Public and Stakeholder Engagement Strategy
Author:Anna Humphries, Communications Officerand Heather Lewis, Speciality Registrar
Date:16 April 2012 / Version:0j
Publication/ Distribution:
- Public Health Wales Board Papers document database with links from the Internet and Intranet
Purpose and Summary of Document:
To set out a strategy for how Public Health Wales will engage the public and stakeholders in the design and delivery of its services.
This document was developed following engagement of Public Health Wales staff, health boards, local authorities, the Board of Community Health Councils in Wales and Participation Cymru. Comments were received from the Senior Management Forum and Directors of Public Health, and the strategy was published for consultation with staff and stakeholders.This version takes into account comments submitted as part of the engagement and consultation process.
Work Plan reference: Communication Team workplan
CONTENTS
1Introduction
2What is engagement?
3Why is public and stakeholder engagement important?
4Policy context
5Methods of engagement used by Public Health Wales
6Engagement arrangements in other Welsh public service organisations
7How should Public Health Wales engage?
8Objectives
9Engagement standards
10Engagement principles
11Making public engagement a reality
11.1When to engage the public and/or stakeholders
11.2When not to engage the public or stakeholders
11.3Methods of engaging the public and stakeholders
11.4Who to engage
11.5Who is responsible for engagement
11.6Social media
11.7Responding effectively to concerns and criticism
12Evaluation
Appendix 1
Methods of engagement employed by Public Health Wales
Appendix 2
Public Health Practitioner’s Public Engagement Toolkit
Appendix 3
Other Public Service Organisations’ Public Engagement via citizens panels
Appendix 4
Examples of ongoing stakeholder engagement meetings
Appendix 5
Template for public engagement evaluation report
1Introduction
Public engagement puts the people who benefit fromservices at the heart of planning and delivery. It involves understanding their experience of services, empowering them to make decisions and involving them in the design and delivery of services.
NHS organisations in Wales have a duty to engage with the public in the planning of health services and policies that may directly impact on individuals or communities. This duty is underlined in the Welsh Government’s Health Standards for Wales, which specifically require organisations to engage with citizens.
Many of Public Health Wales’s services are not public facing. They are provided to inform and advise decision makers in the Welsh Government, NHS, local government, other agencies and the third sector. Stakeholder engagement puts these decision makers at the heart of such service planning and delivery. It involves understanding their experience of services, empowering them to makes decisions and involving them in the design and delivery of such services.
This strategy seeks to explain the value of public and stakeholder engagement and to set out the way in which Public Health Wales will engage with the public and its other stakeholders.
2What is engagement?
The National Principles of Public Engagement in Wales, produced in 2011 under the guidance of the Participation Cymru Advisory Panel, uses the following working definitions:
Engagement: An active and participative process by which peoplecan influence and shape policy and services that includes a wide range of different methods and techniques.
Consultation: A formal process by which policy makers and service providers ask for the views of interested groups and individuals.
Participation: People being actively involved with policy makers and service planners from an early stage of policy and service planning and review.
Engagement should not be confused with communication. Although Public Health Wales employs many methods of communicating information to the general public – such as producing leaflets, updating its website and issuing press releases – this is not public engagement.
Engagement should also not be confused with research. Research activities undertaken by Public Health Wales staff may require ethical approval. Engagement does not require such approval.
In public engagement, ‘public’ may refer to the whole population of Wales, or to specific groups within it. The public to be engaged will be dictated by the issue under consideration. For example, a local service change will probably only affect people living in a specific geographical area and there will generally be no benefit in engaging people who do not live in that area. Another example would be a significant change to the way in which a screening programme delivers its services. This is likely to only affect individuals within the screening population, who may live in any area of Wales but are likely to be defined by their age or gender. However, in the latter case, people not falling into the screening population but who have a personal interest in the issue – for example the relative of someone who died from cancer, or someone diagnosed with cancer but too young to have been eligible for cancer screening – may be keen to be involved in engagement activity. Engagement should therefore be inclusive and the organisation should be careful not to make assumptions about who would wish to be engaged on a particular issue.
Stakeholders are defined as organisations or individuals who have a stake in the services provided by Public Health Wales. Without these services they will be unable to achieve their own objectives so effectively.
There are a multitude of stakeholders with a variety of interests – some very specific and some very broad; some very local and some with all Wales responsibilities.
Public and stakeholder engagement also includes inviting citizens and stakeholders to provide feedback on services, and to act on that feedback to improve services where necessary.
3Why is public and stakeholder engagement important?
Engagement is fundamental to the success of Public Health Wales. It is fundamental to the work of the organisation in protecting and improving the health and wellbeing of the population and reducing inequities. There are few services which Public Health Wales provides alone; and there are no services which are not dependent for their success on the support or active engagement of other organisations and individuals.
Public Health Wales’s mission statement includes a commitment to: “give people power to protect and improve health and wellbeing and reduce inequities by informing, advising and speaking up for them.” This is about engagement.
Good public and stakeholder engagement has the following benefits for the organisation:
- Improved decision-making and outcomes by enabling input by a wider range of stakeholders and communities;
- Public health services and decisionsthat are more responsive to individual needs;
- Challenging of established methods and ideas and encouragement of innovation and creativity;
- Improved accountability and transparency of services;
- A better understanding of the issues that face individuals, communities and other organisations;
- More customer-focused, better qualitypublic health services and decisions;
- Fewer complaints and increased staff morale;
- In the case of local service change, the opportunity to tap into local knowledge;
- Increased respect from the public, stakeholders and potentially the media.
There are also benefits for the members of the public and stakeholders being engaged:
- Improved experience and satisfaction with public health services;
- A better understanding of decision-making, prioritisation and use of resources in services;
- Improved acceptance and ownership of service developments and planning decisions;
- A feeling of being respected and valued and taking responsibility.
Many decisions taken by public service organisations will have a direct impact on a community or communities. Withdrawing or substantially changing a service can meet with opposition from members of the public who fear that they will individually be disadvantaged, or fear that the change is part of a wider strategy to remove health services from their community. The introduction of a new service may be seen as a waste of taxpayers’ money if not developed with the input of service users, or may again be seen as an indication that other services are to be changed or withdrawn.
Failure to engage the public and stakeholders is likely to lead to services and public health advice being planned on the basis of perceived, rather than actual need. When communities and individuals do not feel engaged, the result can be adverse media coverage, a loss of reputation for the organisation and a loss of trust and respect for the organisation. This can be avoided by engaging with communities and individuals from the outset to explain the need for service change or particular advice, and to work collaboratively in reaching a solution. The solution may not be perceived as the ideal outcome by everyone involved, but generally a compromise can be reached and each party involved can understand and respect alternative points of view.
4Policy context
The Welsh Government published the document Doing Well, Doing Better: Standards for Health Services in Wales in 2010. The standards ensure a consistent framework to help NHS organisations in Wales to understand what is expected from them in order for them to deliver a high quality service. Among those standards is Standard 5, Citizen Engagement and Feedback.
Other Welsh Government policies also refer to the importance of public engagement and the need for NHS organisations to ensure that citizens are fully engaged with service delivery and policy development.
In 2011, the Welsh Government published Guidance for Engagement and Consultation on Changes to Health Services, to be followed by all NHS organisations in Wales. The guidance emphasises the need to discuss proposed service changes and the possible consultation needs arising from them with the Community Health Councils at the earliest opportunity. It also emphasises that “continuous engagement on services must be part of the core business of the NHS in Wales.”
In March 2011, the National Principles of Public Engagement in Wales were produced under the guidance of the Participation Cymru Advisory Panel. The principles were endorsed by the First Minister.
5Methods of engagement used by Public Health Wales
Across Public Health Wales, there has been no structured approach to public and stakeholder engagement to date. Appendix 1 sets out the engagement activities being carried out across Public Health Wales prior to this strategy.
In 2011, Public Health Wales published guidance for public health practitioners on public engagement, which included an assessment of the evidence for engagement and a toolkit for practitioners (see Appendix 2). This provides information on more than 50 methods of engagement for practitioners to use when engaging with the public for a variety of purposes.
6Engagement arrangements in other Welsh public service organisations
There is some variation in the amount of public engagement being undertaken by other NHS organisations in Wales. All health boards needto develop a public engagement strategy in order to meet the requirements of the Standards for Health Services in Wales.
The Board of Community Health Councils in Wales runs an e-citizens panel that can be engaged on any consultations the community health councils are asked to become involved with. This is made up primarily of the membership of other citizens’ panels throughout Wales. In some cases, the Board has access to the details of the citizens involved but in other cases, the co-ordinator of the panel will facilitate information exchange with its members.
The majority of local government organisations in Wales have their own citizens’ panels, made up of local volunteers, with whom they engage on issues when they arise. Some local authorities also have youth forums, which follow a similar process but seek to involve people under the age of 18. Many of these are recruited through local schools but councils also seek to widen the membership to ensure representation from groups such as looked after children, and children in alternative curriculum projects.
Each police force in Waleshas its own citizens panel used for public engagement on proposed police service changes. In some areas, these are operated on a county-wide basis in partnership with the health board and local authority and are used to consult on all partners’ issues.
Appendix 3 gives details of other organisation’s public engagement via citizens panel activities.
7How should Public Health Wales engage?
The diversity of services provided by Public Health Wales teams and programmes, and the huge variety of stakeholders they serve, require the organisation to engage in different ways. For example:
- Public Health Wales has some public-facing services, and some invisible to the public for which it only need engage with specified stakeholders;
- It has some national programmes, and some that are local;
- It has some ongoing programmes, and some that are time-limited or one-off projects;
- It has some services that it alone provides, but many that are provided in partnership with other organisations.
8Objectives
The objectives of this strategy are to:
- Build and strengthen mutually beneficial relationships with the public and stakeholders;
- Ensure that the organisation proactively seeks meaningful
engagement with the public and stakeholders to shape services;
- Ensure that the publicand stakeholders feelthey are being offered sufficient opportunities to influence Public Health Wales’s work;
- Ensure that all engagement activities have clear meaning and purpose,setting out service priorities and explaining decision making, so that therelevant audiences are clear about their influence;
- Ensure that plans and decisions made by the organisation have been considered and influenced by the public and stakeholders where relevant;
- Engage a diverse range of individuals in the organisation’s work so that views come from a wide constituency of people;
- Ensure that Public Health Wales meets the Standards for Health Services in Wales.
9Engagement standards
Public Health Wales is committed to meeting the Standards for Health Services in Wales, specifically Standard 5, Citizen Engagement and Feedback, which states that:
Organisations and services (should) use a range of methods and approaches to:
a) engage with partners in supporting and enabling citizens to be involved
in the design, planning and delivery of services;
b) seek feedback from patients, service users and carers about their
experiences; and
c) demonstrate that they act on views and feedback in making changes to improve services.
10Engagement principles
Public Health Wales endorses the National Principles for Public Engagement in Wales:
- Engagement is effectively designed to make a difference
Engagement gives a real chance to influence policy, service design and delivery from an early stage.
- Encourage and enable everyone affected to be involved, if they so choose
The people affected by an issue or change are included in opportunities to engage as an individual or as part of a group or community, with their views both respected and valued.
- Engagement is planned and delivered in a timely and appropriate way
The engagement process is clear, communicated to everyone in a way that’s easy to understand within a reasonable timescale, and the most suitable method/s for those involved is used.
- Work with relevant partner organisations
Organisations should communicate with each other and work together wherever possible to ensure that people’s time is used effectively and efficiently.
- The information provided will be jargon free, appropriate and understandable
People are well placed to take part in the engagement process because they have easy access to relevant information that is tailored to meet their needs.
- Make it easier for people to take part
People can engage easily because any barriers for different groups of people are identified and addressed.
- Enable people to take part effectively
Engagement processes should try to develop the skills, knowledge and confidence of all participants.
- Engagement is given the right resources and support to be effective
Appropriate training, guidance and support are provided to enable all participants to effectively engage, including both community participants and staff.
- People are told the impact of their contribution
Timely feedback is given to all participants about the views they expressed and the decisions or actions taken as a result; methods and form of feedback should take account of participants’ preferences.
- Learn and share lessons to improve the process of engagement
People’s experience of engagement should be monitored and evaluated to measure its success in engaging people and the effectiveness of their participation; lessons should be shared and applied in future engagements.
11Making public engagement a reality
11.1When to engage the public and/or stakeholders
Public Health Wales staff will engage the public and/or stakeholders on an ongoing basis at the point of service delivery to:
- Seek feedback about services, performance and approach and to inform decisions Public Health Wales makes about the way they are run and improved;
Specifically, Public Health Wales will engage the public and/or stakeholders when:
- Considering options for a decision that will have a significant or widespread impact on any community;
- Planning or significantly changing a national or local service or project that faces the public or stakeholder(s);
- Developing organisational strategy or polices that will be visible to service users or impact upon them;
- Required by law to consult.
Public and stakeholder engagement needs to be embedded into the culture of Public Health Wales, rather than being an action for one team or division to take forward. All teams and divisions, both national and local, should understand their own public and stakeholder engagement priorities and, at the time of developing workplans and action plans, consideration should be given at the earliest stage to whether public engagement is appropriate.
Resources for public and stakeholder engagement should be committed at the very outset of projects.
11.2When not to engage the public or stakeholders
A commitment to public and stakeholder engagement does not mean that Public Health Wales needs to involve the public or stakeholders in decisions that will not directly affect them. Examples of when not to engage the public include: