NHS commissioning organisations have a legal duty under the National Health Service Act 2006 (as amended) to ‘make arrangements’ to involve the public in the commissioning of services for NHS patients (‘the public involvement duty’). For CCGs this duty is outlined in Section 14Z2 (and Section 13Q for primary care services) of the Act to fulfil the public involvement duty, the arrangements must provide for the public to be involved in (a) the planning of services, (b) the development and consideration of proposals for changes which, if implemented, would have an impact on services and (c) decisions which, when implemented, would have an impact on services.
To ensure our duties are met and importantly to ensure that our services met the needs of our community engaging and involving our patients and public is essential.
Engagement describes the continuing and on-going process of developing relationships and partnerships so that the voice of local people and partners is heard and that our plans are shared at the earliest possible stages. Examples of this type of engagement would include our patient participation groups and Health Forum where we ask members to get involved in various pieces of work.
It also describes activity that happens early on in an involvement process, including holding extensive discussions with a wide range of people to develop a robust case for change. This can also be used in a pre-consultation stage before any formal consultation.
Engagement is a key element needed to help us improve all aspects of health care, including patient experience and health outcomes – giving people the power to live healthier lives.
Formal consultation describes the statutory requirement of NHS bodies to consult with patients, the public and stakeholders when considering proposals for a substantial development of a heath service. This is outlined in regulation 23 of the Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013.
Formal consultation is carried out if a change is significant. This is determined where the proposal or plan is likely to have a substantial impact on one or more of the following
- Access (e.g reduction or increase in service due to change of location or opening times)
- Wider community (e.g economic impact, transport, regeneration)
- Patients or users (either current or future)
- Service delivery (e.g methods of delivery or relocation of services)
All consultations need to adhere to the Gunning Principles to ensure the process is fair, enough information is given on the proposals for people to understand what is proposed and any impact it may have upon them and that this feedback is taken into consideration.
Experience Based Design is a methodology for working with patients, families, carers and staff to improve services.The approach has been specifically developed for use within healthcare settings.
Experience Based Design allows us to gather insight into how services are experienced based on the person’s emotional response to the interaction.It helps individuals and teams to challenge assumptions and perceptions about what we think the patient or family member feels and needs.
The involvement of patients and staff throughout Experience Based Design projects is more profound than that in traditional patient involvement approaches. Using the insights that are captured, patients, families and staff work together to co-design improvements to the services.The co-design approach assures that improvements made are aligned to patient, carer and staff experience and truly add value by ensuring that the services provided better meet the needs of those who access them and those who provide them.
Experience Based Design is an approach that can neatly dovetail with other improvement or innovation approaches. It helps to ensure that any initiative does not purely focus on the technical or efficiency related components of service delivery, but that the experience of those using the service is always considered.
We are committed to using this approach to co-design services with our stakeholders, staff, patients and the public.