Edward Wernick and Steve Manley: Meaningful patient collaboration—the story continues…

ed_wernickIn our last blog we introduced our roles on the new King’s Fund Collaborative Pairs Programme. With the support of the King’s Fund we are working on a shared challenge facing our local health system. North East Hampshire and Farnham CCG have recently been awarded Vanguard status and co-production is a crucial element 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.

steve_manleyThe challenge began immediately after our first session at the King’s Fund with an event for patients, carers, patient representatives and the public to come and learn more about the project and shape the key messages to be used in the wider community. In September, we hosted an event called “Be part of shaping future care.” We started an important conversation with the local community.

Over 100 people attended from a variety of settings and representing many elements of the local community including service users, carers, patient representatives and NHS and Social Care staff. We were keen to introduce the project, consider the principles that underpin the work then discuss how services and the public could better come together to make it a reality.

The discussion throughout the day was open and honest; beginning with a discussion about what people feel is needed within the local area in terms of health provision. Key issues soon emerged from the numerous, diverse conversations taking place around the room. Many familiar to us and probably to patients, carers and professionals across the country…

“We need a better understanding of what services are available”
“We would like control over our own health and care”
“Treat me as a Person not a Condition”
“I only want to tell my story once”
“Remember the carers”
“Make better use of records; don’t hide behind Data Protection Act”
“Break the rules, think outside the box and be creative!”

A key element of the event was to ask the community how we can begin to effectively engage to start to delve deeper and try to find workable solutions to the challenges faced across the system. This is where the conversations started to get really interesting…

We were well aware that holding the event in a local hotel on a weekday was always going to exclude some people from the conversation and those in attendance weren’t afraid to tell us that! Strong opinions from a variety of angles made it clear that if the Vanguard team want to engage with the local community effectively then they will need to do it in a number of ways and they will need to go to them in their setting. People were keen for a variety of approaches to engagement including creative workshops, social media, short films, “pop-up” shops and focus groups—each carefully planned and chosen for its suitability for the community, group or agency in question and located in a setting appropriate to the audience. So whether it be a workshop in a school to engage young people, a focus group with staff at a local hospital or an informal discussion over a coffee with carers at one of the Carer’s Hubs drop-in sessions in the area it needs to be appropriate, timely and, above all, necessary.

Collaborative Trios

After capturing the thoughts of those that attended the event, they were collated to begin to form an initial work plan for the huge engagement task going forward. The Vanguard project has 11 work streams varying in their focus from “prevention and self-care” and “developing integrated hubs” through to “managing effective engagement” and “redesigning the workforce.” To ensure that patient and public engagement is embedded throughout the work, we are proposing that each of these work streams will be led by a Collaborative Leadership Trio. This will consist of a care giver, such as a doctor or social worker, a patient or patient representative and a managerial lead who will have responsibility for the delivery of that element of the Vanguard programme. The King’s Fund course is entitled “collaborative pairs” and has a partnership of patient and clinical lead. Our thinking has evolved to realise that we need to ensure that we are also delivery focused and that a managerial element was needed, hence the trio. As well as each work stream adopting this new approach we hope that key projects throughout the CCG will also embed patient voice in this way. We are excited to be discussing this approach further at the King’s Fund Annual Conference next month.

Beyond this initial trio for each work stream, a number of people expressed an interest in volunteering their time as Community Ambassadors. These are members of the local community who are not part of any formal organisation or group but will work alongside the co-production team to help inform the process going forward. We hope that these ambassadors will, in some cases, provide a link to local organisations and established groups and agencies who will also need to be represented in the design of the system. Beyond this reach it will be critical to engage with the wider community of North East Hampshire and Farnham. We may have a route to reach them already through the Trio, ambassadors, or established organisations—but equally we may need to reach out to them in a targeted and individualised way.

All of this engagement will lead to feedback that will influence the Vanguard team throughout the varying levels of strategy, work streams and at its highest level, the Vanguard steering group on which Healthwatch Hampshire will have a seat.

So, this leaves us with the beginnings of an ambitious plan, a potential route to achieve our goal of true co-production. This is a really good start, but it is only the beginning of a number of incredibly important conversations with patients, carers and the public. These conversations will help us better understand local healthcare needs, be clearer on the options and opportunities for how these can be met and work together to improve the health of those we care about.

As we gear up for our second session with The King’s Fund and an opportunity to share and shape these plans with others facing similar issues in their own communities, we recognise that we face significant challenges but we are confident that we can make a real difference for local people.

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.