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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 - “ I’ve been lucky syndrome” Emotional not rational reaction

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The future hospital patient and public involvement l.jpg

The Future Hospital:Patient and public involvement

Deborah Mattinson

21st June 2006


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Attitudes to health services

  • General negative narrative

  • Gap between perception and actual experience

    - “I’ve been lucky syndrome”

  • Emotional not rational reaction

  • Breakdown in trust – no longer age of deference but age of reference


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Public attitudes to hospitals

Fear that change = loss of or downgrading services

Strong sense of public powerlessness and frustration


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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


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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 organisation’s staff can be its best advocates

  • Consider use of social influencers


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Key characteristics of deliberative approaches

  • Time

  • Information

  • Deliberation

  • Independence

  • Authority

  • Mutual respect


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Alternative approaches

  • Consultation approaches e.g.

    • Citizens’ Juries

    • Citizens’ Workshops

    • Citizens’ Forums

  • Collaborative/ co-production approaches

  • Large Scale Consultation

    • Citizens’ Summit

  • On-line Deliberation



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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 35-70 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


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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


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Case study

Ongoing work


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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



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Your health, your care, your say

  • Major public engagement programme to inform DH’s 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


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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.


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YHYCYS: Participant reaction

“As long as they listen to the people I think that we’ll have a system that works and that’s fair for everybody no matter where you live in the country.”

“I’m enjoying having a good dialogue and being around people who have some good thoughts. I’m enjoying the day very much. I just hope that it’s successful and that good things come from it.”

“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”


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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


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