Public & Patient Engagement Training – Session 2

9 & 24 May 2013

Welcome

Your trainers:

• Anna Hynes, Health and Social Care Officer, CVAT

• Ben Gilchrist, Policy and Participation Manager, CVAT

• Peter Denton, Healthwatch Tameside Manager

Community & Voluntary Action Tameside (CVAT) is the lead

development and support organisation for community and voluntary

action in Tameside.

Healthwatch Tameside is the local consumer champion for health

and care issues in Tameside.

Refresher – from session 1

• Ladder of involvement

• 4 step process (next slide)

• What may change?

• Who may be affected?

• What do we already know?

• What is ‘given’ and can’t be changed?

• Thinking about one activity to inform several processes (e.g.

AoE)

• What is the potential impact of NOT engaging effectively?

NHS T&G CCG Framework for engagement

Focuses on

commissioning, in 4 steps:

1. Checklist – thinking about your

engagement

2. Impact of proposal – how does this

relate to scale/type of

engagement?

3. Planning the public and patient

engagement activity

4. Evaluating – both the engagement

itself and the impact/changes that

have resulted.

This is about determining the scope of

your project, background research &

getting the ‘green light’ to proceed.

This is about understanding the scale

of potential impact and what level of

engagement is appropriate.

Support and guidance are available.

How successful were you?

What did you learn?

What changed?

Steps 2 & 3 may cause you to revise assumptions in step 1

FRAMEWORK – STEP THREEPlanning your engagement

Your recap

In the groups you were in for session 1:

• Briefly remind yourselves about the project you used in

session 1:

• What is the service?

• What is the expected change?

• Who accesses it/may be affected?

• What do you already know?

• What impact level is it?

Exercise 1 – Scale of engagement

What are the main target

audiences for this service/activity?

Do you need qualitative or

quantitative data (or both)?

Do you need the same data from

each target audience group?

Approx how many people from

each target group do you need to

engage with?

Think about protected

characteristic groups and people

who don’t currently access it

What might the barriers to

engagement be?

Is statistical significance

important?

Cognitive stages for getting responses

The respondent goes through four stages:

1. Comprehension – do they understand you?

2. Recall – can they remember/imagine the

scenario you are giving them?

3. Judgement – are they able to form an opinion

on this?

4. Response – what they actually tell you

Exercise 2 – Type of engagement

Thinking about your answers in

session 1 of the training, produce:

• A list of no more than 3 headline

topics you want to find out about

• For each headline topic, no more

than 5 specific things you want to

find out

When you have done this, think

about the different engagement

methods you could use – and

choose no more than 2 for your

project.

Try to avoid formulating questions

at this point – it’s about what you

want to find out, not the words

you will use to find it out

Check whether or not everything is

relevant to all your target groups

Think about:

• Questionnaires

• Face to face interviews

• Focus groups

• Public meetings

• Online engagement

Exercise 3 – Reaching your audiences

For each of the target groups you

have identified, write a short

statement that:

• Lists the specific things you want

to find out from them

• Identifies the tool/technique you

will use for engaging with them

• Identifies the time and

geographical considerations

relevant to them – so you can

engage in a time/place that

works for them

Think about your answers in

exercises 1 & 2

What do you know (or can you

reasonable assume) about these

groups?

Is anyone in any of these groups

likely to need support to help them

engage (e.g. literacy, IT

literacy, physical

access, interpreters)?

Exercise 4 – Secondary data

What secondary data do you have?

What good practice materials can

you refer to?

Who can you ask for assistance?

What other research has the CCG

done – and who has this?

What have colleagues in other

CCGs done – and how does their

local population compare with

ours?

What national good practice is

there?

What other partners might have

data?

COMFORT BREAKPlease return in 5 minutes

Exercise 5 – Defining your questions

You will see a series of questions from real questionnaires.

For each question, discuss:

• Do you think it’s a good question?

• What aspects of the question are good?

• What aspects of the question are poor?

“It is natural to have an inquiring mind: asking the right people the right questions in a way they can

understand will provide useful answers.”

Sample question 1

What was the medical

problem or reason for which

you most recently saw your

family doctor?

Sample question 2Example from Research into Stroke Patients in a UK city

Q4 WHERE DO YOU LIVE AT PRESENT?(Cross one box)

Own home (owned or Own home (owned or

rented), not alone. rented), alone.

With relative or friends In sheltered accommodation

In a residential home In a nursing home

THIS FORM WAS COMPLETED ON: ___/___/____ (Date)

Sample question 3Example from UK Patient Satisfaction Survey

4.The doctors have done everything they can to make me well again

Strongly Agree Agree Disagree Strongly Disagree Not applicable

11.I had good support at home when I needed it

Strongly Agree Agree Disagree Strongly Disagree Not applicable

13.The ambulances have been reliable

Strongly Agree Agree Disagree Strongly Disagree Not applicable

Final one on health & careExample from Caregiver Burden Scale questionnaire

This question was asked of the wife of someone who’d had a stroke six months previously. The person could not go out of the house unaided and the carer felt unable to go out for more than an hour at a time.

Do you sometimes feel as if you would like to run away from the entire situation you find yourself in?

Not at all Seldom Sometimes Often

Some basic guidelines

Try to avoid:

• Long, complex questions

• Complex terms and concepts

• Asking more than one question at once

• Making assumptions

• Asking by proxy

• Vague quantifiers

• Hypothetical questions

• Agree/disagree questions

Some basic guidelines

Aim to:

• Be clear about what constitutes an adequate answer

• Think carefully about mid categories and ‘don’t know

options

• Think carefully about whether rating or ranking are

likely to get the most useful responses

• Think about how the information in your question may

affect the answers you get

• Check how easy the question is to understand

Analysis of Effect & Exercise 6

• This is a core requirement enabling the CCG to meet it’s

statutory obligations

• What are the 9 protected characteristic groups? Do we have

any extras in the CCG?

• Anticipatory duty – not just about responding to issues – need

to demonstrate that potential impacts have been thought

through and reasonable adjustments/mitigating factors put in

place

• Check your case studies to see if there is anything else you

want to ask when you engage people

• Would it be useful to collect data about demographics?

Informed consent

Discussion about:

• Voluntary participation

• Informing people about what it expected – and what will

happen if they do/don’t participate

• Confidentiality v. anonymity

• Trust:

• Use of people delivering service

• Use of arms length CCG people

• Use of external agencies

Exercise 7 – Unexpected responses

In the context of your case

studies, discuss what you can do if:

• People disagree with your

proposals/ideas but the

disagreement is about something

you can’t change.

• People disagree with your

proposals/ideas but there is a

clear evidence base that what

they want isn’t good practice.

• People disagree with your

proposals/ideas and what they

suggest is practical, supported by

evidence but requires you to

rethink your solution.

Are there any potential objections

that you can predict in advance?

Are you really being clear about

what is up for discussion and

within your power to change?

What is your timescale – how much

scope do you have to rethink at

the time you end your engagement

and how critical would a delay be?

Feedback – Why?

This is about:

• Trust

• Respect

• Honesty

• Openness

• Value

Make sure you tell people how, when and where you will

feedback.

Even if you don’t do what people have asked for, they want to

know what you are doing and why…

FRAMEWORK – STEP FOUREvaluation

Why is evaluation of impact important?

Think in terms of:

• Quality of service

• Cost effectiveness

• Public confidence

• Media and public image

• Evidence for statutory processes

• Building a local knowledge base

What do you know about these?

Here are some evaluation techniques and tools:

• Customer satisfaction measures

• Benchmark and tracking studies

• Self-reported outcomes

• Service-recorded health outcomes

• National performance data

Be careful – this is about focus on the patient/population

Exercise 8 – The impact of your project

In the context of your case studies, discuss:

• What will be the impact measures you can measure?

• What data do you have (or can you collect) at the start of the

project? Have you built this in to stage 3 (Planning)?

• How long is it likely to take for the impact to be measurable?

• What is the most cost-effective way to gather this data?

• What external data sources are relevant?

• What longer-term follow-up would be beneficial?

In conclusion

Action-packed 2 days – hopefully now feel better equipped to

do this by:

• Ensuring clarity of purpose

• Understanding target audiences

• Being clear about what is up for discussion – and what you

want to find out

• Knowing what data sources, colleagues and external

organisations can help with this

• Having a clearly structured process

• Giving feedback to the people you engage with – so they are

more likely to feel positive about the process

• Evaluating the impact of your changes

ANY QUESTIONS?

PLANNING AHEADTracy Turley

THANK YOU