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Dundee Health & Social Care Partnership

Participation and

Engagement Strategy

Ensuring that the voices of the citizens of Dundee are heard and recognised and listened to, to improve the quality and delivery of health

and social care services.

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Table of Contents

Page No

1.0 Introduction 3

1.1 Principles 6

1.2 Landscape 7

2.0 Section 1 – Supporting Participation & Engagement 9

3.0 Section 2 - Learning from Each Other 12

4.0 Section 3 - Hearing Stories 13

5.0 Section 4 – Governance 14

6.0 Implementation Plan 15

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Introduction

This strategy outlines how Dundee Health and Social Care Partnership (the

Partnership or “we”) will ensure that the those who use health and social care

services in Dundee, their families and carers (”you”), will remain at the centre of

participation and engagement relating to the work of the Integration Joint Board

(the IJB).

We committed to understanding the needs of the different communities in

Dundee. This strategy recognises that meaningful engagement and participation

with you requires us to take into account your individual and collective

characteristics in particular the protected characteristics of age, disability status,

ethnicity, gender/sex, religion/belief, sexual orientation and transgender

identity. In Dundee we are committed to reducing inequalities which arise

because of socio-economic status. In Dundee we will aspire to embrace the spirit

of co-production, which has the following ambition:

“No one is more equal than anyone else” Scottish Co-Production Network

We recognise that you are key partners in improving your own health and

wellbeing, and reducing health inequalities. We support the vision of Integration

described by “Our Voice” where:

“People who use health and care services, carers and the public will be enabled to

engage purposefully with health and social care providers to continuously improve

and transform services”.

To do this, we will create genuine opportunities for engagement which build on

existing practice and structures as well actively seeking opportunities for

innovation and change. This will contribute to a partnership with you that

supports the following:

• We will work with you, supporting you to feel that you are at the centre

and have ownership of services that you access;

• We will work with you to co-produce efficient and effective services that

meet individual and locality need;

• We will work with you to create opportunities that build on and

contribute to the assets of local communities;

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• We will work with you to ensure you are involved and contributing to key

strategic decision making structures, making your voices part of our

governance arrangements.

Everyone who is involved in the delivery of health and social care, regardless of

who employs them, and whether they are paid or unpaid, has a key role to play in

ensuring full participation and engagement. This will be embedded into

everyday practice and is not an “add-on” to the work that we do.

Participation and engagement is not achieved by stand alone pieces of work such

as surveys, one off consultations, or attendance at meetings. It is an ongoing

process that demonstrates the commitment to hearing and listening, recognising

and acting on the voices, stories, contributions and ideas of people to improve

pathways and outcomes for the health and wellbeing of communities in Dundee.

It is fundamentally about creating the conditions for an open and honest

dialogue that leads to and supports trust, confidence and respect.

Our strategic priorities are set out in the Strategic and Commissioning Plan,

which will be agreed after consultation, in March 2016. These priorities are as

follows:

1. Health Inequalities

2. Early Intervention/Prevention

3. Person Centred Care and Support

4. Carers

5. Localities and Engaging with Communities

6. Building Capacity

7. Models of Support/Pathways of Care

8. Managing our Resources Effectively

How we listen to and include you as equal partners will be key to achieving these

priorities. Putting your voices at the heart of decision making will ensure that

outcomes improve over time.

We will work closely with you to identify the ways that you want to be involved

in, and contribute to, decision making. This will include engagement at all stages

of the Commissioning Cycle i.e.:

• Planning

• Doing

• Reviewing

• Analysing

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We are committed to building on successes whilst remaining an exemplar of

good practice and innovation; using new and emerging tools, techniques and

approaches that support excellent and meaningful participation and

engagement. Dundee will remain cutting edge.

We will work with communities and organisations, including those with whom

we commission, in order that a shared understanding of the principles of

participation and engagement is reached. Partner organisations will be

supported to show commitment to these principles which is evident in the way

that their services are delivered.

We recognise the ongoing good work already in place and look forward to

opportunities for increased learning from each other.

This is an ongoing and evolving document and will be reviewed to be concurrent

with the Strategic and Commissioning Plan.

Progress made and milestones achieved will be reported back to the IJB through

the Integrated Strategic Planning Group.

An implementation plan accompanies this strategy. This sets out actions to be

taken forward over the period of the Strategic and Commissioning Plan (2016 –

2021). It will be this implementation plan which will form the basis of future

reporting to the IJB and our broader participation and engagement partners.

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1.1 Principles

These are based on those contained within the National Community Engagement

Standards and have been adapted after local consultation. The principles:

• Give a clear message of our intentions

• Set expectations and guide our practice

• Set a mutual context and understanding of our approach to participation

and engagement

• Support embedding of principles of engagement in the way we do things

Dundee Health and Social Care Partnership – Principles of Engagement

1. We will use a variety of ways to engage to make sure that everyone is involved

2. We will make sure that those who provide services and support to people in

Dundee are involved. This will include all staff including those from the third

sector, the private sector and unpaid carers and volunteers.

3. We will build on what we already know works.

4. We will let people know what difference their involvement has made as soon as

possible.

5. We will develop ways to measure the differences engagement and participation

has made, linking these to what we have already said we will do and what

people have told us is important to them.

6. We will make sure that staff are confident, well trained and are able to engage

with communities, service users and their carers.

7. We will make sure that local communities, carers and service users are

supported to feel confident and able to engage with us.

8. We will make sure that the IJB can measure the difference that engagement is

making and keep improving, by evaluating our activities to improve our

practice and outcomes.

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1.2 The landscape of participation and engagement

National legislative and policy context includes:

Public Bodies Joint Working (Scotland) Act

Community Empowerment (Scotland) Act

Patient Rights (Scotland) Act 2011

NHS Reform Act (Scotland) 2004

Chief Executive Letter (CEL) 4 (2010) Informing, Engaging and Consulting people

in developing health and community care services

Chief Executive Letter (CEL) 8 (2012) - Guidance on Handling and Learning from

Feedback, Comments, Concerns and Complaints about NHS Health

Our Voice –

Listen, Learn Act, (National Education for Scotland)

Public Sector Reform Act

Carers Strategy

The Participation Standard for the NHS in Scotland

Ways this happens locally include:

Community Learning and Development Strategy

Pan Tayside Communications and Engagement Framework (April 2015-April

2016)

Local Community Planning Partnerships Plans & Structure

Dundee Partnership Community Engagement Model

Voluntary Sector Networks & Forums

Private Providers Forum

NHS Tayside Public Partners

Public Reference Group

Care Group Strategic Planning Group Engagement plans and mechanisms

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What does this mean for the Strategy?

This strategy sits within, and contributes to, the implementation of a well

developed local and national framework. It does not replace any of these but will

add value to existing methods of participation and engagement, and support

seamless connections between these.

As much of the local guidance is still emerging, the strategy will be sufficiently

flexible to respond appropriately to this continually evolving landscape.

Areas for further development

As a result of a review of the above landscape and the existing work, the

following sections have been identified as priorities to support our maturing

participation and engagement. These sections have been identified as being key

to adding strength and depth to existing relationships. It is recognised that this

work is not exclusive and that other activities will be taking place; the strategy is

not intended to constrain innovation.

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2.0 Section 1 - Supporting Participation and Engagement

You have a unique contribution to make in shaping, improving and developing

health and social care service. You are the “experts” by experience, bringing

skills, qualities, knowledge and life experience. You live in families and

communities, and have common or shared experiences and as such know the

strengths of your communities and where the assets and opportunities lie.

How will we support meaningful participation and engagement?

Co-Production at the Centre

A continuum of participation and engagement exists. This strategy recognises

that different types of engagement are appropriate depending on the individual

situation. However the integration of health and social care services gives us the

opportunity to shift the balance more towards co-production and to allow

services and communities to develop tests of change which help us make co-

production “the norm”.

Co-production is at the centre of integration. Co-production is about engaging

people (patients, service users, citizens and staff) in the planning and design of

services, in assessing their own needs, and deciding which supports would best

meet those needs.

Co-delivering is about the way that services are undertaken and delivered so that

they enable you to make the best use of, and further develop, your own strengths

and assets, and those of your local communities, to improve the health and

wellbeing of yourself and others.

Implementing co-production and co-delivery requires a genuinely different and

creative change in perspective. This change is one that moves from a “narrow”

health and social care technical fix, to one that puts co-production or outcomes at

the centre of the integration agenda. It requires people and communities to be

treated as equal co-producers of outcomes, and the rethink of the use of

organisational resources so that they complement and support the development

and use of individual and community assets.

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The ladder of participation has become a well recognised model to describe the

journey towards co-production. It sets out the stages of participation moving

from a stage of ‘doing to’ to ‘doing with’. While the practice currently varies

across the different agencies our current practice for the integrated partnership

would indicate that we are generally currently sitting within the ‘doing for’ area

of the ladder.

Information:

We will provide Dundee citizens with the information they need to:

• Maintain and improve their own health;

• Make the best use of available services;

• Contribute to service development and improvement.

This will be supported by the Pan Tayside Communication and Engagement

framework and by the work of the Communication and Engagement Sub Group

Dundee.

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Involvement at all levels:

We will involve you throughout your journey of care and all stages of planning.

This will include involvement in relation to planning for your own care, how

services and supports are delivered in your local communities, and how services

and supports are commissioned for the whole City. You will be supported to be

involved. We will ensure that people from all backgrounds are involved and that

everyone has an equal opportunity to participate.

We will ensure that you are involved as equal partners in your own care. We will

actively seek to hear feedback about your care and services in order to make

improvements and learn from your experiences. This will be done within

existing legislative and policy frameworks.

Services will involve and include you at a local level, by linking with existing

locality and engagement structures. You will be supported to choose what the

best mechanism for you is. By strengthening the links with and helping to build

the capacity of these engagement groups the IJB will ensure that the full range of

different voices are heard.

We will ensure that you are fully involved in developing, monitoring and

reviewing Commissioning Strategies by ensuring that each of the Strategic

Planning Groups has its own Engagement Framework.

This practice will contribute to and inform developments across Tayside and at a

national level, with Dundee continuing to be noted as an exemplar of best

practice.

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3.0 Section 2 – Learning From Each Other Together

We aspire to embody a learning organisation which continuously transforms

itself by expanding its capacity to change and evolve and “where people are

continually learning to see the whole together”. (Peter Senge 1990)

We will create the conditions where the following areas become the “learning

norm” across the organisation.

Tests of Change – Experimentation

We will continue to use tests of change to produce incremental gains in

knowledge. We will support the development of a culture where it is

acknowledged that there is permission to create innovative ways to include and

involve you. We will seek to capture the learning from these tests of change in

order to learn from these as widely as possible.

Learning from Past Experience

We will make best use of feedback received by ensuring that learning is shared

across the organisation and beyond. We will learn from what has worked well

and from what could have been done better and will share this learning with

others.

Learning from others

We will continue to widen the range of those with whom we engage, making sure

that we actively seek contribution and involvement from those whose voices are

less likely to be heard. Engagement will be purposeful and will contribute to

achieving the wider outcomes of the Integration body. This will mean that we

develop learning from:

• engagement with individuals

• engagement with communities

• examples of best practice across the City

• practice and developments outwith Dundee

Sharing knowledge and learning

We will ensure that the broad range of methods, tools, models and examples of

participation and engagement, and the learning from this, are captured in what

will emerge as a “virtual” Toolkit. You will be encouraged to contribute to this

and to make active use of the resources captured. As well as using existing

methods of communication such as e-mail, newsletters, e-briefings etc, we will

explore the use of social media such as Facebook and Twitter to create a

platform for engagement and participation. We will build on the existing shared

approach to learning and development that ensures formal and informal

opportunities to learn from each other are accessible to all.

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4.0 Section 3 – Hearing Stories

Stories are an incredibly rich, powerful but underused source of information.

They bring to life issues that really matter to people, in their own words.

“There is evidence that, when they are properly gathered and used, personal stories

empower storytellers. People who share their experience, and know how the

learning from their stories has been applied, feel that they have been positively

involved in service development and improvement. Organisations that use stories to

improve services develop a culture of participation and a reputation for listening

and acting upon what they learn.” (NES – Listen Learn Act)

How are we going to hear stories and how will we act on them?

We will support people to tell their stories. We will set expectations for how

they will be heard. Staff, citizens, their families and carers will have a common

understanding of these expectations. We will create a safe and supportive

environment in which people can have their stories heard.

We will create a range of opportunities for more people to tell us their stories

including making better and safe use of social media such as Facebook and

Twitter (via the on-line toolkit referred to above). We will also use these

platforms to share information.

Before we share stories we will ensure that the story teller and the story sharer

have a joint understanding of what that story is telling us and how it can

contribute to service redesign.

We will be clear about how we are going to use the information people give us in

their stories ensuring that the principles of confidentiality, consent, dignity and

respect are core to this.

We will have a clear route by which stories can be fed into existing planning and

improvement mechanisms.

We will ensure that support is available to story tellers and those listening to

their stories – particularly where those stories may cause potential distress or

emotional concern.

We will continue to develop “Tom’s Story”, which will incorporate the learning

from stories which we hear, making it more and more relevant to people in

Dundee, to ensure that it reflects their lived experiences. We will use the

developing story to inform:

• Citizens about emerging changes to health and social care services

• Evaluation of service improvement

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5.0 Section 4 – Governance

We have overall strategic responsibility for ensuring that the principles of this

strategy are adhered to across Dundee. The IJB itself has wide representation

from across Partner agencies, the voluntary sector, staff, patient and carer

representatives.

Progress on and review of this strategy will be reported regularly to the IJB as

per the agreed implementation plan, and reporting arrangements will be in line

with those of the agreed Strategic and Commissioning Plan.

The ISPG will retain responsibility for overseeing progress of this strategy and

are responsible for ensuring that links across the broader partnership in Dundee

are developed and sustained, in line with the agreed principles of participation

and engagement.

At an operational level, integration managers will be responsible for:

• Ensuring that operational and strategic managers engage and evidence

co-production

• Supporting the development and embedding of participation and

engagement activities across services areas in accordance with the

principles and outcomes in this strategy

• Monitoring progress on the intended outcomes set out in this strategy

• Evaluating the quality of participation and engagement across the

Divisions

Evaluation and Service Improvement:

Citizen Role

We will evaluate our engagement activity to ensure that you have been given the

opportunity to provide feedback on what worked well and where improvements

are needed.

Planning and decision making

We will evaluate how our engagement has impacted on our service planning and

delivery and identify areas for improvement.

What else?

We will evaluate the impact of this strategy to identify successes and areas for

improvement.

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Implementation Plan

2016 – 2021

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Theme: Supporting Participation and Engagement

Outcome: You will be involved throughout your journey of care and in all stages of planning

Outcomes for people who

use services, their

families and carers.

Key Actions

Timescales

Who?

You will know how to get

involved

Your involvement will be

welcomed and encouraged

Your involvement will lead

to better outcomes for

communities and

individuals

You will have the

information you need to

be engaged and involved

You will be supported to be

involved

Your involvement will feel

good and will contribute

positively to your health

and wellbeing.

Map communication routes and opportunities for involvement across

the 3 levels (Strategic, Community and Individual)

Identify and engage with key partners in order to produce information

in a range of formats that inspire a desire to be part of the work of the

Health and Social Care Partnership.

Review existing available formats and identify gaps and areas for

improvement.

To produce a suite of information materials eg leaflets, in alternative

audio / visual / formats and media.

Establish and build on existing links to and between Care Group SPGs

and other groups such as Local Community Planning Partners, third

and independent sector networks and forums.

Continue to create and take advantage of opportunities to work in co-

productive ways.

Create opportunities to support staff and volunteers to increase

confidence in the use of participative and co-produced approaches to

the delivery of services.

October 2016

October 2016.

March 2017.

October 2016

Ongoing,

reviewed in line

with governance

arrangements

Ongoing,

reviewed in line

with governance

arrangements

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Outcomes for people who

use services, their

families and carers.

Key Actions

Timescales

Who?

You will be confident that

staff know how to create

opportunities for your

participation and

engagement.

Make use of Our Voice to support local participation and engagement

processes and developments.

Ongoing,

reviewed in line

with governance

arrangements

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Theme: Learning From Each Other

Outcome: You will know how the learning from participation and engagement supports service improvements.

Outcomes for people who

use services, their

families and carers.

Key Actions

Timescales

Who?

Your individual needs will

be taken into account

allowing you to become

involved in a way that best

suits you.

You will know that the

learning from tests of

change will be used to

make improvements to

services.

Learning opportunities will

be open to and shared by

all, where appropriate.

You will be confident that

staff are continually

developing their skills and

that they have access to the

tools required to

encourage participation

and engagement.

Identify existing learning opportunities relating to participation and

engagement methods across Dundee, from our neighbouring partners,

and best practice at national and international level.

Identify how what is known from other consultations in communities

across Dundee contribute to improvements to health and social care

services – this will include existing community engagement work

undertaken by our community planning partners and others.

Co-produce and design key learning for staff that has a focus on

Participation and Engagement.

Support the development of learning networks across the city that

involve users of services, their families and carers.

Development of a virtual Toolkit that is the gateway to the best learning

resources that support meaningful participation and engagement.

Continue to invest in co-production skills development.

October 2016

October 2016

March 2017

March 2017

March 2017

Ongoing, reviewed

in line with

governance

arrangements and

the life of the

Strategic and

Commissioning

Plan

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Theme: Hearing Stories

Outcome: Health and social care delivery will be shaped by stories shared by people with lived experience of using services, receiving care

and / or treatment, and their unpaid carers.

Outcomes for people

who use services, their

families and carers.

Key Actions

Timescales

Who?

You will have safe and

appropriate

opportunities to share

your story.

You will have support to

share your story.

You will have support to

interpret the meaning of

shared stories with those

who choose to share

them and those who are

required to act on their

lessons.

The meaning of your

story for you personally,

for communities, and for

future service delivery

will be received and

understood by those

concerned in your care.

Map where sharing stories is having a positive influence on helping to

improve people’s outcomes, to include gathering examples of local story

sharing which have helped to reshape services and led to better

outcomes for individuals and communities.

Identify a range of opportunities within communities and services for

people to share their stories.

Identify planning and improvement mechanisms which would be

enriched by the sharing of individual stories.

Define the support available to people who share their stories.

Create innovative ways for the IJB to directly hear people’s stories that

include the celebration and acknowledgement of when things went well.

Develop alternative ways to share and hear stories including digital

stories, animations, and other audio or visual methods.

Create opportunities for people to tell their stories directly to the IJB

where appropriate.

December 2016

December 2016

December 2016

Ongoing, reviewed

in line with

governance

arrangements

Ongoing

throughout 2016 -

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Outcomes for people

who use services, their

families and carers.

Key Actions

Timescales

Who?

You will know what

difference sharing your

story has made.

The insight your story

communicates will be

used by all concerned in

your support and care to

positive effect.

Identify or establish mechanisms for providing feedback to people who

share their stories.

Produce or adapt guidance to inform the process of story sharing, based

on the information gathered.

Examine alternatives to a “complaints” based process that acknowledges

the opportunity for improvements through stories.

Support staff through appropriate staff development, to hear stories and

to know and demonstrate how to use these to improve outcomes.

March 2017

March 2017

From April 2017

onwards

From April 2017

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Theme: Governance

Outcome: You will know that decisions taken by the IJB have been informed by meaningful participation and engagement

Outcomes for people who

use services, their

families and carers.

Key Actions

Timescales

Who?

You will have access to

information relating to key

decisions to be taken by

the IJB.

You will know how you can

get involved in helping to

shape these decisions.

You will be confident that

the IJB is taking its

governance role seriously

and that there are

measures in place for this.

Examine and contribute to best practice across other Health and Social

Care Partnership that ensures governance arrangements are supported

by participation and engagement.

Further develop transparent processes relating to IJB decisions, to

include the range of formats information is presented in and how that is

made available.

Develop a participation and engagement protocol for key decision

making processes which also takes cognisance of statutory

requirements.

Audit public and community attendance at the IJB with consideration of

venue, location, accessibility and how the information is

shared/disseminated.

Report on the IJBs adherence to the National Engagement Standards.

Develop a “plain English” protocol for reports and other documents

being presented to the IJB.

Develop a monitoring and evaluation framework.

April 2017

April 2017

October 2016

October 2017

Annually in line

with the Strategic

and Commissioning

Plan Reporting

Requirements

April 2017

October 2017