NHS Leeds North Clinical Commissioning Group Organisational Communications and Engagement Strategy

NHS Leeds North Clinical Commissioning Group Organisational Communications and Engagement Strategy Author: Stuart Barnes Communications & Engagement Lead Version Date Author Status Draft V9 26-10-15 Stuart Barnes Final Page 1 of 13

Executive Summary The CCG s aspiration is established in its mission statement and the objectives of the organisation. In support of these objectives, the CCG s communications and engagement function will work to ensure two key principles: meaningful involvement of the community we serve in the shared delivery of our CCG strategy; effective corporate communications. Effective support in delivery of the CCG s objectives, will require an approach wherein CCG colleagues show a collective commitment to, and shared responsibility for, the principles of meaningful involvement and, to a lesser extent, effective corporate comms. The CCG will ensure a planned approach to embedding communications and engagement planning and activity within all parts of the organisation. This embedded approach to communication and engagement, whereby all of the CCG s commissioning teams accept the need and responsibility for elements of Patient and Public Involvement will lead to more and higher quality PPI and improved commissioning based on need. What are we good at? Leeds North CCG enjoys strong relationships with partner organisations including clinicians, providers, local authority partners and the third sector. We have a strong commitment to innovation in many areas, in particular in relation to informatics and the use of data. Our links with the third sector and other partners allows for a great deal of patient and public involvement and the numbers of people participating in both quantitative and qualitative research and engagement is testament to the ability the CCG has to reach large numbers of people when discussing commissioned services. Where are there areas for improvement? There are some excellent examples of PPI having been undertaken at the CCG. Equally, there are some areas of commissioning which have not benefited as fully from the views of patients and the public. Similarly, there are examples of PPI having been undertaken but where the link between the learning from this PPI and any effect on commissioning outcomes is difficult to establish, or has not been communicated fully. The CCG currently lacks the mechanisms for an entirely holistic consideration of all PPI intelligence which would enable us to consider experience of the integrated health and care system in the whole rather than isolated parts of the two systems from a narrow perspective of the organisation commissioning services. What do we plan to do about the areas identified for improvement? The CCG will use various methods to ensure that its PPI activity is inclusive and has built upon the JSNA data to enable us to understand and meet the needs of our population. These will include delivery of a revised range of PPI groups and tools. Page 2 of 13

In the case of significant service changes, Communications, Engagement, Equality and Diversity (CEED) plans will set out the way in which the CCG will seek to understand the needs of the population in relation to a given area of commissioned health services. The CCG will use the criteria established between the Leeds NHS organisations and Leeds City Council s Adult Social Care, Public Health and NHS Scrutiny Committee to determine those engagement pieces which require a CEED plan and formal engagement/consultation rather than just ongoing informal involvement. The various channels for engagement and communication will be considered and utilized by the CCG when developing CEED plans. The CCG will deliver CEED plans across all commissioned activity and will use these to enhance the understanding that already stems from the city s JSNA. The CCG will use this learning to drive continued improvement in commissioned services and will deliver services which increasingly reflect those that our population needs. The CCG will establish a Patient and Public Involvement working group. This will provide a forum that will enable the CCG to best utilise the output of the various sources, including informatics developments across the city, to help us achieve greatest benefit from the breadth of PPI information available. This will mean that patient experience is considered more fully and that commissioning becomes increasingly needs driven. How will we know if we have done it? The CCG will provide robust evidence of the impact that patient and public engagement has had on shaping commissioned services. In its simplest form this will be expressed as a You said, we did account of the way in which patients and the public have helped to shape services. Each CEED plan will be followed by an engagement report which will contain this detail. The collective summary of evidence will also be provided in various forms as part of other documents published by the CCG on an annual basis, including its Annual Report, its Annual Review, and its Annual Statement of Involvement. Other evidence of success will include increasing levels of public and patient participation in the CCG s engagement activity, including participation from people in protected characteristic groups and other hard to reach or seldom heard groups such as those from deprived communities. The CCG will also be able to demonstrate, through the work of the newly formed PPI working Group, that it has better understood the needs of the public not just for new services, but in relation to commissioned services at all stages of their commissioning cycle. This will be achieved through the monitoring, reporting and then acting on the intelligence and feedback from patients using existing services. Page 3 of 13

Introduction This strategy document sets out the strategic role for the Communications and Engagement function within Leeds North Clinical Commissioning Group (LNCCG). The fundamental functional objectives for communications and engagement within the work of the CCG are: To ensure meaningful involvement of the community we serve in the shared delivery of our CCG strategy; To ensure effective corporate communications. Whilst meeting these challenges effectively, the CCG will also strategically deliver its communications and engagement function so that it supports the delivery of the organisation s objectives These are to: 1) Ensure that we have comprehensive commissioning processes and management established that enable us to understand and meet the needs of our population through high quality care and which deliver improvement in the health and wellbeing of the poorest the fastest. 2) Establish organisation-wide management systems and processes that enable and encourage robust forward planning, the ability to adapt to change, meaningful stakeholder involvement, transparent decision making and robust governance. 3) Be recognised by our peers as an organisation that has effectively supported and encouraged innovation in the development and implementation of new models of care that better meet the needs of our population. 4) To achieve effective local and system leadership that drives continual performance improvement through authentic clinical and population involvement. As a commissioning organisation, it is critical that communications and engagement are embedded into all of the commissioning activity undertaken this strategy sets out the means through this embedding of communications and engagement is undertaken at the NHS Leeds North CCG and the ways in which the organisation plan to develop and improve these processes. The strategy does not set out the operational level plans for delivery of the C&E function (for example: specific plans for patient and public engagement around commissioning activity; social/digital media plans; political or media engagement plans). Several of these plans are provided as supporting documents in the appendices of the strategy. Page 4 of 13

Section A: Supporting delivery of the CCG s objectives Objective 1 of the CCG: Ensure that we have comprehensive commissioning processes and management established that enable us to understand and meet the needs of our population through high quality care and which deliver improvement in the health and wellbeing of the poorest the fastest. What is the deliverable? By embedding patient and public involvement into the commissioning cycles of the CCG (see image below), we will deliver improved commissioning outcomes and services which are better suited to the needs of our population. The CCG will support this objective by ensuring that our commissioning processes are adequately informed by patient and public views and experience. The approach we will take The starting point for understanding the needs of our population is through collaborative working to develop the Heath and Wellbeing Board s Joint Strategic Needs Assessment. The JSNA, developed and published by the Health & Wellbeing Board following consultation and careful consideration of population level data, provides robust, population-level data about the health and wellbeing of people in North Leeds, including information about specific conditions, behaviours and health inequalities. The CCG will then build on this statistical understanding of the requirements of the population by enriching the information with patient and public involvement and learning. The annual Commissioning Intentions (CIs) of the CCG will be an expression of the commissioning decisions reached by the CCG following a process which includes: Consideration of the JSNA and the commissioning needs; Clinical and patient involvement/engagement; Careful prioritisation of CIs within the finances available and based on the feedback from the public and clinicians. Having established the annual CIs of the CCG, these will provide a plan, or road-map for the year, with further Patient and Public Involvement (PPI) then taking place to establish further detail for the CCG s delivery, evaluation and ongoing management of many of the services arising from specific CIs. This PPI will continue throughout the commissioning cycle of services commissioned by the organisation. The CCG will always ensure that the public is engaged and given the opportunity to consider information about local health commissioning, and to have a say in relation to any proposed changes to commissioned services. To achieve this, it is crucial that a systematic approach is taken to guarantee that patients and the public input into our commissioning activity. (See objective 2 below for information on systems to manage Patient Assurance). The CCG will use various methods to ensure that its PPI activity is inclusive and has built upon the JSNA data to enable us to understand and meet the needs of our population. These will include delivery of a revised range of PPI groups and tools (including Community Voices, a Virtual Page 5 of 13

Practice Reference Group Network, Asset Based Engagement, Working Voices, and improved digital and media engagement strategies). This strategy does not seek to provide the details of these groups or comms tool, but for reference details can be found in the appendices of this strategy. In the case of significant service changes, Communications, Engagement, Equality and Diversity (CEED) plans will set out the way in which the CCG will seek to understand the needs of the population in relation to a given area of commissioned health services. The CCG will use the criteria established between the Leeds NHS organisations and Leeds City Council s Adult Social Care, Public Health and NHS Scrutiny Committee to determine those engagement pieces which require a CEED plan and formal engagement / consultation rather than just ongoing informal involvement. The various channels for engagement and communication will be considered and utilized by the CCG when developing CEED plans. What does success look like? The CCG will deliver CEED plans across all commissioned activity and will use these to enhance the understanding that already stems from the city s JSNA. The CCG will use this learning to drive continued improvement in commissioned services and will deliver services which increasingly reflect those that our population needs. How will we know if we have done it? The CCG will provide robust evidence of the impact that patient and public engagement has had on shaping commissioned services. In its simplest form this will be expressed as a You said, we did account of the way in which patients and the public have helped to shape services. Each CEED plan will be followed by an engagement report which will contain this detail. The collective summary of evidence will also be provided in various forms as part of other documents published by the CCG on an annual basis, including its Annual Report, its Annual Review, and its Annual Statement of Involvement. Other evidence of success will include increasing levels of public and patient participation in the CCG s engagement activity, including participation from people in protected characteristic groups and other hard to reach or seldom heard groups such as those from deprived communities. The CCG will also be able to demonstrate, through the work of the newly formed PPI working Group, that it has better understood the needs of the public not just for new services, but in relation to commissioned services at all stages of their commissioning cycle. This will be achieved through the monitoring, reporting and then acting on the intelligence and feedback from patients using existing services. Page 6 of 13

Objective 2 of the CCG: Establish organisation-wide management systems and processes that enable and encourage robust forward planning, the ability to adapt to change, meaningful stakeholder involvement, transparent decision making and robust governance. What is the deliverable? The CCG will ensure that it fulfils its objective of delivering meaningful stakeholder involvement. This will be done through a thorough forward planning system for Patient and Public Involvement (PPI) and robust governance arrangements all delivered in a transparent and inclusive manner. In focusing on this strategic objective, the CCG will ensure that it discharges its statutory duty to ensure patient involvement and engagement in the planning and commissioning of health care. This is a concept that is critical to the success of the organisation and is included in the aims within the constitutions of the CCG and the NHS. The Health & Social Care Act 2012 includes specific duties for CCGs to: Involve the public in the planning and development of services; Involve the public on any changes that affect patient services, not just those with a significant impact; Set out in their commissioning plans on how they intend to involve patients and the public in their commissioning decisions; Consult on their annual commissioning plans to ensure proper opportunities for public input; Report on involvement in their Annual Report; Have lay members on their governing body; Have due regard to the findings from the local HealthWatch; Consult Local Authorities about substantial service change; Have regard to the NHS Constitution in carrying out their functions; Act with a view to securing the involvement of patients in decisions about their care; and Promote choice. What approach will we take? To discharge these aims in a way that also allows for meaningful involvement, it is essential that the CCG has in place a robust and transparent process for forward planning around commissioning activity. In this way the involvement will be timely and add real value to commissioning work. Effective and robust forward planning will also mean that patient and public involvement / engagement activity will inform commissioning at all stages of the commissioning cycle, rather than just when significant service change is planned. The CCG has worked with its commissioning teams to develop clear written processes for the development within each commissioning team of forward work plans for the year which enable the organisation understand what patient engagement will undertaken throughout the year to support the commissioning work of the CCG and improve the commissioning decisions and health outcomes. These work plans are aligned to the commissioning cycle for each activity and reflect the work of the teams as defined by the Commissioning Intentions of the organisation which have been developed as part of the organisational planning process Page 7 of 13

These plans allow the Patient Assurance Group (PAG) to understand and offer assurance regarding the inclusion of Patient and Public Involvement (PPI) within the commissioning cycle, and the way in which PPI will influence commissioning for improved health and wellbeing outcomes. The PAG is a group of patient representatives established and recognised within within the CCG s governance structure. Its role is to provide assurance to the organisation that its proposed PPI around specific commissioning activity is sufficiently robust and timely, and that commissioners have had sufficient regard for the views of patients in planning commissioned services. The forward work plans can be found in Appendix G. To ensure transparency, summaries of PAG meetings will continue to be presented to the Board, as are PPI summary papers to advise board members of all of the PPI work that has been undertaken and the resulting impact on commissioning decisions. Further transparency is achieved through the CCG s publication scheme. We have adopted the Information Commissioners Office s (ICO) model scheme for health bodies. The aim of the publication scheme is to increase openness and transparency about what we do, what we spend, our priorities, decisions and policies. It also aims to make it easier for patients and the public to find and obtain the information they require without having to make a written request. Documents and information made available to the public through the CCG s publication scheme include Board meeting agenda and papers, financial information and key policies and procedures. The organisation also seeks to enhance public scrutiny and transparency through holding its Board meetings in public, inviting people to attend and observe the decision making sessions of its Directors. Public board meetings are held in venues across North Leeds to try and ensure that they are accessible by as many people as possible. What does success look like and how will we know if we have done it? The CCG s success in ensuring transparency and effective involvement will be demonstrated by the evidence of involvement, and its impact on commissioning decisions and outcomes. This information is included in its Annual Report and Annual Statement of Involvement. Annual audits are also conducted to evaluate the efficacy of the organisations PPI. The results of these audits provide further indication of the CCGs performance against this objective with the CCG using the results and recommendations of the audit to continually improve performance. Page 8 of 13

Objective 3 of the CCG: Be recognised by our peers as an organisation that has effectively supported and encouraged innovation in the development and implementation of new models of care that better meet the needs of our population. What is the Deliverable? The CCG will deliver effective plans to manage and improve stakeholder relations. This includes media, digital media, public and political relations planning. Stakeholder relations also includes the development and management of positive relations and with all parties who have an interest in the CCGs commissioning activity at all stages of the commissioning cycle. This includes providers, patients and the public, the voluntary, community and faith sector (otherwise referred to as the Third sector ), local authority partners, other CCGs and many more. Through more effective management of stakeholder relations the CCG will improve its ability to engage and involve stakeholders in its commissioning of services, so leading to improved commissioning for population needs. What approach will we take? Delivering improvements to the way that the organisation is recognised by our peers as one which actively delivers continual service improvement will be achieved by planned, proactive stakeholder management. This will be achieved by building on the existing relationships with stakeholders, identifying any perceived strengths and weaknesses of the organisation (among external and internal stakeholders) and working with commissioning team leads and the senior management team of the CCG to develop and implement action plans to drive improved stakeholder relations, that will in turn lead to reputational improvement. What does success look like? The CCG s reputation will be improved and enhanced through consistent, high quality and accessible communications. This will help us to celebrate our success and will add credibility to the high impact, important, innovative work that our commissioners conduct. In turn, this reputation management and development will provide the platform for us to increase our organisational influence. The CCG also recognizes the need for effective communications, tailored to relevant stakeholder groups using adaptive and varied communications tools and platforms for stakeholder communication. In planning for improved communication across a range of stakeholder groups, the CCG has developed a Stakeholder Engagement Action Plan which can be seen in Appendix C. How will we know if we have done it? The success of the CCG in effectively managing and improving stakeholder relations will see an increase in positive media exposure of the CCG, greater numbers of positive partnerships being formed with stakeholders, enhanced reach of digital communications and the delivery of messages which we know are more relevant to their intended target audiences. Page 9 of 13

Evidence from analytic data and increased participation figures for Patient and Public Involvement activity (either at group meetings or through other forms of engagement) will indicate that our objective here has is being met. Improved feedback from stakeholders participating in our annual 360 degree survey will also provide an indicator of progress each year. The results of this year s 360 degree survey, and the associated improvement actions can be seen in Appendix A. Other forms of evidence that will help the CCG to gauge how successful it has been in meeting this objective include information from research about high performing CCGs and the results of the assessment that follows the CCG s application for Investors in Excellence (IiE) accreditation. Page 10 of 13

Objective 4 of the CCG: To achieve effective local and system leadership that drives continual performance improvement through authentic clinical and population involvement. What is the deliverable? The CCG will continue to develop and improve its population level involvement of people in North Leeds. By working with partners from across the health, care and voluntary sector in Leeds to ensure that a unified message encourages greater participation and understanding. The CCG will work with partners to use all forms of intelligence available, in combination with the PPI undertaken, to help inform and complement better commissioning decisions and drive improvements in performance throughout the commissioning cycle. What approach will we take? Working closely with external partners, members of the Leeds Health & Wellbeing Board, Leeds Institute for Quality Healthcare and our providers, we will develop mechanisms for a more holistic consideration of all patient intelligence which will enable us to consider the integrated health and care system in the whole rather than isolated parts of the two systems from a narrow perspective of the organisation commissioning services. It will also allow the CCG to best utilize the output of the various informatics developments across the city to help us achieve greatest benefit from them. This will mean that patient experience data is considered more fully and that commissioning is further needs driven. To cement a more holistic approach to the review of patient and public intelligence, the CCG will develop its PPI working group, a working group of internal partners and stakeholders. The group will provide a forum for discussion, planning and performance management of PPI action plans within the CCG so that all elements of the PPI intelligence and planning can be considered collectively (including JSNA, Complaints, Patient Advisory Liaison Service (PALS), Public Health, Provider Management, FOI and Parliamentary Questions, Friends and Families Test etc). The work of the group will allow the CCG to learn from its collective PPI channels and then focus the CCG s ongoing population level discussion on the outcome of this collective learning, or, where necessary, on the collection of further evidence to fill gaps in understanding. What does success look like? Through working more closely with both external and internal partners in this way, the CCG will be better placed to ensure a unified message is developed which reflects our best possible understanding of the way in which the public currently experiences services. Through this unified and informed messaging and communication, the organisation will affect better two-way discussion at a population level. How will we know if we have done it? Communication with our population will involve greater numbers of people and will engage people from broader cross sections of our population. Discussions will be more frequent throughout the commissioning cycle and a greater proportion of the engagement we undertake will be shared and Page 11 of 13

used by partner organisations, just as the CCG will seek to draw upon more of the intelligence gathered by partner organisations. Increased use of digital and online information gathering will enable greater reach and ensure that more powerful analytical tools are at our disposal, whilst always endeavouring to engage those communities of more vulnerable or seldom heard backgrounds through the use of more traditional methods such as face to face engagement and focus groups. Section B: Dependencies and relationships In focusing on it s role in supporting the delivery its objectives, the CCG will continue to develop and progress a number of partnerships and relationships to ensure the optimisation of its work. Many of the commissioned services of the CCG are either commissioned jointly, or are influenced by the interdependencies between various component parts of the health and care provision across the city. It is important to recognise these dependencies and relationships and note that, in some cases, the objectives of the CCG will be considered jointly alongside the objectives of partner organisations or in the context of joint initiatives such as the transformation agenda (Leeds Inspiring Change). The following stakeholder organisations are those identified as those with whom there are existing or planned significant dependencies / relationships which will be integral to the communications function of the organisation: Voluntary, Faith, Community Sector Leeds Involving People Voluntary Action Leeds Volition Touchstone Black Health Initiative Healthwatch Leeds Rhinos Foundation Provider, Health and Social Care Neighbouring Leeds and WY CCGs LTHT LCH LYPFT HDFT YAS Social care providers Healthy Futures Local Authority, Regulatory and Educational Leeds City Council HWB Leeds City Council Health Scrutiny Leeds City Council Public Health Inspiring Change Healthwatch NHSE LIQH The CCG will continue to work with these partners wherever possible to develop unified and complementary approaches to its communications and public involvement activity. Page 12 of 13

Further information relating to the detailed actions and plans, explaining how the CCG will approach delivery of this strategy, will be included in the following documents: Appendix A - 360 Stakeholder Survey and Actions Appendix B - Social Media Guidelines Appendix C - Stakeholder Engagement Action Plan Appendix D - Terms of Reference Virtual Practice Reference Group Network Appendix E - Terms of Reference Community Voices Appendix F - Terms of Reference Patient Assurance Group Appendix G Forward Work Plans Page 13 of 13

Appendix A - 360º Stakeholder Survey Areas for action and potential improvement 2015 Executive summary This is the third annual national survey carried out by Ipsos MORI. Stakeholder details were provided to Ipsos, who made contact by email. They were asked a number of questions around the six assurance domains, with many questions identical to last year. There are additional questions on engagement. The stakeholder response rate this year was 43%. It is important to note that this is a much lower response rate when compared to 2014 (72%) and 2013 (71%). The break-down is below, with 2014 s figures in brackets. Stakeholder group Invited to take part in survey Completed survey Response rate GP member practices 28 (28) (31) 17 (23) (23) 61% (82%) (74%) Health and wellbeing boards 2 (2) (2) 1 (1) (1) 50% (50%)(50%) Local HealthWatch/patient groups 1 (4)(3) 1 (3) (3) 100% (75%) (100) NHS providers 6 (6) (6) 3 (2) (3) 50% (33%) (50%) Other CCGs - (2) (2) - (2) (2) N/A (100%) (100%) Upper tier or unitary local authorities 6 (5) (6) - (3) (2) - (60%) (33%) Wider stakeholders 18 (7) (N/A 4 (5) (N/A) 22% (71%) (N/A) Ipsos has advised that when interpreting the data with fewer than 30 responses, care has to be taken in reaching conclusions and individual responses scrutinised. Any differences are not necessarily statistically significant; a higher score than the cluster average does not always equate to better performance, and a higher score than in 2014 or 2013 does not necessarily mean the CCG has improved. There is a general downward trend nationally in responses to this survey. Page 1 of 9

Conclusions and recommendations are therefore drawn with caveats because of the relatively small number of responses. These are considered alongside the free text responses made by individual stakeholders. Where a theme or comment has been raised by more than one stakeholder, it has been taken into account in putting together the main themes of this report. Member practices formed the majority of the responses, the issues raised reflect this. Although the number of wider stakeholders to be invited to respond was more than twice as many as last year at 18, only four responded. In the free text, most comments were constructive and positive. However there was one stakeholder, a GP practice, who was clearly dissatisfied, this were a definite outlier and it would be inappropriate to draft actions based on the specific criticisms, which were aimed at the system as a whole rather than specific to Leeds North CCG. While the response sample is too small to draw firm conclusions, when taken into account with the free text responses, a number of positive themes emerge, saying the that CCG is: Patient-focused Engaged Strategic Open and receptive Supportive Clinically-led Understanding of local issues In addition the leadership is described as: Excellent Dynamic The areas for improvement highlighted mainly through the free text and raised by more than one respondent related to member practices. These were: Limited time and resources to participate fully (including quality locum cover) Capacity of smaller practices to be fully engaged Setting the agenda to suit all and measuring outcomes Consistency of engagement with stakeholders (particularly patients and the public) Overall communication and openness (co-commissioning and complaints were mentioned) Links to wider organisation development Alongside this national survey, the CCG commissioned The Real World Group to carry out organisational development work with the board and stakeholders. This included a 360º feedback and self-assessment. The actions from these surveys is being fed into the Investors in Excellence submission and action plan due for completion in September 2015. It is expected that Investors in Excellent will be the main focus of the action plan. The action plan from last year s survey is included at the end of this paper. Page 2 of 9

Key themes Overall, and given the low response rate Leeds North CCG does not seem to be an outlier in any area. The survey is RAG rated, showing how we rate against a peer group of similar CCGs. We are in the top third of CCGs (green) on: Overall engagement and relationship Commissioning decisions and contribution to wider discussions The majority of indicators on plans and priorities (with an amber for the indicator on taking comments on board) The majority of indicators on overall leadership (with an amber for the indicator on confidence in the CCG leadership to deliver outcomes for patients ) The majority of indicators on clinical leadership (with an amber for the indicator on delivering continued improvements to reduce local health inequalities ) Areas for improvement As previously noted, the low response rate makes it difficult to draw firm conclusions; however themes do emerge from the free text. The survey is anonymous, but it is clear from the subject matter that member practices have highlighted the majority of the issues. The concerns centre on: Time and resource constraints:.the smaller practices have difficulty in engaging in many meetings, because it takes time away from patients.clearer description of roles, time requirement and pay. Alternatively, the availability of backfill locum provided by the CCG Agenda setting I feel that he agenda for discussion is set by the CCG and our responses are gathered and paraphrased in such a way as to suit a pre-set CCG agenda Sometimes hard to see the link-up between council debate and actions taken by the CCG Engagement The challenge in Leeds is that the 3 CCGs lead in different areas. I have some positive experiences of being engaged in the plans and priorities but am not completely sure that there has been engagement in all areas and services Engagement has tended to be about winter crises etc and although the relationship is very good, I do think it could be more pro-active Ongoing engagement through a variety of communities and groups should grow rather than focused engagement over a specific issue Page 3 of 9

Co-commissioning and complaints I think the issue of conflict of interests in co-commissioning needs to be resolved more clearly. I think the member practices also need a clearer idea of how risks involved in co-commissioning would be assessed and managed Commissioner complaints are few and handled as a central function so evidence is difficult to obtain. More active involvement in primary care and complaints will be welcome with the progression of co-commissioning The positives Positive comments outnumber the negative significantly, with many praising the CCG leadership and staff, naming some individually and highlighting the patient focus. Action plan I think it is a good CCG with a strong set of values and an excellent leadership team with a strong clinical input. Well done A very pro-active CCG with a dynamic Chief Officer very patient-focused The CCG has started making a difference to inner Leeds by directing schemes and resources towards practices and patients in areas where life expectancy is lower than the more affluent parts of the CCG catchment We have strong and positive relations with the key staff members, which is extremely useful The following issues are highlighted for action. As the action plan for the Real World Group and the work programme for Investors in Excellent develops, it should become part of the larger organisational development plan. Issue Low stakeholder response rate Capacity of smaller practices to engage Setting the agenda and measuring outcomes inclusively with member practices Ensure consistency of engagement Action Paper to be presented at Council to highlight 2015 feedback. A further paper is planned for Council later in the year in advance of 2016 survey Ongoing from 2014 action plan. A further locality facilitator is currently in place with discussions regarding further support ongoing Ongoing from 2014 action plan. Request for agenda items inc GP non-exec members as well as other Councilelected representatives. A first paper covering a wide-range of reports which contribute to CCG performance has recently been presented to the Board and on-going development will ensure the CCG continues to be outcome focused Review of Chair and Chief Officer s Page 4 of 9

Issue Ensure consistency and quality of communication with member practices and other stakeholders Co-commissioning Action briefings to include and promote the wider health and social care economy and partnerships A new practice based bulletin is currently in development as a result of feedback already received. The website is currently under review to ensure it is informative, current and promotes the strategy and progress of the CCG New NHS England guidance on conflicts is being shared across the CCG with all parts of governance Page 5 of 9

Actions from 2014 Council Comment Action Agenda (size and complexity) Part of CDU / Non-exec objectives are to constantly review format, topics for discussion Timing (length and different times of day/week) Tuesday was the day selected by practices and the dates are known 12 months in advance Papers in advance not long enough to discuss across Paper are sent out and made available on the intranet seven days in advance wider practice Reimbursement Members are already reimbursed for attendance at Membership and feeding back to wider practice (positive and negative) Put meds optimisation on meds optimisation only meeting More open questions / discussion / input to agenda Council meetings Part of communications plan to be revised in the Autumn Much of this work has already transferred from the Council, but a focus is still required at Council especially when there is a gap in meds optimisation meetings such as March and April Request for agenda items inc GP non-exec members as well as other Council-elected representatives Clinically led We are now providing an increased level of support of our GP portfollio leads to enable greater and more effective clinically-led commissioning across a range of clinical commissioning areas. Practices Comment Resources eg dawn Amelia Build on two way conversations Reaching out to the smaller ones More visits (both supportive and by CO) Engagement scheme complexity and resourceheavy Action We recognise the value of the locality facilitator role and are in the process of recruiting to an additional facilitator within the primary care locality team to build on these resources. We need to be a balance between support / facilitation and monitor issues. It needs to be remembered that they can't do the work for the practices 2014/15 CO visit schedule to be developed We have summarised all of the 2014/15 CCG schemes available to LNCCG practices and on an individual practice basis, forecasted practice income in relation to participation in these schemes and will send this summary on a quarterly basis, showing practice actual income vs forecast income and to work with WYCSA to ensure that all CCG scheme payments are described according to the terminology in the attached schedule. We have kept topics in for longer than 12 months on request by practices Page 6 of 9

Comms Comment More documents on website - which website (intranet / internet) which docs (all Board / sub-committees / CDU / Executive) Reference to blog and chair / chief officer board reports - Open executive - Open CDU Promote bulletin with links to all the above - survey who reads bulletin and if not why not Examples of what's going well - so we have them all as case studies Continuing face to face all staff visibility (not just senior management) and their roles Increased clinicians leading work not managers Profile raising of PAG and how they fit into structure and feed into Board Increased engagement with GPs briefings / SMT Action The website will be used to store minutes and papers of the Executive and CDU on the intranet. All Board papers will be published on the internet and a link to the area will be included in the blog and the bulletin. Comms also working on the Publication Scheme for the CCG regarding what documents are on the internet including FOIs The website will be used to store minutes and papers of the Executive and CDU on the intranet. All Board papers will be published on the internet and a link to the area will be included in the blog and the bulletin. Promote fortnightly bulletin in blog and on website, ask colleagues in primary care to encourage practices to submit articles etc. Comms team will audit who the bulletin goes out to, how many read it etc and carry out a survey of people s thoughts about the bulletin to ascertain how it can be made more useful. See case studies section below. Encourage all staff to attend Council; event with all Council members on 3 June includes more than 20 CCG staff We are now providing an increased level of support of our GP portfolio leads to enable greater and more effective clinically led commissioning across a range of clinical commissioning areas. PAG session on 4 June specifically asking them what measures / actions that they would expect to be included in our progress tracker for our Clear and Credible Plan Board meetings to be held in different locations across Leeds North to encourage more varied attendance Event on 3 June for all GPs about federation / collaboration Page 7 of 9

Good news stories Comment The CCG need to celebrate success, and let stakeholders know where good progress has been made. These stories can be used for press releases, annual reports and other publicity documents etc. LNCCG has tried to develop services to support commissioning intentions Primary care improvements through commissioning various local contracts to deliver improvements in quality for patients. Examples include with the voluntary sector to commission practice champions within the Chapeltown locality and with statutory providers to commissioning alcohol services in Seacroft. Care closer to home & improvements to mental health contract Engagement scheme - review of use of services at practice level to improve targeting of care Council - feedback to various services in how we would like services to develop - also through localities making suggestions Admissions avoidance scheme - proactive care for high risk patients. Hospital inpatient care district nursing service Action Comms will add a standard call for stories section to the fortnightly bulletin and to Nigel s blog with a contact email and phone number. The team are willing to visit practices to interview people and write the story if necessary. Develop a case study Develop a case study around working with the voluntary sector to commission practice champions within the Chapeltown locality and with statutory providers to commissioning alcohol services in Seacroft. Develop a case study Through the 2013/14 Core Engagement Schemes, the CCG has worked with member practices to improve the health and wellbeing of our local population by delivering. Practices worked with patients to undertake an additional 24,000 alcohol screening questionnaires as well as sign posting to alcohol support services and the provision of brief alcohol interventions. Event on 3 June for all GPs about federation / collaboration Develop a case study Statistics yet to be seen as to impact but aim to reduce hospital admission is excellent Develop a case study Page 8 of 9

Engagement Comment Stakeholder engagement needs more work specifically carers / third sector. Making it meaningful Better with older rather than younger Governance Comment Promote conflict of interests / declarations / further involvement and succession Promoting progress on the plan tracker and commissioning intentions (inc CDU) Locality level engagement re future commissioning intentions Action PAG session on 4 June specifically asking them what measures / actions that they would expect to be included in our progress tracker for our Clear and Credible Plan PAG session on 4 June specifically asking them what measures / actions that they would expect to be included in our progress tracker for our Clear and Credible Plan Action Declarations of interest have been chased up and are publically available through our CCG website. Conflicts are requested at the start of every Council, Board, sub-committee and CDU meeting. Quarterly C&CP update to public Board; considering adding to the tracker as the year progresses to reflect elements not included at the point of sign-off. Part of the process this year included Portfolio lead GPs; discussion was undertaken at Council; consideration within the commissioning cycle to visit GP localities The Primary Care Locality Team is now supporting four locality meetings across the CCG area. These are Wetherby, Otley, Chapeltown and the central area. This means that all practices have the opportunity to meet with other local practices to identify opportunities for improved commissioning of services for their local populations. Page 9 of 9

Appendix B NHS Leeds North CCG - Social media guidelines July 2015 1. Purpose These guidelines are to advise managers at Leeds North CCG on how to make best use of social media in helping the organisation to achieve its objectives. They describe the different social media platforms and their best use. They also discuss where the use social media may be inappropriate. The guidelines contain contact details for the Communications and Engagement team who will be happy to support you or your colleagues in exploring the use of social media where appropriate. For those managers who decide to progress the use of social media within their teams, there is also a set of guidelines provided in Appendix I 2. What is social media? The Chartered Institute of Public Relations (CIPR) defines social media as: The term commonly given to internet and mobile-based channels and tools that allow users to interact with each other and share opinions and content. As the name implies, social media involves the building of communities or networks and encouraging participation and engagement. 1 Typically these tools include: Twitter Facebook YouTube Pinterest Instagram Google + Flickr Vimeo Linked In Snapchat What s App Facebook remains the most popular social networking site, with 28 million users in the UK. Three in ten social networkers say they have a Twitter profile. Twitter has 13 million users in the UK, 80 per cent of them accessing it through a smartphone. More people are accessing social media through hand-held devices (smartphones) than desktops. Ofcom s Adults Media Use and Attitudes Survey 2014 points out: Over eight in ten (83%) of adults now go online using any type of device in any location. Nearly all 16-24s and 25-34s are now online (98%), and 42% of those aged 65+ now go online. The number of adults using tablets to go online is 30% in 2013. Six in ten UK adults (62%) now use a smartphone. 1 http://www.slideshare.net/ciprpaul/cipr-social-media-guidelines-final-2013 Page 1 of 7

The major difference between social media and traditional media such as newspapers, television and radio, is that generally it is not moderated or corroborated. It is authored by the general public and interested parties with no requirement to be balanced or even factually correct, though it is subject to the laws of contempt of court and libel. Its lack of accountability also makes it immediate and likely to come to public attention before any official announcements are made. It also has a global reach and it is not always clear where posts come from and who has made them. 3. What can social media do for Leeds North CCG? The CCG serves a population of just over 212,000. We are a commissioning organisation which seeks to involve our local population and wider stakeholders in how we commission and monitor health services. We also seek to inform them about specific and general health messages or alert them to issues which need attention. Social media can help us reach many people immediately with one message and enable them to respond easily. It also means they can contact us at any time at little or no cost to themselves. However there is a limit to the level of detail the can be given in a social media post, in the case of Twitter, just 140 characters per tweet. Examples of best use could therefore include: Publicising meetings and events (eg board meetings) Sending an immediate, urgent message (eg a surgery closure) Asking vox pop-type questions to gauge opinion quickly Sending links to provide more detailed information Forwarding further information from other organisations eg re-tweeting Holding a general dialogue in the public domain 4. What can social media NOT do for the CCG? Although it seems to be everywhere, social media is not used by everyone and those it does reach tend to be more empowered and have easy access to computers and hand-held devices. Those we describe as seldom heard because of social isolation, language, learning or cultural issues are unlikely to use social media regularly if at all. Posts in social media have a limited lifespan, in the case of Twitter, it s 18 minutes and 75 per cent of Facebook engagement is within the first five hours. So messages have to be given frequently, or they will get lost. This could lead to an information overload and user fatigue, as well as requiring a high level of monitoring. While social media can raise general awareness and be one of the mechanisms to help deliver the communications and engagement strategy, it cannot replace the kind of in-depth dialogue that face-to-face meetings can bring. In short, social media is just one of a number of communications and engagement mechanisms available to the CCG. Page 2 of 7