The Future Hospital: Patient and public involvement

1. The Future Hospital:Patient and public involvement Deborah Mattinson 21st June 2006

2. Attitudes to health services • General negative narrative • Gap between perception and actual experience - “I’ve been lucky syndrome” • Emotional not rational reaction • Breakdown in trust – no longer age of deference but age of reference

3. Public attitudes to hospitals Fear that change = loss of or downgrading services Strong sense of public powerlessness and frustration

4. Why public engagement? • Not only statutory obligation but also: • Better decisions and design • More likely to meet ‘market’ demand • Improved accountability • Improved democracy • Improved trust • Risk of not consulting • High profile media campaigns

5. How to engage? • Involve people early on in the process • Ongoing rather than sporadic engagement • Avoid exercises in ‘lip service’ • Meaningful consultation vs. social marketing • Engage with the public and other stakeholders • An organisation’s staff can be its best advocates • Consider use of social influencers

6. Key characteristics of deliberative approaches • Time • Information • Deliberation • Independence • Authority • Mutual respect

7. Alternative approaches • Consultation approaches e.g. • Citizens’ Juries • Citizens’ Workshops • Citizens’ Forums • Collaborative/ co-production approaches • Large Scale Consultation • Citizens’ Summit • On-line Deliberation

8. Case study

9. Birmingham Black Country Strategic Health Authority • A new model of consulting with the public to aid the redesign of NHS care in Walsall, Wolverhampton & Dudley • 3 workshops with 35-70 people on three occasions (reconvened) • Stage 1: obtaining initial views • Stage 2: response to proposed changes in cancer, cardiac and paediatric care • Stage 3: comment on the final Consultation document

10. Key outcomes • Input into the final service design • Empowered participants • Some went on to join a local PPI forum • Built internal capacity • As part of the consultation we trained peer facilitators

11. Case study Ongoing work

12. Reconfiguration of a two site PCT Aim: get beyond knee jerk reaction to the bigger picture Consultation • Deliberative forum: 100 members of the public, upweighted seldom heard groups • Citizens’ advisory panel – 10 members of the public; 3 meetings Sounding board for materials and consultation, citizen centred • Materials for wider reach – online and devolved events • Training for staff to facilitate other events

13. Case study

14. Your health, your care, your say • Major public engagement programme to inform DH’s white paper on out of hospital care • Depth, Reach, Splash Range of methods including Citizens’ Summit Seldom heard groups Technology enabled: polling key pads, instant analysis Communications – materials, webcast

15. Your health, your care, your say: outputs • Robust data • Deliver considered and informed responses • New way of writing White Paper • Citizen input throughout even at launch of WP • “From now on serious engagement between citizens and government is going to be part of the future of democracy”. Patricia Hewitt.

16. YHYCYS: Participant reaction “As long as they listen to the people I think that we’ll have a system that works and that’s fair for everybody no matter where you live in the country.” “I’m enjoying having a good dialogue and being around people who have some good thoughts. I’m enjoying the day very much. I just hope that it’s successful and that good things come from it.” “It was really refreshing to be asked your opinion and to get together with a group. We are all so different, all different backgrounds but fundamentally we all want the same things from the NHS”

17. YHYCYS Reconvened event: participant reaction • 72% felt the results of the consultation had been influential • 97% agreed that they had had their say • 96% agreed strongly that events like this should be conducted on other topics in the future