Co-designing a Patient & Public Involvement work plan t: w:

Housekeeping Fire alarms and evacuation Refreshments Facilities Lunch Who’s in the room Agenda Introduction to Healthwatch Workshops 1-4 Feedback & next steps

Welcome to Healthwatch Birmingham Commissioned by Birmingham City Council to provide 6 statutory Local Healthwatch Functions. An important part of the national regulatory and scrutiny function of Health and Social Care. Part of a national network of Local Healthwatch Represented at national level by Healthwatch England

Welcome to Healthwatch Birmingham Healthwatch England sits as a committee of the Care Quality Commission Every piece of work we do is shared with Healthwatch England and is potentially used by the CQC to inform their work in hospitals, Adult Social Care and Primary Care Services.

Welcome to Healthwatch Birmingham One of the largest Local Healthwatch serving a population of 1.1 million. A social enterprise by statute of the Health and Social Care Act Entering our third year and developing a new strategy.

Our purpose We are intended to hold commissioners and providers of health and social care services to account for ensuring patients, the public, carers and service users are at the heart of all changes made in the name of service improvement, through our role on Health and Wellbeing Board and other Scrutiny Boards, by using our 6 statutory functions.

Six statutory functions: 1.Gathering the views and understanding the experiences of patients and the public and 2.Making their views known in order to bring areas for improvement or celebration to the attention of commissioners and providers. 3.Promoting and supporting the involvement of people in the commissioning and provision of local health and social services and how they are scrutinised in order that services meet needs and expectations.

Six statutory functions: 4.Recommending investigation or special review of a service via HWE or directly to the CQC in order to public-lead experience is taken seriously to inform quality improvement. 5.Providing advice and information about access to services and support for making informed choices in order patients, the public, services users and carers understand their constitutional right’s.

Six statutory function 6.Making the views and experiences of people known to Healthwatch England and the Local Healthwatch network, and providing a steer to help it carry out its role as national champion in order to work together as a network for national patient and public-lead service improvement, learn from each other and reduce duplication of effort. N.B. A 7th function relates to commissioning of complaints advocacy which is not included in Healthwatch Birmingham’s contract.

Why are we needed? More and more demand for health and social care services. Aging population Growing population Growing number of people with life style related diseases Growing number of people with one or more long term condition Growing inequalities in health and wellbeing outcomes Higher and higher public expectation Less and less money to pay for health and social care services. More and more pressure to improve outcomes AND work within reducing budgets.

Policy is clear: No decision about me, without me* The NHS Constitution The NHS Mandate: A Mandate from the Government to the NHS England (2012) * Equity and Excellence: Liberating the NHS (Dept of Health) (2011) NHS England Business Plan “Putting Patients First” (2013) Everyone Counts: Planning for Patients (2013/14) Developing Clinical Commissioning Groups: Towards Authorisation (2012) CCG Assurance Framework – outline proposal and interim arrangements (2013/14) The NHS Outcomes Framework (2013/14) Healthy Lives, Healthy People White Paper (2011) White Paper: Equity and Excellence: Liberating the NHS (Dept of Health) (2010) The Power of Information – putting all of us in control of the health and care information we need (Dept of Health) (2012) NHS Patient Experience Framework (Dept of Health) (2012) Principles of Consultation Guidance (Government) (2012/13) Equality Act (2010), including the Public Sector Equality Duty. Local Government Act (1999) Creating Strong, Safe and Prosperous Communities; Statutory Guidance (2008) Revised Best Value Statutory Guidance (2015) Health and Social Care Act (2012)

“Patients, the public, carers and service users are at the heart of all changes made in the name of health or social care service improvement in the City of Birmingham” What does this mean exactly? Is it true right now, at this moment, for EVERY service-improvement-in-progress? How would we know? What’s our role in making it true?

Lets unpick it together Your Table Facilitators Who else are you sitting with? Has anyone at your table ever contributed their voice to any stage of a service improvement? Why?

ONE As a member of the public, I am at the heart of all changes made in the name of service improvements in the City of Birmingham which are relevant to me or my family. What’s stopping this being true right now? Why are YOU not at the heart of all this? Post-its. Marker pens. Complete sentences. See ‘rules’

Before you start - rules 1.The thing stopping you must actually exist, right now, at this moment. 2.It must be described in a complete sentence written in the present tense. 3.It must be worded in a way which does not imply or allocate blame. 4.It must be factual and not subjective or speculative – ie, evidence could be collected and would be accepted by everyone at your table. 5.Only ONE obstacle can be described at a time (no ‘and’ or ‘which means’ linkages, this implies more than one obstacle)

ONE What does it mean? What’s stopping this being true for you personally? As a member of the public, I am at the heart of ALL changes made in the name of service improvements in the City of Birmingham which are relevant to me or my family. 1.The thing stopping you must actually exist, right now, at this moment. 2.It must be described in a complete sentence written in the present tense. 3.It must be worded in a way which does not imply or allocate blame. 4.It must be factual and not subjective or speculative – ie, evidence could be collected and would be accepted by everyone at your table. 5.Only ONE obstacle can be described at a time (no ‘and’ or ‘which means’ linkages, this implies more than one obstacle) 6.Each post-it must be numbered

TWO What does this mean? What’s stopping this being true SYSTEMICALLY? Patients, the public, carers and service users are at the heart of all changes made in the name of EVERY service improvement in the City of Birmingham. 1.The thing stopping you must actually exist, right now, at this moment. 2.It must be described in a complete sentence written in the present tense. 3.It must be worded in a way which does not imply or allocate blame. 4.It must be factual and not subjective or speculative – ie, evidence could be collected and would be accepted by everyone at your table. 5.Only ONE obstacle can be described at a time (no ‘and’ or ‘which means’ linkages, this implies more than one obstacle) 6.Each post-it must be numbered.

THREE For EVERY yellow post it note… What ideas have been implemented which have overcome or evaporate the obstacle? Use a different colour post-it, number it the same as the obstacle, and put the idea on top of the obstacle. Some obstacles may need more than one idea to be implemented in order to overcome or evaporate them. Ideas must be worded in complete sentences. Ideas must be worded as sentences of ACTIONS WHICH HAVE ALREADY COMPLETED, (not as actions to be completed in the future). Each idea post-it must only describe ONE idea – there must be no ‘and’ linkages.

FOUR Write a post-it with the goal statement “Patients the public, carers and service users at the heart of all changes made in the name of every service improvement in the City of Birmingham” Put it at the top of a piece of flip chart paper. Working down the paper, add all the obstacles with the ideas which have overcome them in the order which they must be completed. The language is important – “In order to A we must B…In order to B we must C…In order to C we must D and E…etc.

Thank you Thank you for coming Thank you for contributing Thank you (in advance) for telling people what we have discussed today Thank you (in advance) for scrutinising what we have done today, tomorrow. Thank you for completing a feedback sheet.

Next steps We’ll be transcribing everything and sharing it more widely. We’ll transcribe that and share it widely. Then we’ll be working with you to work out what actions need to be taken and who are the best people to take them, to make something happen – which we’ll also share widely This will form an important part of Healthwatch Birmingham’s strategy.