We know that the public want a much greater say in how health and care services are organised, and we know that patients and their families/carers want much more say in how their personal care is delivered. We also know that patients and the public want much more and better information about how they can stay well or help to manage their own illness and to have greater access to information, communication and technology to support this.

How we engage people in their own care and treatment and on the services we commission requires us to ensure we follow a number of actions which will assure our process, these actions are to:

• Ensure the public understand the services we are responsible for commissioning through appropriate information and clear communication
• Ensure that when we review our services we will engage with appropriate stakeholders and service users whilst utilising current, focused patient experience intelligence to inform our decisions
• Make sure we will equality impact assess our commissioning intentions and decisions and assess if we need to take mitigating actions or change our plans to ensure we meet our legal duties
• Decide our priorities by formally consulting with public, patients and carers using a wide range of methods which take into account the needs of our local population
• Use our patient experience mechanisms to listen to patients views on the service we have commissioned
• Work in partnership with patients, staff and carers to ensure that the service meets their needs through service redesign and procurement
• Continue to engage with our partners and use their networks and relationships to reach people.
• Use the commissioning cycle to drive our decision-making process so that the public is at the centre of everything we do.

Engagement and consultation is a process governed around legal obligations. It’s important the the CCG allows time at the beginning of any process to follow a programme approach to determine the requirements for engagement and or consultation, communication and equality as described in the diagram below.

Our process for engaging people on services

Engaging people on service change is not just a legal requirement we are committed to engaging people on any changes to the way a service is currently provided or delivered and in the development stage of any proposals. A good engagement process will ensure the organisation is enabled to make better commissioning decisions based on the views of local people. We use a number of processes to support this engagement work:

• Engagement – gathering views through a number of approaches
• Co-production – developing solutions together
• Pre-engagement – ensuring we have had the right conversations before formal decisions are made about options for formal consultation.

As part of our assurance processes for delivering any engagement activity we will always:

• Complete an internal assurance tool which sets out what the service is, the impact and what the change will be.
• Review any existing information we already hold on peoples’ views, based on their experiences of service use, including individual comments raised through our patient experience systems.
• Develop a clear plan which sets our plans for engagement, including who will be engaged and how with an accompanying action plan.
• Deliver our engagement activity within a 6-8 week timeframe depending on the service.
• Write a report of findings from our engagement activity
• Consider the findings and provide an appropriate time for consideration.
• Provide feedback on our findings from our engagement process and describe the next steps.

In addition we will always follow a number of principles in the delivery of our collective engagement activity so that the public know what to reasonably expect from our commissioners and providers.

Our principles are to:

• Keep the channels of communication transparent and open
• Use ongoing methods of communication to keep people informed
• Make sure communication reaches all our local population by using a range of methods and approaches
• Ensure that communication is in plain language, jargon free and appropriate for the target audience and considers the needs of all protected groups as defined by The Equality Act 2010
• Keep local people informed and developing solutions together
• Demonstrate active listening and creating opportunities for everyone to be involved
• Responding and providing feedback

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Our process for formal ‘Consultation’

This process is supported by our legal obligations and the requirement to make decisions on options that have been developed as part of any engagement stage.  Formal consultations are always delivered once the engagement process has been completed.  Consultations help commissioners make final decisions on any options.

As part of our process for delivering any formal consultation we will always:

• Develop our options based on what people have already told us.
• Develop a clear plan which sets our plans for formal consultation with an accompanying action plan.
• Develop a clear communication plan to support our consultation process.
• Deliver a formal consultation within a 12 week timeframe using a variety of methods and approaches.
• Write a report of findings from the formal consultation.
• Consider the findings and provide an appropriate time for making a decision.
• Provide feedback on our decision and describe the next steps.

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What happens if the legislation is not followed?

Anyone can take a decision ‘to change the way a service is provided or delivered’ to judicial review if they think that the process for consultation has not been followed.

The Gunning principles are:

• Consultation must take place when the proposal is still at a formative stage
• Sufficient reasons must be put forward for the proposal to allow for intelligent consideration and response
• Adequate time must be given for consideration and response
• The product of consultation must be conscientiously taken into account

Gunning principles only apply at consultation stage – not engagement.

It is important to note: It is the process that is undertaken that determines whether a consultation has been robust (or not) and followed the legal obligations, not the decision of the outcome from the consultation.

As part of our decision-making processes we use insight and feedback to continually learn from our local population. Insight and feedback supports a whole system approach in helping us identify how services may need to change and the aspects of a service that require redesign.

We are using more patient stories, gathering case studies and building in insight into our communications. The organisation has improved how we listen and learn from the insight and feedback we gather and we continue to evidence how information is used in a much more robust manner.

Our audit trail of evidence is strengthened by the information we gather and using this information we can demonstrate how the views of patients, carers and staff have influenced our commissioning decisions. This is a key part of upholding our legal requirement and ensuring we have taken the time to consider all insights and feedback.

Every engagement and consultation delivered throughout the year provides more rich information and intelligence to support service development and design.  Prior to embarking on a piece of work to gather views, the CCG gathers any existing patient experience and engagement information. 

By working through existing intelligence the CCG can identify key emerging themes and also identify where there are gaps.  In addition we can also identify through the Equality Impact Assessment (EQIA) the communities we have already reached and need to reach, in line with our equality duties.  The information sources we use are:

• Patient Advice and Liaison (PALS) queries
• Friends and family test Reported
• Complaints
• Websites such as Patient Opinion and Patient Choices– see clare link to page
• National and local surveys– see clare link to page
• Findings from any engagement/consultation activity locally and nationally – see clare link to page
• Calderdale Health Forum
• Equality Health Panel

The information we gather is saved in a format that allows for further interrogation.  By looking at what we already know we can draw down information again and use it to support other service areas.  The data we hold not only allows us to draw on a wealth of intelligence but further assures our local population that their views are an important source of business intelligence. The CCG also equality monitors all activity ensuring the insight we have can be used to represent the views of a range of protected groups. 

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Our aim is to ensure that we analyse the information we receive, review it on a regular basis, identify any areas of concern, and develop recommendations on which to base actions in partnership with providers for the improvement of services. We currently receive a quarterly dashboard patient experience reports which gathers and triangulates information received from all our main providers; this report is received at the CCG PPEE and quality committees. The feedback used to inform the dashboard reports is reflective of all data sources listed above.

As part of our process feeding back to people about all our engagement activity and consultations involve a number of communication methods and approaches depending on the target audience. The mechanisms we use are:

• Calderdale CCG and Calderdale Engage websites, and wider partner websites where appropriate.
• Directly in the form of presentations and conversations to the people who contributed.
• Through our partners organisations such as the ‘Engagement Champions’ and ‘Calderdale Health Forum’.
• Communication, Engagement and Equality Collaborative
• Involving People Network
• Through media stories and press releases.
• By producing our annual statement of involvement report of our engagement activity each year

There are a number of mechanisms already in place which help us to involve, engage and listen to patients, public, communities and our partners and stakeholders.  Information we gather in our mechanisms feed into the overall themes arising locally as part of the development of our commissioning intentions and supports our decision making in respect of future actions. We regularly cross reference the themes which arise from all activity to update and reflect on the intelligence we have to date.

Throughout the year we actively promote activities for people to become involved. If you would like to know more about how you can get involved please see the Get Involved section of our website.

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Involving People Network

A diverse network of people across Calderdale who share knowledge, skills and resources and provide peer to peer support to involve local people and our communities. Working together, with our communities to understand their needs and celebrate the great things that are happening in local areas.

Communication, Engagement and Equality (CEE) Collaboration

Communication, Engagement and Equality leads from key partner organisation who come together to facilitate system-wide projects, involvement or campaigns – a do once approach

To ensure all expertise is considered in advance of any communications being published or involvement taking place, we will do this by working together using our networks and our existing mechanisms by supporting our Calderdale Cares localities and the communities and people who live and work in them.

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Equality Health Panel

The Equality Health Panel provides an opportunity for protected groups and their representatives to share their views, information and feedback with the CCG and our providers to promote equality in the Calderdale healthcare system.  The Equality Health Panel is a forum where the voices of those people with characteristics protected by the Equality Act 2010 and other disadvantaged groups are represented in the health care system; and it brings together commissioners, health care providers, stakeholders and local communities to identify areas for improvement and suggest recommendations.

Due to the ongoing COVID-19 pandemic the panel has been suspended temporarily. This decision will be reviewed in April 2021.

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Calderdale Health Forum

Calderdale Health Forum (HF) provides patient input into key CCG priorities and potential service redesign.  Members are also informed of additional engagement opportunities as they arise.  Health Forum members are representatives of Calderdale GP practices who have a Patient Participation Group (PPG).

Due to the ongoing COVID-19 pandemic the Health Forum has been suspended temporarily. This decision will be reviewed in April 2021.

A PPG is a group of patients interested in health and care services and peoples experiences of those services who want to get involved with and support the running of their local GP Practice and contribute to the continuing improvement and development of your local GP practice.

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Website (www.calderdaleccg.nhs.uk)

NHS Calderdale CCG has a website which provides information to the public and has a page called ‘Involving People’. We use our website to inform of our plans to engage, raise awareness of any consultation activity and also provide opportunities to become involved. The website is updated on a regular basis and we regularly report on the outcomes of all our engagement and consultations and what we have done as a result of our activity.

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Calderdale CCG’s Complaints Service

The Complaints Service helps the NHS to improve services by listening to what matters to patients and their families, and making changes when appropriate.  It also provides the following functions to the population of Calderdale:

• It is responsible for receiving, handling and investigating complaints relating to the actions of Calderdale CCG and the NHS services it commissions.
• Providing information about the NHS complaints procedure and how to obtain independent help if the person decides they want to make a complaint
• Providing information and help for example: support groups outside the NHS
• Providing an early warning system for the CCG, NHS Trusts and monitoring bodies by identifying problems or gaps in services to prevent a recurrence.

More information can be found in our Complaints Policy at https://www.calderdaleccg.nhs.uk/download/complaints-policy/

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Healthwatch

Healthwatch Calderdale is an independent consumer champion organisation for both health and social care. It exists in two distinct forms: local Healthwatch – Healthwatch Calderdale – and Healthwatch England. NHS Calderdale CCG works alongside Healthwatch to ensure it forms part of our mechanisms of involvement with the local population. The aim of Healthwatch Calderdale is to give citizens and communities a stronger voice to influence and challenge how health and social care services are provided within their communities.

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Voluntary and Community (VAC)

Engagement Champions were established to help the CCG engage with health-focussed Voluntary, Community and Enterprise sector (VCSE) organisations. The aim of the project is to support the sector voice in commissioning and to use their communities to ensure we reach local people at a grass roots level. ‘Engagement Champions’ is an asset based approach to engagement, and involves training members of the VCSE sector as approved engagement providers for the CCG, they in turn seek the views of their members. The programme is delivered by VAC on behalf of the CCG.

‘NHS Calderdale CCG is committed to work both in partnership with and alongside the voluntary, community and Enterprise sector and the communities it serves.  Through investment in the Engagement Champions project the CCG have reached out into communities supporting the voice of those that otherwise may not have a say in how health services are designed and delivered’.  Quality for Health and Wellbeing and Engagement Manager, VAC.

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Patient stories

Patient Opinion is a feedback platform for the public so they can share their story or experience of healthcare services. Anyone can post an opinion on the website. NHS Choices also provides a similar facility. Calderdale CCG searches these facilities by provider to identify what patients are saying about local NHS services.

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National and local surveys

National and local surveys take place throughout the year by various providers and local GP practices. Patients are encouraged to contribute to these surveys. The public can use surveys to have their say on current services. Calderdale CCG is able to use such surveys to understand the patient’s view of services. In addition surveys can be used collectively to inform commissioning decisions.

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Friends and family test

We work closely with our provider organisations to monitor the patient views of services as close to them receiving care as we can. These surveys are ‘real time feedback’ and help us to understand in real time what is happening in the service and how patients are finding the care and treatment they receive. In addition the CCG website features a feedback form ‘I’d just like to say’, which patients are encouraged to complete. This form is also circulated by staff at public events. Information gathered by both of these mechanisms are stored on databases and used to inform commissioning decisions.