involvement in commissioning processes and corporate conversations. Establish and maintain effective two-way engagement and communications channels with all stakeholders. Raise the profile of the CCG as the new and future commissioners in Trafford. Domain(s) Ensure the reputation of the CCG is protected at all times and crises are managed effectively. Provide patients with information using appropriate methods, such as communications, publications or marketing. Build relationships between the CCG and its general practice membership base using appropriate internal engagement and communications methods

13 Chapter 6: Stakeholder mapping 6.1 As all activity will be carried out with a stakeholder management approach, a range of stakeholder mapping work has taken place, which has helped to identify a number of stakeholder groups into 12 broad, common categories: I. CCG governing body II. CCG staff III. CCG practice members IV. Politicians and unions V. Clinicians / providers VI. Patient groups VII. Statutory partner organisations VIII. Community groups IX. Voluntary organisations X. Campaign / pressure groups XI. Specialist interest groups and individuals XII. The media 6.2 These broad categories have been segmented in more detail and we have undertaken a comprehensive stakeholder analysis to identify their level of interest and influence. At a very high level, this is outlined below, although they are detailed more specifically in the tactical delivery plan. 13

14 6.3 The stakeholder mapping results have then been used to determine how best to engage these groups based on the following criteria. Symbol Power/Interest High influence and high interest Low influence and high interest High influence and low interest Low influence and low interest Level of communication High-capacity methods. Highest priority Pro-active engagement and support. High priority (some of these stakeholders have more power to influence decisions, but they will need support to achieve this) Keep informed throughout. Low priority Information provision. Acknowledge right to participate. Lowest priority. If appropriate encourage desire to participate through targeted publicity. 6.4 Specific priority audiences that need to be taken into account as part of ongoing engagement and communications activity for the CCG include: I. Trafford Council Executive Team II. Trafford Overview and Scrutiny Committee III. Trafford MPs IV. Trafford councillors V. Trafford Health and Wellbeing Board VI. Trafford LINk / Healthwatch VII. Trafford Adult Social Services VIII. Trafford Children s and Young People s Service 6.5 Trafford CCG will also ensure it meets its obligation to engage and communicate with diverse communities and groups according to the protected characteristics as defined by the Equalities Act 2010 in the following areas that are traditionally under-represented: I. Age II. Disability III. Gender reassignment IV. Pregnancy and maternity V. Marriage and civil partnership VI. Race VII. Religion or belief VIII. Sex (previously known as gender) IX. Sexual orientation 14

15 6.6 Although on the whole common tactical approaches can be used for the individual categories, some specific groups, for example, particular special interest or pressure groups may need more individualised approaches depending on the situation at the time. 6.7 A more detailed breakdown of Trafford CCG s stakeholders can be found in appendix D (page 33). 15

16 Chapter 7: Messaging 7.1 It is essential that key messages are used consistently throughout all engagement and communications activity. 7.2 The core messages listed below relate back to the mission, values and aims of Trafford CCG Mission To ensure the provision of safe and high quality services are available in the right place for the right people at the right time, which are affordable and represent value for money for the people of Trafford Values - Compassion, respect and dignity - Commitment to quality care to improve lives - Working together for patients - Selflessness and recognition that everyone counts - Integrity, openness and honesty in all our interactions - Objectivity and accountability in all we do Aims Overall to ensure that the Trafford population has the best possible healthcare outcomes by commissioning high quality, equitable and integrated services, but more specifically: - To improve population health - To improve the care provided and the healthcare experience of individuals - To lower the per capita costs of provision 7.3 Core messages The following core messages have been established for 2012/13: I. Trafford CCG is the emerging clinical commissioning organisation for the borough II. Trafford CCG will be responsible for commissioning key health services for the local population, including secondary and community care services III. The clinicians leading the establishment of the CCG are already very experienced in commissioning healthcare services for patients IV. There are numerous and inclusive opportunities for the public to get involved with Trafford CCG, in shaping its strategies, and helping with commissioning decisions Above and beyond the core messages, individual campaign or project messages may need to be created, although these should still be tracked back and linked to these core messages. 16

17 Chapter 8: Engagement 8.1 In this strategy, the delivery of engagement covers patient and public involvement, stakeholder relations and events. 8.2 Clinical commissioning groups will be required by law: I. To involve the public in the planning and development of services II. To consult on their commissioning plans III. To report on involvement in an annual report IV. To have two lay members on their governing body V. To have due regard to the findings from the local Healthwatch VI. To consult local authorities about substantial service change VII. To have processes to handle complaints, both about their own activities and for complaints escalated to them in their role of commissioner VIII. To have regard to the NHS Constitution in carrying out their functions IX. To act with a view to secure the involvement of patients in decisions about their care X. To promote choice XI. To reduce inequalities between patients with respect to outcomes achieved CCGs need to show how they will ensure the inclusion of patients, public and communities when undertaking commissioning, by collecting and evidencing a broad range of views. 8.4 The aim of the following engagement framework is to put the clinical commissioners at the heart of public involvement by creating a range of direct links between the public and those making decisions on healthcare spending. 8.5 This correlates with the principle of no decision about me, without me The framework will also ensure that wider, key stakeholder relationships are taken into account. 8.7 Engagement principles All activity will adhere to the following principles and be: I. Accessible, equitable and supportive II. Honest, accountable and transparent III. Responsive IV. SMART 6 Better health, better experience, better engagement, August 2011, DH 7 Equity and excellence: Liberating the NHS, July 2010, DH 17

18 8.8 Engagement methods The mechanisms chosen allow for involvement from as many members of the public as possible, and also as many types of people as possible, by using a variety of ways for people to get involved, and by using a mixture of mass and targeted activity All engagement activity will be carried out in conjunction with the CCG s clinical director for member relations, and the CCG s lay member for patient and public involvement. 8.9 Engagement framework Practice-level Patient participation groups 8.9.1a It is proposed that GP practices come together within Trafford localities to form joint patient participation groups made up of patients on their registered list who have volunteered b Suggested localities, which match the integrated care neighbourhood hubs that will be set up: I. Altrincham, Hale and Timperley II. Sale III. Stretford and Old Trafford IV. Davyhulme, Flixton, Urmston and Partington 8.9.1c Each group, which would also be joined by GPs from the locality, would elect a chair from its patient cohort. The groups would be responsible for feeding local information and views into the CCG, via a patient reference and advisory panel, which each of the group chairs would sit on (see section on page 19.) This would help to inform patient choice, plans and decision-making at the CCG corporate level, as well as issues regarding quality of services d Practices would be provided with template governance and infrastructure for the development and ongoing management of the groups Toolkits 8.9.2a As most patients gain their patient experience of the NHS when visiting their GP, it is vital that when GPs are at the heart of the commissioning process that its practice members have a good reputation that extends out to all practices 8.9.2b Toolkits would be produced to advise practices on how they can engage and communicate well with their patients, and also provide a range of tools and templates that they can use. 18

19 Corporate-level Patient reference and advisory panel 8.9.3a The local patient participation groups detailed in section (page 13) would report into a patient reference and advisory panel. This panel would report directly to the clinical policy committee, which in turn, will report into the CCG s governing body, and would be made up of the chairs of the patient participation groups, with other members of the public recruited to join if necessary b The panel would be able to undertake some specific corporate actions as needed, such as feeding information back through to the patient participation groups, acting as a steering group for public accountability work or approving patient information literature Prioritisation panel 8.9.4a NHS Trafford runs a prioritisation panel that is convened to assess business cases to help with decision-making to commission, re-commission, suspend or de-commission services b This panel already has public representatives sitting on it that have been trained and assessed on their capability to score a business case, so it is proposed that this panel continues under the management of the CCG Thematic events 8.9.5a The CCG should host between two and four public engagement events a year as a way of continuing to test and track that its commissioning work is in line with what the public expects, wants and needs b Each event would have an overriding theme through which members of the public would be able to provide specific or general feedback on a variety of healthcare issues c Suggested themes: I. The integrated plan II. 2013/14 commissioning intentions III. CCG engagement framework 8.9.5d In 2013/14, further could be undertaken to ensure that the commissioning plan is accurate and based on current needs. 19

20 8.9.6 Trafford Talks Health Network 8.9.6a NHS Trafford already manages a database of local people who want to have regular conversations about the commissioning of their local health and social care services b This database can continue to be used as a resource for recruiting patients or members of the public into any form of engagement activity, from taking part in one-off surveys about general health topics, to forming new reference groups or patient panels concerning specific services or issues c The database holds demographic information (where provided) and it is recommended that further work is undertaken to refine the seldom heard audience groups from the Trafford population using up-to-date data and intelligence, so that a plan can be put in place to ensure that these people are engaged with on a regular basis. Cross-cutting Consultations 8.9.7a Individual public consultations will always need their own handling plans, but to provide a framework, it is recommended that all consultations follow a consistent structure, as follows: I. Engagement Gather general views to find out what people want II. Pre-consultation Gather views on changes proposed in response to engagement phase III. Consultation Formal process to gather views on the detail of proposed changes IV. Post-consultation Explanations and feedback before implementation 8.9.7b This work will need to adhere to the four tests by having support from GP commissioners, demonstrating public and patient engagement with key stakeholders, a clinical evidence base and consistency with current and prospective choice c The new health deal engagement project is already underway in Trafford as a way of involving local residents in the review of local hospital services. It is proposed that this continues as the framework for any engagement work that may result in a consultation (see section 10.4 on page 13) d Web-based consultation software will be used to support the new health deal work, so this could also be used going forward for the CCG e It is advised that the CCG board is given training in consultations so that they can participate effectively in public meetings, and be able to answer questions from the public in an appropriate way. 8 Equity and excellence: Liberating the NHS, July 2010, DH 20

21 8.9.9 Engagement mechanisms 8.9.9a In order that the CCG gains optimum benefit from its engagement activity, it is important that engagement is carried out at a variety of levels: I. Research Obtaining the views and experiences of the public on a range of open issues public share general views and experiences II. Consult Obtaining public feedback on proposals to inform decision making public give views about a fixed proposal or idea III. Involve Working with the public to explore solutions to specific issues and concerns public help identify potential ways forward IV. Collaborate Working in partnership with the public in decision-making public help decide on ultimate way forward V. Empower Public decision making and/or devolved budgets leading to service commissioning public make decisions directly themselves 8.9.9b To ensure that opportunities for members of the public to get involved with the CCG extends to as wide a range of people as possible, it is important to apply a range of engagement mechanisms. This may include: I. Observational research II. Surveys and polls online, telephone or paper based III. Interviews including peer interviews IV. Focus groups online or face-to-face V. Public events and webcasts VI. Self-facilitated workshops VII. Patient reference groups VIII. Public/patient representatives attending corporate meetings 8.9.9c Identifying speaker opportunities for the CCG board at community and partner meetings is also an ideal way of raising its profile (section on page 26) d Reasonable support will be offered to encourage people from protected groups to take part in engagement activity (as already detailed in section 6.5 on page 14) Online engagement portal aAs a wide range of engagement activity and evidence has been gathered as part of work carried out by NHS Trafford, it is recommended that an online portal is established so commissioners can use existing intelligence at the start of any commissioning process b The web-based software which supports the new health deal consultation is designed to be a hub for multiple engagement projects, with a searchable database of activity and outcomes. This, or another comparable product, could be used as the basis for an online engagement portal and could be hosted as part of a CCG extranet (see section on page 28). 21

22 Promoting best practice aIn order to fully embed an effective engagement culture within the CCG, best practice should be understood and followed by all staff. This is especially relevant for commissioners, in order that engagement can be fully aligned with commissioning activity bNHS Trafford has a best practice guide for engagement and this will be updated to ensure it remains relevant for the CCG going forward. It is recommended that this guide is used to develop training and development on engagement for commissioning staff and is available through the online engagement portal as an interactive resource for helping staff to plan engagement activity on a day-to-day basis The commissioning engagement cycle aThe CCG will embed a culture that has engagement at its heart. Commissioning processes, as detailed in the integrated plan, will use a commissioning engagement cycle to ensure robust patient and public involvement in CCG decision-making, as detailed in the chart below: 9 9 NHS Institute for Innovation and Improvement 22

23 8.9.12bThe commissioning engagement cycle will translate to a local method for Trafford CCG, which will ensure that commissioned services provide increased responsiveness, a culture of personalisation, patient reported outcome measures, and a linkage between the population conversation and the service contract. Patient and public involvement will be deliberative, and the outcomes of conversations, discussions and insights will be incorporated into the CCG s planning and delivery cThe CCG will develop an annual business cycle that divides the planning year into two phases - a deliberative phase and a contracting phase. This will ensure that contracting positions are developed as early as possible to enable robust clinical engagement with both commissioners and providers to take place. The deliberative phase would focus on stakeholder engagement between January to September every year so that the wishes of the population are embedded into all commissioning and contracting processes. (See more in the chart below.) dThe commissioning engagement cycle methods will be enabled by: I. Building a shared understanding of the cycle amongst the CCG governing body, the GP council and CCG staff (this would be supported by an internal communications campaign to promote the engagement cycle and wider engagement framework). II. The establishment of the engagement framework (section on page 19) into the governance of the CCG as outlined in the constitution. III. A lay member for patient and public involvement, who sits on the CCG governing body. 23

24 Stakeholder engagement aBest practice engagement will also be used to support staff engagement and member relations activity. This will be carried out in close liaison with the CCG Governing Body, and in particular the CCG s clinical director for member relations bOther areas that need examining further include looking at how face-to-face engagement with CCG members (GPs and practice staff), providers and CCG staff should be carried out, building on what already exists within NHS Trafford, such as staff or education forums (section on page 27) cThis strategy will also take into account some of the operational mechanisms in place to engage with stakeholders such as the local authority, Trafford Health and Wellbeing Board and Trafford LINk / Healthwatch are put in place Engagement monitoring It is essential that all engagement activity is properly tracked and evidenced. It is proposed that an online log is set up to ensure that any individual undertaking commissioning activity can show how they are fully involving the public and patients in the work they undertaking throughout the commissioning cycle from identifying needs through to service design and procurement This will also ensure that there is a process for gathering feedback from any engagement that has taken place, including informal conversations, and tracking that action has been taken as a result of this Equality and diversity monitoring, equality impact assessments and patient experience will also be continually monitored and tracked to help inform and amend the engagement framework and activity as necessary All of this engagement monitoring will be incorporated into an annual public involvement report, which will be published on the CCG s website and sent out to key stakeholders. 24

25 8.11 First steps for implementation I. Engage with commissioners to understand how engagement fits practically into their work at an operational level (not just strategic) to test that the framework will adequately meet their needs. II. Scope the content for the practice toolkits, defining what levels of engagement will be included and whether this includes patient experience. III. Review the prioritisation panel to identify what works well, why, and what can be improved in order to strengthen guidance to practices. IV. Test with communities whether locality groupings for the patient participation groups are appropriate in particular the grouping of Stretford with Old Trafford as trying to group communities that are organically separate at a neighbourhood level can be labour intensive and take much longer to bond. V. Define the role and remit of the patient reference and advisory panel, potentially to include proposing potential issues for corporate engagement based on low level engagement from patient participation groups and overseeing the processes and strategy of engagement at a corporate level. VI. Define the role and remit for the patient participation groups and the logistics for how they would operate, including how they will ensure advocacy on behalf of the communities they represent and how they will link into the Trafford Talks Health network. VII. Test any emerging ideas with commissioners, GPs, practice managers, patients and the general public. 25

26 Chapter 9: Communication 9.1 In this strategy, the delivery of communications covers crisis management, public relations, media relations, internal communications, online communications and marketing. 9.2 Undertaking good communication practices is vital to ensuring that the CCG develops and sustains a good reputation amongst all of its stakeholders. It can also help to ensure that a wide variety of people, whatever their stake in the organisation, feel that they have a real part of play in the organisation. 9.3 It is worth noting that communications should be the responsibility of all in the organisation, and that appropriate processes would need to be put in place at CCG committee level to help ensure that reputation can be managed effectively, from the monitoring of complaints and incidents to having an overview of how CCG members are behaving. 9.4 The communications framework aims to help the CCG deliver its strategic objectives, and each method will incorporate audience feedback mechanisms to ensure that the communications is not purely one-way. 9.5 Communication principles All activity will adhere to the following principles, and be: Open, honest and transparent Timely Accurate SMART 9.6 Communication framework Corporate branding 9.6.1a To help support this it is vital that the CCG s NHS branding is used throughout all communications, from meeting minutes to signatures b It is recommended that the CCG looks into a corporate identity that can support this branding and rolled out on all channels Media relations 9.6.2a Proactive media relations activity will be a key tactic for raising the profile of Trafford CCG b As part of the CCG s organisational development plan, robust media and public consultation training will take place with members of the CCG s 26

27 governing body. Following this, CCG spokespeople will be established and assigned as the lead commentator on various topics c Media visits will be set up with key local journalists to introduce them to the CCG lead / accountable officer, and interviews will be offered with the selected spokespeople d To ensure that proactive media relations is as effective as possible, a system will need to be put in place to ensure that stories can be generated from the Executive Committee and used as part of this profile-raising activity. Providing a good service to the media is important, as they will always be a key outlet for helping to promote any ongoing engagement activity or PR campaign work e Operating in a public arena means that there will always be negative issues to deal with in the media, but if the communications principles already outlined are adhered to, most situations can be dealt with effectively f For example, by being open and responding to journalists in a timely manner you can build strong relationships with those individuals who will often provide the same respect and benefit of the doubt in return g The bigger and on going negative stories that occur would always require their own crisis management plans, which would feature prepared handling lines and media statements h The media are, for the most part, a 24/7 service, so it should be thought about further whether the CCG will require 24/7 communications on-call cover to deal with any issues that arise out of office hours i It would also need to be established whether the CCG would handle all media service for its GP practice members Internal communications 9.6.3a Keeping the people of the organisation fully updated and involved at all times is vital to ensure that an organisation is operates effectively. Good internal communications can ensure that people are motivated, and therefore can act as powerful advocates b For the CCG this isn t as simple as communicating with its staff, as its GP practice members are a crucial internal audience as well c A primary care briefing monthly e-newsletter would be utilised to become a key communications channel for all CCG practice members to provide key corporate updates d Regular e-briefings and face-to-face staff forum briefing sessions would be used to undertake regular engagement and communications with CCG staff. 27

28 9.6.3e It is also important to ensure there is a mechanism for issuing urgent or oneoff communications or briefings to all internal audiences f It is vital that these internal audiences are always communicated to before information is released externally, so that they don t find out information about the organisation they work for, or are members of, by reading the local paper g All internal communications activity will be carried out in close liaison with the CCG s clinical director for member relations Stakeholder communications 9.6.4a To ensure that there is a mechanism for communicating regularly with key stakeholders, it is recommended that the following communications channels are put in place: I. Health briefing to update key community, political, partner and statutory stakeholders with corporate news II. Provider briefing to update all providers commissioned by the CCG with key operational information 9.6.4b As with staff and CCG members, a mechanism should be put in place so that urgent or one-off communications or briefings can be issued Online 9.6.5a Online communications is essential to ensure that the CCG is able to reach widely into the Trafford population. The CCG already has an interim website ( and this will develop into a fully accessible, externalfacing website to help the public to easily connect with and find their way around the organisation. A key element of this will include letting people know on the homepage of the website how to complain or raise comments or concerns, and to show how public feedback has contributed to health service decisions and change. The site will also host the CCG s constitution, key documents such as the integrated plan and the quality strategy, and articulate the CCG s mission, values and aims b Much of the information that is held currently on the NHS Trafford website can be used, but developing a new site provides the opportunity to ensure that all the latest technologies and techniques for communicating online are integrated with it c This includes the implementation of corporate social media channels, such as Twitter and Facebook, using video creatively to produce blogs, campaign and engagement messages, and providing enhanced real time information for patients. It will also allow people to access key information, such as map of medicine. 28

29 9.6.5d Because coordinating the latest operational information to member practices is so vital, an extranet will be developed as part of the site, where all the CCG members and staff can log on to find out key policy information, access essential tools and talk to each other through forums e In the future there is the potential to produce a separate online communications strategy that integrates e-communications with frontline patient experience using technology Marketing, promotion and publications 9.6.6a All marketing techniques used in the CCG will be undertaken using the principles of social marketing, in that they will be informed by good insight and intelligence, and undertake activity with the aim of influencing or starting some sort of behaviour change b Marketing, promotion and publication tactics are often used for campaigns, but may also be used to support the engagement framework, such as by publicising public meetings c The implementation of campaign-led marketing and advertising activity would need to be delivered based on individual project aims and objectives and the budget available for that project d A publication that currently exists within NHS Trafford (and is due to be in place until at least January 2013) that can be utilised by the CCG, is a magazine produced jointly with Trafford Healthcare NHS Trust and other providers and partners eThis is an advertising-funded publication that is distributed through primary care practices and outlets, hospital and health centre sites, libraries and other public buildings. It provides a wide variety of local health service news, health promotion and corporate updates from providers f Partner and community publications, such as Trafford Council s Your Trafford, Partington Transmitter and Old Trafford News can also be targeted using a combination of PR and marketing techniques g The CCG would have some responsibility for producing patient information, although mostly this is likely to be restricted to producing and distribution local versions of national or regional template information. It has been outlined in the engagement section that any patient information produced directly by the CCG would need to go through processes to involve patient and public representatives in its production, and all information produced would need to follow equality and diversity guidelines h It is this area of communications that is most likely to need budget and outside resourcing for elements such as media buying, design work and distribution methods. Guidance is also available that details how NHS organisations can work with partners and sponsors on projects. 29

30 9.7 Communication monitoring It is essential that all communications activity is tracked on an ongoing basis, to ensure that the audience are receiving the messages and, where appropriate, acting on the information In terms of the set communications channels, this tracking could be achieved by undertaking regular surveys with the receiving audiences to ensure that the channels are as effective as they could be In terms of media relations activity, good administration practices are essential. All requests for information should be logged so that enquiries can be dealt with in a timely manner and journalists with particular interests can be tracked and monitored It is also useful to undertake some sort of media evaluation activity. Key messages and tone of voice can be analysed, although there is no set rule for this, and it is probably more useful to evaluate media coverage alongside other strategic or campaign objectives, rather than in isolation. 30

31 Chapter 10: Integrated campaigns 10.1 The commissioning engagement cycle (section on page 22) deals with collective-level engagement my/our say in decisions about commissioning and delivery of services Communication campaigns would focus on individual-level engagement my say in my own care and treatment Work would need to be undertaken to examine the CCG and NHS Trafford s operating plans in detail to focus on appropriate themes, but the following campaigns are suggested as they relate to national policy and QIPP: I. Patient choice no decision about me, without me (could include any qualified provider and ties into QIPP activity) II. Patient education incorporating choose well, prescribing, DNAs (appointments not attended), specific speciality or long-term condition areas. III. Patient involvement - how to raise concerns or complaints, how to contact PALS to get help or advice, and how things have changes in the local health service as a result of feedback from patients and the public As already detailed in the engagement section, it is proposed that the new health deal for Trafford campaign, which provides the existing framework for the current consultation to redesign local hospital services (including website, video, social media and other communications channels), is used for potential future engagement on the integrated care system and ongoing patient and public involvement with commissioning decisions Other campaigns would be developed to follow organisational priorities, such as focus areas from the integrated clinical commissioning plan All campaigns should follow a strict process of measurement and evaluation, meaning that clear objectives will be outlined at the start. 31

32 Chapter 11: Evaluation and evidence 11.1 To evaluate the effectiveness of the overall strategy, the evidence areas for the relevant authorisation domains will be used Evaluation, evidencing and monitoring will also be incorporated into individual campaign or project plans. 32

33 Appendices 33

34 Appendix A 2 October 2012 Welcome to the first of the new primary care briefings from your clinical commissioning group (CCG) Introducing the CCG committee A number of national assessment centres and interviews have been taking place to appoint statutory positions to the committee of Trafford CCG. The confirmed membership is as follows: Dr Kath Sutton chair Dr Nigel Guest interim chief clinical officer Dr Michael Gregory clinical director (strategy and policy) Dr Mark Jarvis clinical director (finance, quality and performance) Dr Stephen Jenkins clinical director (member relations) Dr George Kissen clinical director (transformation and reform) This committee will evolve into the Governing Body of the CCG, and more appointments will be announced soon following national guidance on organisational governance for CCGs, such as for a non-practice based lay nurse and a hospital doctor. An announcement is also expected soon in relation to the statutory chief finance officer role. The constitution A CCG cannot operate without a formal constitution, and all practices that are part of Trafford CCG will need to be signatories of the document. You will have already have had a chance to comment on Trafford CCG s constitution, and following an extraordinary meeting of the GP Quarterly Forum (which will become the CCG s GP Council) many member practices have now signed up. The CCG committee is inviting the remaining practices to sign up during practice visits that are currently in progress. The current Inter-Practice Agreement (IPA) that exists from the practice-based commissioning (PBC) arrangements will cease when the new CCG constitution comes into force from 1 April The Department of Health has also published a document that outlines the functions of clinical commissioning groups, including their key statutory duties, which is a useful reference guide.

35 Mission, values and aims Following engagement with the GP community and stakeholders, the following has been established. Mission To promote the provision of safe and high quality services and to secure services that are available in the right place, for the right people, at the right time, whilst ensuring they are affordable and represent value for money. Values Compassion, respect and dignity Commitment to quality care to improve lives Working together for patients Selflessness and recognition that everyone counts Integrity, openness and honesty in all our interactions Objectivity and accountability in all we do Aims Overall to ensure that the Trafford population has the best possible healthcare outcomes by commissioning high quality, equitable and integrated services, and more specifically: To improve population health To improve the care provided and the healthcare experience of individuals To lower per capita costs of provision 360 survey and authorisation process All GPs and practice staff are reminded that a 360 survey has been issued to them as part of the Trafford CCG authorisation process. The survey is an essential part of helping the NHS Commissioning Board to understand how relationships between the CCG and its stakeholders are developing, and therefore the CCG s readiness for authorisation. Ipsos MORI, which is running the survey independently, has released guidance on completing it. The deadline for completing the survey is Friday 5 October. Authorisation is essential, as without it CCGs cannot operate as a statutory commissioning organisation. Trafford CCG will be assessed as part of wave 4, which will take place in December 2012, and the results of the survey will be used as evidence during the assessment. We will be notified of the outcome of the authorisation process in January 2013.

36 New website Trafford CCG now has an interim website up and running, which features details of the group s membership, as well as links to committee meeting papers. This will eventually be developed into a more substantial site featuring advice and information for the public and patients, and also into a useful online back office for GPs and practice staff to use. Getting in touch Your views, thoughts and opinions are vital in ensuring that a robust CCG for Trafford is set-up and authorised to ensure that high quality, safe, accessible and sustainable services are commissioned for Trafford residents. If you would like to get in touch about the CCG, its development, the authorisation process, or merely if you have any comments or concerns, contact mike.barker@trafford.nhs.uk Useful dates Thursday 11 October GP education forum Monday 15 October QOF QP indicators external peer review meeting (not 17 October as previously advertised) Tuesday 30 October Trafford CCG committee meeting (public) Thursday 1 November Trafford North practice managers forum Wednesday 28 November Trafford South practice managers forum And in other news You will no doubt be aware of the extensive public consultation currently underway for the new health deal programme of work. This proposes changes to services at Trafford General Hospital, to ensure it can continue to provide a high level of quality care, to resolve financial issues, and to ready the site to become a key part of the integrated care system being developed in the borough. It is essential that everyone has their say. Please help us to promote the consultation to patients in your waiting areas. More promotional materials and copies of the consultation documents will be sent to all GP practices soon. We want GPs and practice staff to have their say too. You can review the documentation and respond to the consultation online. Coming next month Updates on policy development work for Trafford CCG, including the new quality strategy.

37 Appendix B Trafford Talks Health magazine distributed in August 2012 to networks and through primary and secondary care settings

38 Appendix C Homepage of Trafford CCG website

39 Mission, vision and values on the Trafford CCG website

40 Communicating how people can raise comments, queries or concerns