Edward Wernick and Steve Manley: Meaningful patient collaboration—a mountain to climb?


In early September we arrived at the King’s Fund HQ in Cavendish Square to be welcomed to their new Collaborative Pairs Programme, designed to bring together 12 pairs from across the country—each made up of a healthcare professional and a patient or patient representative—to work on a shared challenge facing their local health system. The NHS Five Year Forward View and the current national programme for system change have focussed on developing a new relationship between citizens, communities and the health and social care system. From our respective positions, with clinical, strategic and community development experience between us, we know the challenges in turning this aspiration into a reality.

steve_manleyEach pair were asked to bring with them a “real” challenge that is a genuine current issue in their area. We will have five days over the next six months to utilise the support offered by the Kings Fund and the shared knowledge of other participating pairs. Our facilitators introduced the concept of the programme clearly…”To develop the skills and practices which enable collaborative relationships and offer a constructive, reflective space to learn about how to do this work well.”

So what is it that we want to do well? North East Hampshire and Farnham Clinical Commissioning Group (CCG) has recently been awarded Vanguard status, one of 50 sites that will take a lead on the development of new models of care, acting as inspiration for the rest of the health and care system. In our area the focus will be on designing and implementing new models of care across the primary and acute care system. Co-production is crucial for the success of the project, the aim is to engage patients at every point in the design and implementation of the new look service—that is the part of the process where we will be focussing our attention. For Healthwatch Hampshire, the project is an opportunity to do what they do best – give citizens and communities a stronger voice, through creative consultation and community engagement, to influence and challenge how health and social care services are provided within their locality.

We are well aware of the ambition of the project, it will require our organisations to evolve beyond one of commissioner and critical friend and move towards a more collaborative model. We will need to work together in the best interest of the communities we serve and develop our skills and abilities to ensure we avoid the easy trap of tokenistic or “tick box” engagement.

Involving patients is one thing, we have both been to our fair share of meetings in which a patient has been plucked from somewhere at the last minute to represent the voice of the entire patient population. Our goal is to move to away from the more traditional methods of patient engagement and embrace the concept of citizens as partners and equals. The result of this work will be a CCG in which things look very different… perhaps we will start to see patient leaders on the Vanguard steering group, decisions at every level being supported and guided by patient feedback and experience and a future model of care developed with, rather than delivered to, patients.

For us, this work begins immediately with an event for patients and patient representatives to come and learn more about the project and shape the key messages to be used in the wider community. This is the first step in what will be an interesting, eye-opening and challenging year ahead… this was demonstrated with our first activity at The King’s Fund. We were asked to select a postcard, from a huge selection, that contained an image representative of our feelings towards the task ahead of us. For reasons that probably don’t need explaining we chose an image of an expansive landscape dominated by a mountain… but it is a mountain we have already started climbing and we are both excited about the challenges that lie ahead!

Written collaboratively by Edward Wernick, GP and Clinical Director for Quality and Patient and Public Engagement, North East Hampshire and Farnham Clinical Commissioning Group and Steve Manley, Community Outreach and Engagement Officer, Healthwatch Hampshire.

Competing interests: Steve Manley is an outreach officer for Healthwatch Hampshire. Edward Wernick is a GP partner at the Downing Street Group Practice, Surrey and a practicing GP. He is a Clinical Director at North East Hampshire and Farnham CCG.