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

Attitudes to health services General negative narrative Gap between perception and actual experience - Ive been lucky syndrome Emotional not rational reaction Breakdown in trust – no longer age of deference but age of reference

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

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

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 organisations staff can be its best advocates Consider use of social influencers

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

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

Case study

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 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

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

Case study Ongoing work

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

Case study

Your health, your care, your say Major public engagement programme to inform DHs 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

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.

YHYCYS: Participant reaction As long as they listen to the people I think that well have a system that works and thats fair for everybody no matter where you live in the country. 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 Im enjoying having a good dialogue and being around people who have some good thoughts. Im enjoying the day very much. I just hope that its successful and that good things come from it.

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