We involve the public and patients in a variety of ways and use several different methods to capture views, reach seldom heard communities, ensure views are influencing decision making and to feed back to those who have been involved.
We aim to actively work with patients, carers and the public to embed the values of the NHS Constitution into everything that we do.
Vision and commitment to involvement
Wandsworth CCGs corporate objectives demonstrate our commitment to:
Improving Outcomes and Reducing Inequalities: Ensuring access to high quality and sustainable care
Leading with ambition for our communities, driving transformation through innovation:
Delivering better care and a better patient experience.
Working Together: Continually improve delivery by listening to and collaborating with our patients, members, partners, communities and other stakeholders.
This is further supported by the CCGs constitution by our Chair Nicola Jones who states that:
"to achieve our vision of better care and a healthier future for Wandsworth, we will involve and engage our patients in designing services, support them to co-produce systems of care and empower them to look after their own health."
Principles for involvement
NHS England have developed 10 principles for participation, which we follow and have built on:
Use a number of different methods to reach people – rather than expecting them to come to us
Be proactive in seeking the views of people who experience health inequalities and poor health outcomes
Provide clear and easy to understand information in a diverse range of formats
Make sure patient and public involvement is properly resourced
Be open, honest and transparent about what can be influenced and maximise those opportunities
Work in partnership with other organisations to share learning to avoid duplication
Review experience of involvement
Recognise people's contributions and feedback
Involve people as early as possible
Be clear how feedback has or will influence decision making
How do we engage?
The approach we use depends on what we are engaging on and who we need to engage with, but often include events, surveys, focus groups, social media, direct contact and support through our partner networks. We consider the best approaches to take, in conversation with those communities we hope to reach.
We use our Joint Strategic Needs Assessment, and other local intelligence to identify which communities experience the poorest health outcomes and health inequalities. We are working to make sure Equality Impact Assessments are always completed prior to the start of any project or engagement process. This helps us to identify those people who would be most impacted by our plans so that we can reach out to them when seeking opinions. It also enables us to consider inequalities and health inequalities when planning and implementing commissioning decisions so that services are accessible and delivered in a way that respects the needs of each individual and does not exclude anyone.
See our visual snapshot of PPI activity for 2018:
The approach we use depends on what we are engaging on and who we need to engage with, but includes events, surveys, focus groups, social media, and direct contact and via our partner networks. Our opinion is that no-one is hard to reach, but we need to invest the time and resources to creatively reach those we aren't currently hearing from. It is our view that it is best to go to people where they are, rather than expecting them to come to us.
Involvement in our governance
Patient and public representatives take part in our decision making – including through the appointment of lay members to our Governing Body and members of CCG staff (where appropriate).
We have three lay representatives on our Governing Body (including our Patient and Public Involvement Lay member) to hold us to account for the involvement work we are doing.
Healthwatch Wandsworth is a member of our Quality sub-committee, attends our Governing Body meetings and Clinical Quality Review Groups, Thinking Partners and Patient and Public Involvement Reference Group.
We also have individual patient representatives on commissioning programmes such as for cancer, as well as a service user group feeding into mental health work- all influencing the commissioning cycle. You can read more about this in our engagement annual report.
This diagram (above) illustrates how the public is involved in governance and how our patient and public involvement work is structured within Wandsworth CCG.
As part of our commitment to transparency and accessibility we make recordings of Governing Body meetings in public available after the meeting.
To hear or watch the proceedings click on the link here:
Examples of public involvement in the board business:
- Lay representatives highlighted the issue of homeless people in Wandsworth and raised the suggestion of an emergency shelter programme being linked into health initiatives via the Healthy London Partnership in addition to a request for a briefing on NHS Homeless health work.
- Patient representation was called for on working groups for the Neurology Planned Care Transformation programme including the design of a new care pathway, an integrated community-based neurology care team and provision of rapid access to neurology services.
- On the subject of Health and Social Care Integration, Lay members raised concern regarding the balance of bedded home rehabilitation and what happens if the patient is ready to go home but the home care is not in place. This concern was responded to at the board. Non-acute rehab step down beds can be made available in the community in these circumstances.
- Board discussion on the Multispecialty Community Provider Transformation Framework with the public highlighted good practice in End of life care planning through the Planning all Care Together (PACT) programme meaning a patient was able to die at home as he wished. Public members discussed the way care was wrapping around patients was very positive and discussions were had about consideration on how this could apply to children with complex needs.
Examples of public questions put to the board and the responses received:
Question asked: “I liked the Corporate Objectives but what was missing was how the CCG would work with people and empower them. This needs to be included in the supporting text”.
Response given: This was agreed and that such information could be included in the Objectives’ supporting text.
“With regard to winter awareness, I have been approached by people at the
local mosque who were concerned about elderly people. Can flu jabs be given in
Response given: This was agreed as an excellent idea.
“It was hard to do patient and public involvement but, if properly targeted,
it could bring “quick wins.” This could be applied to the Planned Care
Programme with patients asked about their experiences at various stages of the
pathway. This approach could also be used in IAPT.”
Response given: This suggestion
was welcomed by the Board.
asked: “I would like to see an acknowledgement of voluntary sector organisations
and social prescribing and queried whether there is a consistent process or
mechanism where voluntary and charity sector organisations are involved."
Response given: It was explained: "there is a Wandsworth Transformation Group and
the Wandsworth Care Alliance is part of this group and acts as a channel for
the voluntary sector. The CCG also
supports the voluntary sector co-ordination project and is in discussions with
the local authority on how we build on that and will be talking to the sector
on how it can be strengthened."
We work hand in hand with Thinking Partners, the Patient and Public Involvement Reference Group and directly involve patient and community representatives in decision making.
Critical to our success is also maintaining strong and effective relationships with our local communities and partners to support us to make effective decisions and assure our patient and public involvement.
Through our partnerships we share information about getting involved and the work we are doing on a range of other partner websites and bulletins including through Healthwatch and the Voluntary Sector Coordination Project. They promote our involvement opportunities and host content on their websites, which enable us to get a much wider reach to the local population.
We work very closely with Healthwatch and they are involved in several CCG committees. We share information regularly and seek advice and guidance on our plans. This enables us to reach more people across Wandsworth, through using their networks.
Healthwatch have undertaken engagement work alongside us during the grassroots project and more recently on the project around changes to access at the walk-in centre at Clapham Junction.
Wandsworth Voluntary Sector Coordination Project (WVSCP)
The CCG funds this project to provide support and guidance to voluntary sector organisations and to support better understanding of the NHS and it's processes.
Through the projects connections we share information about opportunities to be involved with us. The VSCP are also members of our Thinking Partners group.
Wandsworth Community Empowerment Network
Wandsworth CCG and Wandsworth Council supported and contributed to a series
of Wandsworth based consultations with young BME people, which included a
Childrens and Young Persons Conference in 2018. These series of events were led
by Wandsworth Community Empowerment Network (WCEN).
The resulting conference
highlighted key challenges and started a further set of discussions about
possible youth work and creative community based therapeutic work with young
people in general and vulnerable young people in particularly. Wandsworth CCG
have made a commitment to feedback to the next BAME Young Person’s CAMHS
Conference in 2019.
WCEM then ran a summer programme, partly hosted by SWLSTG MH Trust: a Youth
Leadership Development Summer Programme and a programme of monthly engagement
activities. This proposal sets out activities that have been co-produced with
young people that WCEN wish to deliver in the Spring of 2019 to pilot creative
therapeutic activities for these groups of young people.
Local Transformation Board (LTB) Communications and Engagement Group
The LTB Communications and Engagement Group brings together communications and engagement staff from all the statutory and voluntary organisations in Merton and Wandsworth to work together on shared priorities. The group discusses their engagement activity so that outcomes and intelligence can be shared and more communities can be reached through coordinating activities.
We ensure all our documents are easily accessible to the public and easy to understand. Documents are written in plain English and those we share publicly are reviewed by the Patient Engagement Group.
To ensure we are able to engage widely, all of our printed materials will include information about how people can get access to alternative formats and easy read materials.
Example in practice
We recently undertook some engagement with young people with various diagnoses of autism, difficulties in being at school due to troubled behaviours and being from a part of the borough where there are high rates of violence and crime. We do this using creative and diverse methods for example we used the Bodymapping tool in our work with young people and children with Learning Disabilities in their after-school clubs.
To respond to their needs, they drew and annotated body maps to describe their experiences and medical issues in a way that felt most comfortable to them. The group, aged from 11-18, had had various experiences of medical care and experienced different ways of communicating.
Young people told us that they liked to use apps on their phone to help distract them if there were any difficult procedures in hospital like injections or being put to sleep. Applications can support young people to communicate their health needs. This information is useful when considering our approaches to engagement in the future.
We also ensure our surveys are disability friendly and enable people to give their feedback for example using pictures and simple language in this health survey for people with Learning Disabilities:
How we use digital tools to support engagement
Using social media to engage with local people is an important part of our communications and engagement approach. It provides us with additional techniques to listen and access people and communities who may have less time to get involved in more traditional ways, due to family or work pressures. The social media ethos is about engaging, participation and relationship building. This makes it a strong vehicle for informing patients and getting their feedback.
We use Twitter regularly and have posted videos that promote our work as well as photos, links to reports, quotes from our engagement work to encourage engagement, promote how to get involved, our events, healthy lifestyle information and self-care campaigns. We currently have nearly 5,000 Twitter followers.
For example, we recently tweeted our latest Productive PPI Survey to find out peoples experiences of Cancer services:
NHS Wandsworth Twitter link to Cancer service survey
Twitter enables us to reach out to a wider audience through our own followers and through retweets by followers and partners. It allows us to also reach people who do not usually engage and build effective relationships with those who follow us. We monitor activity daily to enable us to respond quickly to comments received and feed these back quickly into the organisation.
We live tweet through public events and use #hashtags to get more people reading and responding to our information.