Talking Health Evaluation Report
Author(s): Julia Stackhouse, Communications & Engagement Coordinator
Status: Final Version
Date: March 2012
1. About us P.3 1.1 The Oxfordshire Clinical Commissioning Group
1.2 NHS Buckinghamshire and Oxfordshire Cluster P.5
1.3 About Oxfordshire P.5
2. Executive Summary P.7
2.1 Talking Health Background
2.2 Purpose of the evaluation
2.3 Process and Methodology
2.4 Key Findings P.8
2.5 Conclusion
3. Background P.10 3.1 What is Talking Health
3.2 What was the purpose of the evaluation? P.11
3.3 Why undertake the evaluation?
3.4 Evaluation duration
3.5 How will the feedback be used
4. Stakeholders P.12 4.1 Key stakeholders identified
5. Evaluation Process P.13
5.1 Online engagement
6. Survey responses from the Public P.15
6.1 Number and geographical spread of responses
6.2 Survey Results P.17
7. Survey responses from Staff P.25
7.1 Survey responses from Staff
8. Key Findings and analysis P.32
9. Key Recommendations
10. Next Steps P.34
11. Thanks
12. Supporting Information P.35
Appendix 1 Staff Survey P.36
Appendix 2 Public Survey P.40
Appendix 3 Background information for the public P.431. About Us
1.1 The Oxfordshire Clinical Commissioning Group
In July 2010 the Government published a White Paper, Equity and Excellence: Liberating the NHS, setting out its long term vision for the NHS, which will be achieved by:
· putting patients at the heart of the NHS
· focusing on driving high quality and improving outcomes
· empowering local organisations and professionals
· cutting bureaucracy and improving efficiency
In order to shift decision-making as close as possible to patients, power and responsibility for commissioning health services - the planning, designing and paying for your NHS services, which is currently the responsibility of Primary Care Trusts (PCTs) - will become thejob of local groups of GPs, supported by other health professionals.
To implement these plans, GPs across Oxfordshire decided to come together in December 2010 to form one county wide clinician-led commissioning model initially called the Oxfordshire GP Consortium. Following a legislative pause in May and June 2011, this group is now known as Oxfordshire Clinical Commissioning Group (OCCG).
Clinical commissioning means that health professionals will be financially accountable for their decisions. It builds on Practice Based Commissioning (PBC), which saw groups of GP practices holding delegated budgets in order to shape health services locally. It also builds on the key role that GP practices already play in coordinating care and acting as advocates for their patients.
Structure
OCCG is headed by an elected lead GP (Chief Executive), Dr Stephen Richards and deputy lead (Deputy Chief Executive), Dr Mary Keenan and features six localities;
· Oxford City
· South East
· South West
· North
· North East
· West
Each locality will has an elected lead and deputy(s) and feeds into the OCCG Board.
The OCCG Board is a subcommittee of the NHS Buckinghamshire and Oxfordshire Cluster Board and is responsible for developing a work programme through the transition period.
Board membership includes GP locality leads and members of NHS Buckinghamshire and Oxfordshire Cluster’s executive team. As OCCG develops it will assume more responsibilities for commissioning services. It is currently responsible for around 35% of the Oxfordshire PCT budget and during 2011/12 will take forward commissioning of specific areas of care, including all planned procedures, complex care, and prescribing. By April 2012 OCCG will be accountable for around 70% of the budget for commissioning healthcare for Oxfordshire.
Communications and Engagement
Informing and engaging with the public is important for the development of OCCG, especially during this time of change and transition. It is vital that OCCG develops its stakeholder relations, including engagement with GPs and the way it seeks and uses feedback to inform decision making in developing health services for the people of Oxfordshire.
OCCG is seeking to build on the platform established by Oxfordshire PCT to develop and extend its own relationships with stakeholders so that people living in Oxfordshire and working within the NHS locally feel informed and included in its work.
1.2 NHS Buckinghamshire and Oxfordshire Cluster
The Primary Care Trusts NHS Buckinghamshire and NHS Oxfordshire have joined together or ‘clustered’ to form NHS Buckinghamshire and Oxfordshire Cluster.
NHS Clusters have been established by the Department of Health to ensure that the NHS maintains business continuity of commissioning healthcare locally and to facilitate the change to the new structure of the NHS in 2013, including the move to clinical commissioning. All NHS Clusters will have three principal functions:
· Delivery of the PCTs’ Operational Plans and driving clinical service change for 2011 to 2013 and ensuring financial stability for the handover to Clinical Commissioning Groups
· Ensuring and supporting development of Clinical Commissioning Groups and transferring of other current cluster functions to the new organisations yet to be established i.e. the National Commissioning Board, Public Health England, Health Education England, Health and Wellbeing Boards, public health to Local Authorities
· Creating the relevant commissioning support organisation for Clinical Commissioning Groups after post PCT abolition.
1.3 About Oxfordshire
We are ambitious about improving the health and wellbeing of local people. The NHS Buckinghamshire & Oxfordshire Cluster intends that, by 2013, the people of Oxfordshire will:
· be healthier, particularly if they are vulnerable or live in our most deprived communities
· be working with us to promote physical and mental wellbeing and prevent ill health
· be actively supported to manage their health and care needs at home when this is appropriate
· have access to high quality, personalised, safe and appropriate health services
· get excellent value from their local health services
Oxfordshire is the most rural county in south east England and has a large geographical area to cover as well as a diverse population to serve. The population of Oxfordshire ranges from a predominantly older, white population in the rural areas to very ethnically diverse populations in Banbury and Oxford city where one third of the population are students.
The NHS in Oxfordshire works with our communities and our partners to improve health in the area and to make sure that local people’s needs are being met. We also work with organisations from the voluntary, private and community sectors so that we can make sure that the organisations providing health and social care services are working effectively.
2. Executive summary
2.1 Talking Health Background
NHS organisations have long been required by law to consult the public on substantial changes to services and there is now a wider duty to involve and consult patients and the public in:
· The ongoing planning of services
· Considering and developing proposals for change
· Decisions that may affect the operation of services
In 2009 NHS Oxfordshire identified that, in order to capture this information and to make it useful and relevant, the organisation would need a Patient and Public Involvement (PPI) management system which would be multipurpose, sensitive, accessible, innovative, yet simple to use. The system would enable NHS Oxfordshire to proactively engage all stakeholders in designing, planning and delivering local healthcare services. NHS Oxfordshire envisaged that it would help to strengthen relationships with stakeholders and help to develop ongoing dialogue and feedback amongst stakeholders; as well as ensuring that stakeholders were well informed.
Based on this information Talking Health was designed and delivered for NHS Oxfordshire.
The website went live in early 2010 and to date we have over 1000 members registered to the site.
2.2 Purpose of the evaluation
The Talking Health system went live in early 2010 and we are now at a point where we need to evaluate whether the system is working as intended. A survey was launched for both staff and members of the public from 9 November 2011 to 12 December 2011.
2.3 Process & Methodology
A number of methods were used simultaneously to enable maximum feedback from a wide variety of stakeholders in the time available.
This involved:
· A staff survey and a public survey set up on Talking Health, along with a briefing document explaining the background behind the system.
· Hard copy surveys were available on request.
· Feedback via email or by phone
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* Quotes have not been altered to ensure that the meaning in the feedback remain unchanged.
2.4 Key Findings
Analysis of the survey findings resulted in a positive overall opinion of Talking Health due to its ease of use, and that it encourages the public to get involved with commissioning health services. It is seen as a transparent public engagement tool and lots of suggestions for further development and improvement of Talking Health were made.
It was clear from the findings that the Talking Health interface needs more branding and that there should be more information on the site to promote the mechanism used by the PCT for engaging with the public. The public did indicate that there is often confusion around the ownership of consultations from different statutory organisations.
Going forward people felt that there was little evidence of how their comments had been used by the PCT and that there was not enough evidence of how patient experience is captured.
Despite this people were happy that the PCT is engaging with the public and Talking Health was seen as the beginnings of developing engagement further and should continue to be in place as the health service moves into GP commissioning.
2.5 Conclusion
For Talking Health to be sustainable in the future and for NHS Buckinghamshire and Oxfordshire Cluster to remain a leading and innovative organisation moving into GP commissioning it is important that the software continues to meet our needs and the needs of the public that use it. There are constant technological advances and the software needs to develop and change with these. In addition to this the public need to identify with the software and staff need to have ownership.
Further development of the site with its designers (Inovem) to ensure that the software is meeting the needs of the PCT and the public as further versions of the software are released.
The report makes the following recommendations based on the comments and feedback that have been received through this evaluation process:
1) Publicity and training: It is clear from the feedback received that there needs to be further integration of Talking Health in all engagement and involvement activities across the Cluster. Moving into GP commissioning, Talking Health, is seen as a positive tool to retain going forward but greater understanding of and training in its functionality is needed to add value to the roles of staff undertaking commissioning roles within the Cluster and the Clinical Commissioning Groups.
2) Public engagement: For those people that participated in this evaluation, public engagement is valued and recognised as important in developing NHS services going forward. There is concern that whist people are happy to share the knowledge and experiences with the NHS they are not always fully aware of how their comments and feedback are utilised. For these participants it is not always apparent that the NHS is listening and acting on feedback received.
3) Strategic development: As the NHS changes and GPs take greater responsibility new relationships in the statutory sector will develop. Greater integration between organisations and brand awareness is needed to ensure that the public are involved in the changes and understand how the face of the NHS is changing. It is important that Talking Health is a positive tool for engagement.
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* Quotes have not been altered to ensure that the meaning in the feedback remain unchanged.
3. Background
3.1 What is Talking Health?
NHS Oxfordshire and Buckinghamshire Cluster actively engage and consult with residents and patients in many ways. We have been developing a tool for staff to use when making commissioning decisions to encourage public engagement and consultation.
Traditionally public involvement has been through workshops, focus groups and responding to paper questionnaires but with advances in technology we can now offer a more comprehensive way of engaging with our public. NHS Oxfordshire was keen to find a way to involve patients and public in the designing of health services in the county that was more meaningful and transparent. We also wanted to find a way to evaluate our engagement with the public and to ensure that we were reaching out to a wide audience and not over consulting the same people over and over again.
Towards the end of 2009, NHS Oxfordshire’s Communications and Engagement team identified some software that would help us to meet these needs by:
· Enabling us to manage our relationships with stakeholders
· Enabling stakeholders to be identified in a range of ways for example: areas of interest, preferred methods of contact etc.
· Allowing individuals to sign up to ‘get involved’ online and participate in consultations.
The software allows us to:
· Generate e-mail campaigns, hard copy letters, and other consultation documents
· Generate reports, view maps of where responses come from
The software allows the public to see:
· How their feedback has been used to inform decisions
· The outcomes and recommendations of consultations
· A calendar of what engagement activity is happening in the PCT
The NHS Buckinghamshire and Oxfordshire Cluster uses this software (Talking Health) as a means of engaging with the public for all public consultations. It is now a part of the engagement function within the Cluster and is importantly used alongside traditional methods of involvement.
This engagement service has now been rolled out in Buckinghamshire and will continue to support all engagement activity going forward.
3.2 What was the purpose of the evaluation?
The purpose of the survey was to evaluate the success of Talking Health for public engagement. Talking Health has been live for 18 months and we now want to evaluate how successful Talking Health has been for the following:
§ supporting internal staff communications
§ managing public and other stakeholder consultations
§ establishing service user and carer representation for PCT led projects