All stakeholders have the opportunity to engage with, influence and shape their local place-based health and care system. This is achieved through a clearly communicated vision, involvement in decision making and having quality information readily and easily accessible.
Local government, NHS England, CCGs, and NHS trust/foundation trusts all have separate but similar legal obligations to consult or otherwise involve the public.
Duties for local government to consider are that of:
- overview and scrutiny
- public sector equality duty
- health and wellbeing boards
- the legal requirement to hold meetings in public, except where it is permissible to exclude the public.
Due to the democratic accountability of local government, even where there is no legal duty, public consultation is a principle that it continually reinforced.
The four main stakeholder groups it is important to reach are:
- service users and the wider public
- clinical staff
- the wider workforce
- local leaders and local politicians.
Frequently asked questions
What does good person centred, community focused health and care look like?
- a well thought through and documented engagement approach, involving the public, communities and other stakeholders, even where there is no obligation by law to do so, is in most circumstances the right thing to do and will ensure services meet the needs of the population
- where possible joint public involvement exercises are encouraged between local government and NHS partners as they reduce the burden on service users and the wider public
- effective communication and involvement throughout will help to build ownership and support for proposals.
What does good communication and engagement look like?
- a clear vision is important to underpin engagement and buy-in - one that is routed in making a positive difference to individuals – and in order to monitor progress. This is clear from the ‘Mrs Smith' case study (see below)
- a communication and engagement strategy can sit across all workstreams and set out how stakeholders will be communicated with
- defining and segmenting the population can make targeting and engaging populations much easier
- successful relationships and integrated delivery will in part come down to how information is shared. It will form part of the communication strategy and wider partnership agreement
- holding events to engage the public, local and national partners can be a key platform to showcase and develop work.
What are some key engagement techniques?
The ‘Ladder of Engagement and Participation' is a model for understanding different forms and degrees of engagement. Transforming participation in health and care discusses the following:
- devolving: placing decision-making in the hands of the community and individuals. For example, personal health budgets or a community development approach
- collaborating: working in partnership with communities and patients in each aspect of the decision, including the development of alternatives and the identification of the preferred solution
- involving: working directly with communities and patients to ensure that concerns and aspirations are consistently understood and considered. For example, partnership boards, reference groups and service users participating in policy groups
- consulting Obtaining community and individual feedback on analysis, alternatives and / or decisions. For example, surveys, door knocking, citizens' panels and focus groups
- informing: providing communities and individuals with balanced and objective information to assist them in understanding problems, alternatives, opportunities, solutions. For example, websites, newsletters and press releases
Case studies and examples
- NHS Involvement Hub: Good practice examples: films and case studies showing the positive impact of participation and examples of how to work together to improve services
- Integrating health and social care in Torbay: Improving care for Mrs Smith exemplifies a clearly communicated vision and bottom-up, person centred approach
LGA support and resources
- DevoNext resources hub: Engaging citizens in devolution describes a range of approaches that areas can use at varying scales from local to city region, all of which can be re-modelled to suit various budgets
- CommsHub: a range of guides and resources to help support and advance communications activity
- Our Place! Community Engagement: a guide to learning from the pilot areas
Selected tools and resources from our partners
- NICE guidance: Community engagement: improving health and wellbeing and reducing health inequalities covers community engagement approaches to reduce health inequalities, ensure health and wellbeing initiatives are effective and help local authorities and health bodies meet their statutory obligations
- Transforming participation in health and care this guide will help health and wellbeing boards and commissioners of health and care services to involve patients, carers and the public in decisions relating to care, treatment and commissioning
- Health Empowerment Leverage Project (HELP) supports neighbourhood partnerships which boost community activity and service improvement. HELP developed a research-based cost benefit model and a handbook on Commissioning Community Development for Health
- Skills for Care: Community Skills Development an extensive programme of practical guidance into the use of skills led approaches to support skills led community empowerment
- PB Network: Participatory Budgeting (PB) resources PB directly involves local people in making decisions over how public money is spent in their community
- Nesta and Health Foundation: Realising the Value: a national programme to further develop the field of person and community-centred approaches for health and wellbeing
- Government Communications Service: Writing a Communication Strategy: a guide to developing effective communications strategies
- NHS Networks: Smart Guides to Engagement: series for everyone working in or with CCGs on all aspects of patient and public engagement (note: NHS Networks sign in required)