Patient, Public, Engagement and Participation Strategy · the public, our stakeholders and our...

SASH Final PPE Strategy 2018 February 2018 /GFM

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Patient, Public, Engagement and Participation Strategy 2018 – 2020 Final February 2018


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Contents Page

Executive summary 3

Overview of the Trust 4

Strategic context 5

Why this PPE strategy is important 6

How we developed this strategy 9

Who is our strategy for 9

Our aims 10

Strategy objectives 12

Reward and recognition 14

Conclusion and how to get involved 14

Appendix A – Definitions 15

Appendix B – Engagement action plan 17


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1. Executive summary

Surrey and Sussex Healthcare NHS Trust Patient and Public Engagement Strategy (PPE) sets out how the Trust will achieve its objective to strengthen patient and public engagement throughout the organisation. This document outlines the aims and objectives of our three year strategy and also includes an implementation plan, ways of measuring success and impact. SASH has a long and positive history of involving and engaging patients, the public and a variety of voluntary and community groups in its plans along with the review and development of services. Some examples include patient engagement in the development of, open visiting hours, carers strategy, membership engagement strategy, the way finding project and the role of the Council of Governors. The Trust has also used patient feedback from Care Opinion and Your Care Matters to make improvements to patient experience. The Trust aims to improve its methods of engagement in a more co-ordinated, proactive and intentional way. The development of this strategy is a means of bringing all engagement and involvement work together under one umbrella. Our ambition is that patient and public engagement and participation becomes part of our everyday business. The five aims of our Patient, Public Engagement and Participation strategy are: 1. Involvement in individual care and treatment: We will involve patients and carers in decisions

about their care at all stages of the patient journey

2. Service delivery, development and transformation: The Trust will actively seek the views and engagement of patients, their carers, our Members and the wider community in the design and delivery of services.

3. Strategy – planning our future services: Patients, our Governors, Members, the local

community and our stakeholders will have a greater opportunity to inform how we plan and develop our services for the future.

4. Assurance: Our Trust Board of Directors and our

Council of Governors will actively seek demonstrable evidence that Trust services are listening to, learning from and acting upon the views of patients, carers and stakeholders.

5. Meeting our statutory and regulatory obligations:

The Trust will continue to meet its statutory and regulatory duties to involve patients and the public, Healthwatch and local authorities’ health overview and scrutiny committees in our work.

Gillian Francis-Musanu Director of corporate affairs January 2018

‘Involving people, communities

and stakeholders in developing

plans and services is the right

thing to do to ensure that the

plans and their implementation

are robust and meet the needs of

people and communities.’

NHS England, (2016) Engaging

Local People


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2. Overview of the Trust Surrey and Sussex Healthcare NHS Trust (SASH) provides a comprehensive range of emergency and non-emergency services to the residents of East Surrey, northeast West Sussex, and south Croydon, including the major towns of Crawley, Horsham, Reigate and Redhill. The Trust owns East Surrey Hospital (ESH) which is located just south of Redhill. ESH is a designated Trauma Unit and the designated hospital for Gatwick Airport and sections of the M25 and M23 motorways. The hospital is situated at the heart of our local community of over half a million people and provides a full range of district general hospital (DGH) services. SASH staff also deliver a range of outpatient, diagnostic and day case services at Caterham Dene Hospital, the Earlswood Centre and Oxted Health Centre in Surrey and at Crawley and Horsham Hospitals in Sussex. The Trust is a medium sized DGH providing associated services with a significant catchment population. SASH is uniquely positioned approximately 15 miles in any direction to the next nearest NHS DGH running similar services; (most are further away). The catchment size and this geography make SASH a key emergency centre. A walk in centre at Crawley Hospital and Minor Injury Unit in Horsham deals with significant volumes of less acute emergency activity leaving the Accident and Emergency Department at East Surrey with an almost entire Type 1 A&E patients.


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The Care Quality Commission visited SASH in May 2014 to determine whether services provided were safe, effective, caring, responsive and well led. The Trust was rated as “good” overall. All inspected services were rated as “good” in the caring domain with End of Life care receiving an “outstanding” rating for responsiveness. This was a significant milestone for the Trust and the inspection team commented that the culture and engagement in the organisation was excellent. There were some recognised areas for improvement in outpatients and significant progress has been made. The Trust is on a journey to become an “outstanding” organisation.

The main site (ESH) is operated as a health campus and there are notable partnerships in place with other organisations to maximise the healthcare available to the community. These partnerships are a key aspect of the Trust’s strategy (two linear accelerators for cancer treatment are operated by Royal Surrey County FT, a respiratory unit run by Guy’s and St Thomas’ FT in partnership with British Oxygen Company and a Cancer Information Centre in association with Macmillan). Our partnerships are currently extending to partnerships with Marie Curie to integrated working with East Surrey CCG and Surrey County Council over urgent care services with an Integrated Reablement unit and a Frailty Unit, both opened in 2016. We also provide Hospital @ Home services.


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The Trust entered into a Joint Venture for pathology services with Brighton and Sussex University Hospitals NHS Trust (BSUH) when a full business case was considered and approved by the Board in September 2014. The Trust is an Associate University Hospital of Brighton and Sussex Medical School and strong links

with the University of Surrey and Health Education England both in terms of clinical training and

career development. We run innovative programmes for Physician Associates, “Mouth Care Matters”

as well as Kent Surrey and Sussex Academic Health Science Network. The Trust is also a member of

Surrey Health Partners which underpins our relationship with the University of Surrey. SASH has also

promoted healthcare career recruitment by supporting both local secondary school career fairs and

the ‘Care Hub’ collaboration at East Surrey College.

3. Strategic context

The Trust is working to a five year strategic plan as outlined in its integrated business plan and the core elements of the Trust’s strategy are illustrated in the single diagram below.


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4. Why this PPE strategy is important

Reports about NHS care, in particular the Francis Report (which reported on the failings at the Mid Staffordshire Foundation Trust), have emphasised the importance of real patient and public involvement and engagement in the NHS. Like all NHS organisations, the Trust has a legal duty to involve patients and the public in its work, but our commitment goes beyond this. The Trusts Vision is to “pursue perfection in the provision of safe, high quality care that puts the community first”. There are many ways that we can and do put this vision into practice – from how we involve patients and carers in decisions about their care, to how we work together with patients and the wider community in developing and planning our services. Ultimately we want to ensure the voices of patients, carers, the public, our stakeholders and our staff are at the centre of our everyday business. Patient engagement is also a priority for the Sussex and East Surrey Sustainability and Transformation Plan (STP) with a particular focus on the development of place based plans through developing and refining care pathways. Everyone at the Trust is responsible for patient and public engagement and staff will have wide and varying roles in supporting the implementation of this strategy. This strategy describes a range of activities to achieve this and there are examples of good practice across our services, our goal is to make this more widespread. We want the voice of patients, the public and our voluntary and community sector partners to be heard in all parts of our organisation, from the recruitment and training of our staff, to being the driving force of service design and assessing the care we provide. With these voices the care delivered at SASH can become even more person-centered. Since the first iteration of the national Patient and Public Engagement Strategy in 2013-15, the Government and Department of Health policy has shifted from its role as a moral and ethical responsibility, to a legal requirement. No longer simply ‘the right thing to do’ the NHS has a statutory duty to involve people in the planning, delivery and improvement of NHS services.

*You have the right to be involved, directly or through representatives, in the planning of healthcare services commissioned by NHS bodies, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services. The NHS also commits to encourage and welcome feedback on your health and care experiences and use this to improve services (pledge). *27th July 2015, NHS Constitution pgs 9 & 10

This strategy sets out how the Trust will achieve its objective to strengthen patient and public engagement throughout the organisation. This document outlines the aims and objectives of our three year strategy which and includes an implementation plan, ways of measuring success and impact.


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SASH has a long and positive history of involving and engaging patients, the public and a variety of voluntary and community groups in its plans along with the review and development of services. Some examples include patient engagement in the development of, open visiting hours, carers strategy, membership engagement strategy, the way finding project and the role of the Council of Governors. The Trust has also used patient feedback from Care Opinion and Your Care Matters to make improvements to patient experience. The Trust aims to improve its methods of engagement in a more co-ordinated, proactive and intentional way. The development of this strategy is a means of bringing all engagement and involvement work together under one umbrella. Our ambition is that patient and public engagement and participation becomes part of our everyday business.

4.1 Drivers for development of a PPE Strategy There are many examples where PPE is delivering improvements to services provided by the Trust. We are proud of our track record of community engagement; however, there are a number of drivers to develop a strategy further including our ability to translate this into tangible deliverables which increase patient value and benefits:

Evidence of impact: Building on examples where PPE is working well within the Trust and making a difference to the experience of patients and to share best practice and upscale its role in quality improvement and patient experience consistently across the Trust.

Council of Governors: Our Council of Governors is now established and Governors are actively seeking further ways in which to engage with patients and the public.

Extending beyond statutory requirements: While we have a formal role with organisations such as Healthwatch; there is a desire for the relationship to become

o increasingly collaborative and sustained as improvement plans are designed, fulfilled and celebrated for their impact. Primary Care providers routinely seek and receive feedback about hospital experiences and coordination between the acute and primary sector alongside social care and private care providers. GP Patient Groups and similar forums are keen to collaborate for improvement.

How people navigate PPE: The Trust’s communications about PPE and the different levels of participation are not as clear as they could be. Patients, staff and the wider community have fed back that they are not clear about how to navigate the different opportunities and ways to get involved. People who are already involved lack clear evidence that their time is valued and meaningful. There is clear work to do to communicate the sincerity of PPE, its role within Trust culture and decision-making.

Increasing consistency and joining up the Trust’s plans for engagement: Whilst some services have benefited from PPE; this does not permeate across all services in a consistent and joined up way


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Increasing the reach of PPE: PPE is not always representative of all the communities we serve. It is recognised that there is a significant willingness of the local community to be involved with the hospital and contribute to the experience of patients that use it. Ensuring that it is easy for patients, the public, and staff to navigate the mechanisms for PPE at SASH in particular for groups that are “seldom heard” (traditionally known as hard to reach) and this is a significant reason for developing this PPE strategy.

Empowering individuals and the collective: Recognition that all staff, Governors, Members, volunteers and ‘active citizens’ hold vast amounts of insight for improvement in almost every encounter they have with the Trust. PPE has the potential to empower all Trust stakeholders to understand their rights and entitlements to encourage and recommend changes that are within their gift to make. There is a real opportunity to recognise the softer, immediate and every-day sources of feedback and increase everyone’s ability to recognise and act on them that collectively, empowers the continuous cycle of listening, learning and acting for improvement.

Breaking down barriers and working in partnership: Can create a common language that breaks down a feeling of “us and them”, which in turn will lead to improvement in communication between hospital staff and patients. It can also help reduce any potential anxiety of accessing Hospital services “improves people’s sense that they can actually get the services to respond to them.”

5. How we developed this strategy

This strategy has been developed by the corporate affairs team with input from the patient experience team, together with staff, governors and in partnership with Healthwatch, Clinical Commissioning Groups and voluntary and community sector groups in Surrey and Sussex. The Trust looks forward to the continued support of these groups as we implement this ambitious strategy.

6. Who is our strategy for and who does it apply to?

The strategy applies to all hospital and community services for adults and children. The strategy applies to all departments which have (direct) contact with patients and visitors, such as clinical services providing care and treatment, and services such as portering, reception, facilities. It includes many departments who may not work directly with patients, families and carers, but whose activities affect the quality of care and service we provide, for example workforce and education, who are responsible for recruiting and training our staff. At the very centre of our strategy are our patients, their families and carers. It is their individual and collective experiences and knowledge of care and services that should contribute to shaping the Trust’s work. The diagram below shows some of the patient and public groups to whom this strategy will apply.


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SASH Patient and Public Engagement and Participation Matrix

7. Our aims: what we want to achieve through our strategy

The five aims of our strategy are: 7.1 Involvement in individual care and treatment We will involve patients and carers in decisions about their care at all stages of the patient journey which is within our remit, whether in our hospital, in services and facilities in the community, or in patients’ homes. The Trust will actively encourage feedback on how all services perform. SASH has separate policies and processes for complaints and compliments and we welcome feedback on which will help us improve our services and the experience of patients. We use PALS, Care Opinion and other forms of feedback. Please see https://www.surreyandsussex.nhs.uk/contact-us/compliments-and-complaints/

https://www.surreyandsussex.nhs.uk/contact-us/compliments-and-complaints/

https://www.surreyandsussex.nhs.uk/contact-us/compliments-and-complaints/


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7.2 Service delivery, development and transformation The Trust will actively seek the views and engagement of patients, their carers, our Members and the wider community in the design and delivery of services. Patients’ and carers’ views will help us to monitor and drive improvements in the quality, safety and efficiency of our services.

Under the Equality Act 2010, all public sector employers must abide by the Public Sector Equality Duty (PSED). The PSED has three key aims, which are to:

Eliminate discrimination, harassment, victimisation

Advance equality of opportunity between people who share a protected characteristic and people who do not

Foster good relations between people who share a protected characteristic and those who do not

These are sometimes referred to as the three aims or arms of the general equality duty. The Act explains that having due regard for advancing equality involves:

Removing or minimising disadvantages suffered by people due to their protected characteristics

Taking steps to meet the needs of people from protected groups where these are different from the needs of other people

Encouraging people from protected groups to participate in public life or in other activities where their participation is disproportionately low

The Trust has a Diversity and Inclusion strategy and key elements are aligned and integrated with our PPE strategy. 7.3 Strategy – planning our future services Patients, our Governors, Members, the local community and our stakeholders will have a greater opportunity to inform how we plan and develop our services for the future. 7.4 Assurance Our Trust Board of Directors and our Council of Governors will actively seek demonstrable evidence that Trust services are listening to, learning from and acting upon the views of patients, carers and stakeholders regarding the design, quality, safety and efficiency of the care and services we provide. 7.5 Meeting our statutory and regulatory obligations The Trust will continue to meet its statutory and regulatory duties to involve patients and the public, Healthwatch and local authorities’ health overview and scrutiny committees in our work.


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8. Strategy objectives: what we will do to achieve our aims There are four main objectives, which will be delivered over the next three years. A detailed plan about how and when we will complete this work can be found in Appendix B of this strategy which will also be available on our website. In summary our objectives are: Objective 1: Involvement in individual care and treatment

Listen to our patients; involve them in decisions about their care from a first outpatient appointment, to admission and discharge, for example by improving the way we plan care for all patients and ensuring that patients can access information that meets the NHS Accessible Information Standards.

Continue to embed the ‘Duty of Candour’, so that patients are aware when something has gone wrong and make sure the voice of patients, their families and carers drive improvements in care, by involving them in our reviews of care

Look for ways, where appropriate, to involve patients, their families and carers in the design and delivery of education and training for our staff so we can provide high quality care and services that meet their needs

Find ways to appropriately involve patients and carers in the appraisal process (achievement reviews), and use results of both staff and patient Friends and Family Test and patient surveys to improve staff and patient experience together


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Objective 2: Service delivery, development and transformation

Recruit staff based on our Trust values and behaviours and involve patients and carers where

appropriate in the recruitment of our staff

Develop support and resources to help our staff and departments to involve patients, their

families and carers in the development and delivery of services and engagement plans

Value and support patients, carers and other stakeholders who are involved in our service

development work

Listen to our patients and improve the way we respond to and act upon feedback to improve

their experience

Make sure the views of patients and service users inform our plans and the proposals for

service improvement, buildings and estate

Find ways to involve the voices of seldom heard and marginalised groups so they can

influence the design and delivery of services

Continue to involve patients and the public in our research and development programmes

Involve, engage and encourage people from protected groups (see Appendix A) to participate

in the development of service development and in other activities where their participation is

disproportionately low

Involve patients, carers, Governors and Members in reviewing the quality of patient services

Look for opportunities to involve and engage patients and members of the public in education,

training and research

Work together with local health and care partners to involve patients and the public

Involve Governors, Member and the public in SASH+ development programmes and

transformation of services

Objective 3: Strategy – planning our future services

Find more ways to engage and involve our Members

Develop our Membership to ensure that it reflects the populations we serve

Support our Governors to review the quality and safety of patient services

Build stronger relationships between Governors, Members, community & voluntary sector,

local Healthwatch and local authority committees


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Objective 4: Assurance

Make sure the Board of Directors is kept informed about patient and public engagement

activities and how these have improved the quality of care and services

Continue to improve the way we present and share information about the performance of our

services with our patients and stakeholders

Measure our success and impact through the Patient & Public Engagement Working Group

who would report on progress of implementing the strategy and action plan to the Council of

Governors, Executive Committee and to the Trust Board

9. Reward and Recognition Patient, members of the public and those from voluntary and community organisations would be able to claim reasonable travel expenses and those who require it would be able to access relevant internal training and development opportunities within the Trust to help develop and improve their ability to contribute to the Trust and as a way of rewarding and recognising their contribution. As the Trust develops its SASH Awards one suggestion is of a PPE annual award which would be another way of recognising this important contribution.

10. Conclusion

Patient and public engagement must add value to the services we provide at SASH. Indicators will be developed to measure the outcome and impact of increased PPE that demonstrate:

If PPE has increased patient experience and satisfaction

Better design of services

Improved patient, carer, public and staff morale from better engagement

Whether the intended outcomes of actions have been achieved

What difference has been made as a result of involving and engaging patients and the public;

particularly in the area of in service provision and improvement

How to get involved If you are interested in getting involved and you would like more information, please contact the

patient and public engagement team at [email protected] or telephone 01737 231 701.

mailto:[email protected]


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Appendix A Definitions:

Patients People who currently use any of the Trust’s services

Relatives Family members and others who are significant to patients

Carers Anyone who cares, unpaid for a friend or family member who, due to illness, disability or a mental health problem or an addition cannot cope with their support

Members Patients, staff and members of the public who have committed to becoming a member of the Trust and who want to be informed/involved/engagement in service development

Governors Individuals who are elected by the members to represent the membership constituencies or who have been nominated by their partner organisation

Marginalised Groups

Groups of people within communities that face additional barriers to accessing and influencing public services and community life which leads to health inequalities

Seldom Heard Groups

Groups of people that are overlooked because they have needs, e.g. disability or no fixed address that make them more complex to engage using traditional methods. Without targeted engagement, these groups will continue to lack power and influence in their local health and social care economy

Protected Characteristics

The Equalities Act 2010 introduced nine ‘Protected Characteristics. Protected Characteristics are the characteristics that can ‘trigger’ against discrimination in the Act:

Age

Disability

Gender reassignment

Marriage and civil partnership

Pregnancy and maternity

Race

Religion or belief

Sex / Gender

Sexual orientation

Public People who take an interest in the Trust and its services but who may not necessarily have direct or recent experience of its services


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Voluntary and Community Sector

Organisations in the third sector who provide services, and advocate on behalf of a range of groups

Patient and Public Engagement/

Involvement

The term Patient & Public Engagement and Involvement (PPE/I) is used throughout this document and includes the following groups and individuals that the Trust wants to actively work in partnership with within this umbrella definition:

Patients

other service users

carers

families

patient advocates

Foundation Trust members

individual members of the public

groups

community representatives

voluntary and community sector organisations


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Appendix B

Patient and Public Engagement Action Plan

Actions Success criteria Timescale by year

Lead Other supporting

strategies

Objective 1: Involvement in individual care and treatment 17/18 18/19 19/20

a) SASH commitment to ensuring the delivery of the provision of safe, effective, caring, responsive and well-led services

Consistent improvements in local inpatient survey results

Evidence of Divisional activities

Chief executive

NHS Constitution

Patient Experience Strategy

Care Quality Commission Standards

Inclusion Strategy

b) Opportunities to extend the use of tools such as patient passports across specialities that care for patients with long term conditions and learning disabilities

Evidence of Divisional activities

Divisional chief nurses

Patient Experience Strategy

c) Continue to look for ways in which carers of patients are involved in the planning and care of patients and family members through the on-going implementation of the Carer’s passport and informed choice

Evidence of use of carers passport

Chief nurse Patient Experience Strategy


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Actions Success criteria Timescale by Year Lead Other supporting strategies

Objective 2: Service delivery, development and transformation 17/18 18/19 19/20

a) Involve and engage patients, carers, governors, members, voluntary and community sector in focused initiatives throughout the year. E.g. open visiting, hot topic events, surveys, focus groups, relevant working groups etc.

Appointment of a PPE Lead to take a lead in this area of work

Compile a comprehensive overview of all involvement & engagement taking place across the Trust

Increase engagement activities in all areas across the Trust with a focus on seldom heard groups

Director of Corporate Affairs

Patient and Public Engagement Strategy

Communication Strategy

b) Develop support and resources to help staff involve patients, their families and carers in the development and delivery of services

Develop engagement support packages available and to be used by staff in each division

Patients, public, members & governors involved in designing new ways for them to participate and ensure



Estates Strategy


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reward and recognition

d) Identify opportunities for patients, the public and Governors to be involved and engaged in the development and review of strategic plans and objectives for the Trust

Involvement and engagement of patients, public and Governors in the development and review of strategic plans

Council of Governor meeting minutes

Director of Strategy and Director of Corporate Affairs


e) Re-engage and development relationships with Healthwatch both in Surrey and West Sussex and work in partnership to agree a work plan to support patient engagement

Agreed work plan with Healthwatch

Chief Nurse Patient Engagement

Strategy and Patient Experience Strategy

f) Find ways to ensure that the voices of seldom heard and marginalised groups are involved, heard and engaged to support patient and public engagement

Work with the voluntary and community sector in Surrey and Sussex who represent seldom heard and marginalised groups (including those with Protected Characteristics) to ensure their voices are heard in service development and planning as identified the Trusts Inclusion Strategy


Director of OD and People


Inclusion Strategy


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g) Involve patients and public in appropriate research projects

Continue to increase the number of patients and the public appropriately involved in research projects

Medical Director

Research Policy

h) Work together with local health and care partners to involve patients and the public and co-design services

Agree joint partnership plans with health and social care partners to involve and engage patients and the public


Patient & Public Engagement Strategy

i) Involve Governors, Member and the public in SASH+ development programmes and transformation of services

Increase the number of patients, members and governors in SASH+ programme

Director of KPO

SASH+

j) SASH awards to include a new category for recognition of patient, public, governor or voluntary sector contribution to patient care or involvement

New lay-category for SASH awards

Director of OD and People

k) Increase the pool of trained PLACE assessors to include a wider and more diverse range of patients, members and governors

Increase pool of trained assessors involved in annual PLACE assessments

Director of Information and Facilities

Estates Strategy


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Actions Success criteria Timescale by Year

Lead Other supporting strategies

Objective 3: Strategy – planning our future services 17/18 18/19 19/20

a) Undertake a review of the current demographic profile of Membership to understand whether this is broadly representative of the population we serve

Review undertaken and findings share with the Council of Governors Use the findings of the review to explore the development of a recruitment plan to increase representation in under-represented groups


Patient & Public Engagement Strategy

b) Undertake a survey of Members to determine how they would like to be involved and communicated with by governors

Findings of the survey reported to Council of Governors A plan to address the results be developed and implemented


c) Learn from best practice models outside the Trust and explore the possibility of developing a plan and tools to develop a group of active Members who are engaged through building relationships

Proposals shared with the Council of Governors


d) Ensure community and voluntary sector networks receive information about Trust activities relating to service delivery, development and engagement opportunities

Communication links with CVS and umbrella organisations set up and utilised


Communication Strategy


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e) Mechanisms in place to ensure that the Trust continues its duties to consult with Overview and Scrutiny Committees and Healthwatch

Timely consultation with OSC and Healthwatch


Actions Success criteria Timescale by Year

Lead Other supporting strategies

Objective 4: Assurance 17/18 18/19 19/20

a) The Board to receive a bi-annual report on patient and public engagement

Bi-annual report received by the Board


b) An annual impact report is submitted to the Board, Council of Governors demonstrating how the Trust has discharged it responsibilities in relation to Patient and Public Engagement

Annual report presented to the Board and Council of Governors


c) Set up the Patient, Public, Engagement and Participation Working Group who will oversee the implementation of the strategy and action plan

Group set up and meeting, providing regular reports to the CoG, Executive Committee & the Trust Board


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