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«People and Communities Board Six principles for engaging people and communities Definitions, evaluation and measurement June 2016 Published by the ...»

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People and Communities Board

Six principles for

engaging people

and communities

Definitions, evaluation

and measurement

June 2016

Published by the People and

Communities Board, with

support from National Voices

What is this document?

This document is about creating person-centred, community-focussed approaches to

health, wellbeing and care. It builds on the proposed new relationship with people and

communities set out in the NHS Five Year Forward View.

Using the information and suggestions in this document, you will be able to better understand and measure the impact of engaging with local people and communities.

It aims to complIment a wider suite of products to be produced by national bodies for the health and care system as it moves forward with the implementation of innovations in care delivery. It will be received by people working at full tilt in a system under great pressure. We hope that in this document you will find inspiration, reassurance and practical support.

Who should read this document?

This document is useful for anyone engaged in improving and transforming health and care services in England, including patients, carers and the public.

It is particularly aimed at:

Leaders in the NHS, and national and local government ◆ Managers in the NHS, and national and local government ◆ Practitioners in the NHS, and local government ◆ How should this document be used?

This document is designed to help build knowledge, confidence and motivation to develop person-centred, community-focussed approaches to health and care.

It is accompanied by Six principles for engaging people and communities: putting them into practice,1 which provides more context for the principles, and ideas for implementing them.

These principles are referenced in the NHS Shared Planning Guidance, published in December 2015.2 2 Six principles for engaging people and communities The six principles Graphic: Six principles for engaging people and communities Care and support

Volunteering and is person-centred:

social action are Personalised, key enablers coordinated, and empowering Voluntary community Six principles Services are and social created in for engaging enterprise, and partnership housing sectors people and

–  –  –

The six principles map the key elements of person-centred, community-focussed approaches to health, wellbeing and care.

At the heart of the principles is the assertion in the NHS Five Year Forward View that ‘a new relationship with patients and communities’ is key to closing the three gaps identified by the NHS Five Year Forward View: health and wellbeing, quality of care and treatment, and finance and efficiency.3 The evidence is increasingly clear that better engagement – by which we mean involvement and co-production – is not a nice-to-have, it is core business. There is a growing body of knowledge and practice that demonstrates that engagement is doable and has real impact.

Six principles for engaging people and communities Care and support

is person-centred:

Personalised, coordinated, and empowering We recognise the following as key interventions for high quality care

and support, especially for those with long term conditions:

Information, support and advocacy for patients, service users, carers, ◆ and families, tailored to their level of health literacy.

Shared decision making as the default mode for clinical consultations.

◆ Personalised care and support planning as the core model for working ◆ with people with long term conditions.

Support for self-management at scale, so people are informed, ◆ skilled and confident.

Care is coordinated, as set out in Integrated Care: Our Shared Commitment,1 ◆ and is based on the Narrative for person-centred coordinated care.2 Access to personal health records which people can use, correct ◆ and amend, and which prioritise their personalised care plans.

Personal budgets across health and care.

◆ Widespread availability of effective peer support.

◆ Joined up mental and physical health care.

–  –  –

Improvement in health and wellbeing outcomes attributable to person centred interventions.

Improvement in people’s health ‘activation’, especially among the least health ◆ literate groups.

People feel supported to attain their own health and wellbeing goals, ◆ i.e. what matters to them.

People’s experiences of:

–  –  –

People’s reported access to personalised care and support planning.

◆ People’s experience of care coordination, including discharge and transitions.

◆ Access to records and personal budgets.

◆ Care professionals’ knowledge, confidence and skills in person centred approaches.

–  –  –

Six principles for engaging people and communities Indicators and evidence Additional indicators Patient Activation Measure (PAM).11 ◆ Assesses knowledge, skills and confidence.

–  –  –

6 Six principles for engaging people and communities Services are created in partnership with citizens and communities We create services in partnership with citizens and communities, engaging groups of people at the earliest stages of service design, development and evaluation.

This means we:

Reach out to and work with a wide range of citizens, reflecting the diversity of ◆ our community, to have the necessary conversations about health, wellbeing, prevention and services.

Directly involve citizens in gathering feedback on experiences of care from a ◆ range of sources. There is also direct involvement in using insight from feedback on complaints, experience and outcomes to inform the development of care models and make improvements.

Use the ‘family’ of community-based approaches, outlined by Public Health ◆ England and NHS England, to build and use community resources for health, prevention and wellbeing.

Use co-production approaches, e.g. Experience Co-Design, to design services ◆ with service users, people with lived experience, and carers.

Recruit, train, support and involve experts by experience, carers, patient leaders ◆ and lay leaders in meaningful roles including in programme governance and service design.

Work with the voluntary, community and social enterprise sectors, patient ◆ participation groups, carers, and Healthwatch as partners.

Specifically target deprived and excluded populations to address health ◆ inequalities, working with civil society groups.

Six principles for engaging people and communities Measures of success Improvement in health and wellbeing outcomes attributable to community ◆ based interventions.

–  –  –

Voluntary sector organisations report good experience of involvement ◆ in commissioning.

Improvement in the number of less-heard people/groups listened to and ◆ relevant actions taken.

The area’s Joint Strategic Needs Assessment has good data on deprived and ◆ excluded groups.

Experts by experience, carers, patient leaders and lay leaders report that they are ◆ making a real difference.

–  –  –

Six principles for engaging people and communities Focus is on equality and narrowing inequalities We tackle the ‘social gradient’ in health by identifying, reaching out to,

and involving different groups in order to improve:

–  –  –

Their experience of services; and ◆ Their health and wellbeing outcomes.

This includes:

People with the lowest health literacy, worst health status and outcomes, and ◆ worst experiences of care as a result of poverty, deprivation, unemployment, and poor housing.

All groups protected under the Equalities Act 2010.

◆ People less likely to use services, e.g. homeless people, gypsies and travellers, ◆ and non-English speakers.

–  –  –

Improvement in health and wellbeing outcomes attributable to ◆ outreach interventions.

Narrowing the gap on measures of access, outcomes, and experience.

◆ Person-centred interventions accessed by the most deprived/excluded ◆ groups (e.g. care planning, support for self management, peer support).

–  –  –

Six principles for engaging people and communities Carers are identified, supported and involved We recognise that many family members and close friends provide support that is essential to the quality of life and death for many people, and that this support contributes as much value as the NHS budget.

We therefore:

Identify carers, help them identify themselves, and assess their needs.

◆ Support and provide care for carers as individuals in their own right.

◆ Train carers for their caring role.

◆ Provide health and wellbeing interventions for carers.

◆ Involve carers systematically as key partners in care.

◆ Work with carers’ organisations, including to co-produce services.

◆ Measures of success Carers’ quality of life: experience of recognition, support, health and wellbeing, ◆ involvement, and their ability to perform their caring role.

Being aware of what matters to carers and taking action accordingly.

–  –  –

Six principles for engaging people and communities Voluntary, community and social enterprise, and housing sectors are involved as key partners and enablers We work strategically and in partnership with the voluntary, community and social enterprise sector, large organisations and small groups, benefitting from

its reach and diversity:

We commission and/or grant fund key contributions to holistic person-centred ◆ care from the voluntary, community and social enterprise sector, e.g. prevention activities, peer support, befriending, social prescribing, health coaching, care navigation, crisis prevention, support for recovery, and other forms of social action.

Voluntary, community and social enterprise sector bodies act as a neutral and ◆ trusted broker to initiate dialogue with service users and communities, especially disadvantaged, and marginalised groups.

We invest to build capacity in the voluntary, community and social enterprise ◆ sector, including through grant funding, asset-based community development, and use of the Social Value Act 2012.

Measures of success Local voluntary, community and social enterprise sector partners are positive ◆ about their relationships with us and their ability to add value.

The voluntary, community and social enterprise sector is adequately represented ◆ in key strategic partnerships (devolution body/STP area, vanguard, pioneer, health and wellbeing boards).

–  –  –

Six principles for engaging people and communities Volunteering and social action are recognised as key enablers

We recognise the value of volunteering and social action understood as:

Volunteering – time given freely for the benefit of others. It takes many ◆ forms and may take place through organisations (formal) or with friends and neighbours (informal). In health and care, it can happen in any services including GP surgeries and hospitals.

Social action – time freely spent with others to tackle local problems, negotiate ◆ with public services, and improve conditions that benefit all. It is often carried out through independent community groups. Social action can be aimed at improving the health of individuals or the community, and it can also ensure that the people involved keep well, and improve their wellbeing.

We ensure that:

Volunteering and social action support key functions, e.g. prevention, peer ◆ support, befriending, social prescribing, health coaching, care navigation, crisis prevention and support for recovery Local conditions are favourable for community groups, e.g. places to meet, small ◆ grants, community development support

–  –  –

Increase in level and diversity of volunteering effort.

◆ Volunteers report feeling useful and supported.

◆ Wellbeing outcomes for supported people and for volunteers themselves.

◆ Extent and condition of community groups.

◆ Responsiveness of health commissioners and agencies to community voice.

◆ People see volunteering and social action as normal, enjoyable and valuable, ◆ and recognise the role it plays in improving their health and wellbeing, as well as athat of others.

People using health, care and support services are as likely to be giving their time ◆ and sharing their skills as taking or receiving.

People feel part of their community and are able to look to that community ◆ when things become difficult for them. Local health and care service policies and practices are more transparent, better understood, and held to account The community recognises the NHS as a social movement for health and ◆ wellbeing, and everyone feels they have a role to play in this, whether or not they currently use or need health and care services.

Volunteering and social action are recognised and valued by commissioners and ◆ providers.

People who are employed to provide services see volunteers as equals, with a ◆ vital contribution to make to health, care and wellbeing.

There is a wider range of person-centred support available, and providers and ◆ professionals can use their time and skills to best effect.

Six principles for engaging people and communities Indicators and evidence

–  –  –

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