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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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Presentation Transcript
attitudes to health services
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
public attitudes to hospitals
Public attitudes to hospitals

Fear that change = loss of or downgrading services

Strong sense of public powerlessness and frustration

why public engagement
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
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
key characteristics of deliberative approaches
Key characteristics of deliberative approaches
  • Time
  • Information
  • Deliberation
  • Independence
  • Authority
  • Mutual respect
alternative approaches
Alternative approaches
  • Consultation approaches e.g.
    • Citizens’ Juries
    • Citizens’ Workshops
    • Citizens’ Forums
  • Collaborative/ co-production approaches
  • Large Scale Consultation
    • Citizens’ Summit
  • On-line Deliberation
birmingham black country strategic health authority
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
key outcomes
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 study11

Case study

Ongoing work

reconfiguration of a two site pct
Reconfiguration of a two site PCT

Aim: get beyond knee jerk reaction to the bigger picture


  • 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
your health your care your say
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

your health your care your say outputs
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
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”

yhycys reconvened event participant reaction
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