Engaging patients and communities in new long-term health plans

The challenge

The NHS, local councils, charities and other groups are increasingly being asked to work together to plan and deliver health and healthcare services. At the centre of this new way of working is a different way to work with communities so as to deliver services that fit patients, not the other way round.

The organisations working together in south east London (called the South East London Integrated Care System wanted to carry out a significant engagement exercise over a three month period to think about their priorities. This was in response to a national strategy, the NHS Long Term Plan.

The purpose was to understand the views and experiences of relevant individuals and groups in relation to future health priorities, and produce an engagement report to inform the system’s future direction.

This included:

• summarising strategic plans into clear and concise language, accessible for a range of stakeholders
• collaborating with all organisations within the Integrated Care System to ensure messages were endorsed and aligned as well as ensuring alignment with the London health and care vision and national communications and engagement approaches around the Long Term Plan
• ensuring meaningful engagement with the appropriate groups of public, patients and other stakeholders. This included innovative as well as traditional approaches for engagement and an approach to ‘seldom heard’ groups that demonstrated wide and deep engagement
• providing clear written outputs summarising feedback into a compelling engagement summary.

Our approach

We designed and delivered a programme of engagement that aimed to give people as many different opportunities to engage with the process as possible – through face-to-face events and discussion, social media, and written and video outputs.

Face-to-face engagement events

We facilitated 12 face-to-face engagement events across the six boroughs in south east London. The morning of each event focused on the specific boroughs, with the afternoon focusing on one of the six topics where the local system was especially interested in local people’s views – from getting the best start in life, and young people’s mental health to access to services and social isolation.

We used a series of questions such as: ‘When would you like the hospital doctor to give you a ring?’ and ‘Should GPs prescribe cooking classes and lunch clubs?’ to prompt broad discussions of what was important to local people within each of the six topics.

We promoted these events through local news and social media, NHS communications channels, patient groups and posters in care settings such as GP practices and care homes.

Conversations with community groups

We had a series of conversations with 19 community groups whose voice is seldom heard in the NHS.  We wanted to ensure we had a broader set of views so we took the conversation out to people – going to places where harder to reach groups meet, at times convenient to them, and talked about the things they want to talk about.

Online input

We gave people the opportunity to answer a short survey for those that could not input their views in person. We provided the content for a dedicated page on the Our Healthier South East London website including blogs from local leaders which we supported the development of and short video clips with reflections from the events.

Results

Neary 300 people attended the 12 face-to-face engagement events with a broad range of participants from patients, people working for charities, to NHS staff and local authorities. These events enabled participants to share their views and experiences on the areas that mattered most to them from the six discussion topics.

Of those who took part, 4.3 out of 5 people said they would recommend this type of event to a friend or colleague. Participants also praised the events as informative, thought-provoking, well-organised and a way to find out what is going on in their local area.

Around 200 people engaged through our outreach conversations and we had 76 survey responses. The outreach conversations meant we were able to access views and genuine engagement from those that do not traditionally participate. We were able to shape the agenda from their perspective and couch messages in the things that are important to them to ensure these groups had the opportunity to share their thoughts.

Through this work we heard some different messages as well as  different perspectives on the messages we heard through the engagement events. For example, there was general agreement across those we engaged with that it is increasingly difficult to get GP appointments, and this was having an impact on increased attendance at A&E and other urgent services. The outreach discussions highlighted many different barriers to access – availability of appointments (especially in primary care and mental health), postcode lottery, awareness of what’s available, location, hours of operation, language and communication difficulties, lack of reasonable adjustments for people’s needs and a fear of authorities. There was a clear need to build trust with many communities, who feel that their needs or cultural differences are not properly understood or respected.

We produced clear written outputs from each of these opportunities and a report that summarised the views of local people based on these activities. This report was used to support the development of south east London’s response to the NHS Long Term Plan, which will help to shape the future of local service provision.

Kaleidoscope offered a fresh approach to what can sometimes be formulaic public engagement conversations. They positively challenged our thinking, delivering a creative set of engagement events that were well received by participants and have had a demonstrable impact on the development of our NHS Long Term Plan response.

Tom Henderson, ICS Programme Manager, Our Healthier South East London