Reviewing our engagement
Patient and Public Involvement is at the heart of the work of NHS Croydon CCG.
Within NHS Croydon CCG we aim to involve local people as part of a series of meaningful conversations so that we can respond to local population needs and views. As well as influencing our commissioning decisions and transformation work, we make sure we take the time to communicate back to people how their views have influenced our work and if we are not able to take suggestions on board, the reasons why. Some examples of the ways we hold ourselves to account are listed below.
We constantly strive to improve engagement and continuously monitor and evaluate our work as well as feeding back to the people we speak to.
If you have any comments about our approach to engagement or have ideas of ways we can improve please contact us:
You can read about some practical examples of how we monitor and evaluate our work
How we work with local people
We know that the best way for us to achieve our vision for engagement is to work closely with our partners in the community and voluntary sector, including Croydon Voluntary Action and Healthwatch Croydon. Members of our engagement team and commissioners regularly visit community groups and organisations to talk to Croydon residents about their experiences of local services and hear what they think about our future proposals and plans, to give them the opportunity to work with us to shape future health and care services.
Through getting out and about and meeting people across Croydon we are able to have in-depth conversations with local people who we might not usually speak to, people who do not feel their voice is heard or residents who face particular barriers which makes it more difficult to get involved in our work.
Some service re-designs require several visits to the same group so that they can be part of an iterative design process. Examples of two from 2019 are as follows:
Through 2018 and 2019 we have been meeting with mental health service users and community and voluntary sector organisations who support them in the community as part of our commitment to transform adult mental health services specifically with BAME communities as we identified that people from those groups were under represented in previous engagement . Our initial event in July 2018, working with the BME Forum and other relevant community groups asked people who we can improve and adapt our services in the community and how we could work to address the needs of diverse groups. We have met on five further occasions to update the group and changes showing how their insights have helped us to design plans which work best for people in Croydon.
Across south west London a large number of children self harm. Alongside the other five south west London boroughs we have been working with children, young people, parents, carers and teachers to identify how we can work together to prevent young people from self harming and, importantly, what a whole community approach can do to help support young people to access help at an earlier stage. We have met throughout the year with the same groups of young people as we develop these plans and promotional materials so that they can see how their views have made a difference.
The CCG holds open meetings called Patient and Public Involvement Forums which are held quarterly. The forums are an opportunity for the CCG to share its early thinking on commissioning areas and to hear the views of patients, stakeholders and members of the public. During these meetings we also feedback how we have responded to any views we have heard in previous meetings as well as providing updates on any proposed changes we have discussed in the past. At the end of the meeting, attendees are asked to complete an evaluation form about the meeting they have just attended as well as asking for ideas for future meetings which helps us shape future meetings.
During 2019, we held two joint forums with Croydon Health Services (CHS) to discuss both the alignment of Croydon CCG with CHS and the merger of the six south west London CCGs into a single CCG on 1 April 2020. At the second event we were able to demonstrate the impact of what we heard during the first event in our future plans.
We work with our local Patient Participation Groups who provide an important way for patients registered with a Croydon GP practice to engage with commissioners and vice versa. PPGs are crucial to ensuring that the views of local patients can work to influence as well as helping their own GP practices to shape and support the CCGs work.
The Patient Participation Network meets monthly and is attended by our engagement team to provide updates on the feedback they have given us as well as more to update on changes to Primary Care, including in 2019, the formation of Primary Care Networks and the merger of south west London CCGs into a single CCG.
South West London Health and Care Partnership People's Panel
A new way of engaging with people is our digital panel of 3,000 people across South West London (approximately 800 panel members are Croydon residents). The panel members take part in online surveys sharing their views and feeding back on plans, services and what matters most to them about health and care. In the future, they may be offered the opportunity to take part in a group discussion. Their views are then shared with decision makers to help shape developments for the future.
Panel members are recruited to reflect the make up of our local population and must be new to our engagement programmes. They are given regular feedback on the results of surveys and how theses re being used to influence developments.
Twitter is used by the engagement team to complement face to face engagement. Tweets cover a wide range of topics and include re-tweets of our partner organisations. We use twitter as one way to advertise our current events, to live tweet our events, to invite comments and to respond to queries and comments. We have invested significant time and resources into building up our Twitter profile and to use it to promote self care initiatives.
If you aren't able to come to one of our events, and would like to hear up to date news about our engagement opportunities or you have other feedback you wish to share with us, please follow us on @NHSCroydonCCG
This website also acts as a source of information and engagement for patients, the public and stakeholders including sharing feedback reports. We are always interested in your feedback and ideas for how we can make use of this space, so if you have any thoughts you would like to share, please contact us on Croydonemail@example.com
We are currently trialling a monthly – or more frequently if we have important news - e-newsletter which keeps our volunteers and stakeholders abreast of feedback we have received and how that has made a difference as well as the latest developments in patient and public engagement and opportunities to engage in Croydon, South West London and beyond. If you wish to receive this, please contact us on Croydonfirstname.lastname@example.org
How we work together in the CCG
NHS Croydon CCG recognises that engagement is everyone's business. As an organisation we are dedicated to planning and commissioning the best possible services for the people of Croydon. Key to this is ongoing effective communication with our patients, residents, the wider health and social care community, Healthwatch Croydon and other stakeholders.
We have built clear structures that support engagement throughout the commissioning process, from pre-planning to implementation and on-going review of services. This means that our engagement team have a close working relationship with all commissioners and teams and works in partnership, providing advice, support and access to our networks when planning engagement activity.
Engagement is part of the induction rotation for all new commissioning staff so that staff are briefed on both statutory duties and best practice for engagement. Staff are encouraged to attend informal training on engagement responsibilities and to share ideas on what has worked well in terms of engaging with people living in Croydon. Information from the NHSE/I Get Involved hub is cascaded to all staff who are encouraged to refer to the hub when planning engagement activities. During Spring 2020 we plan to host a lunchtime learning about engagement which will include a review of our activity during the year; our you said we did and reflect on what we have learned in the last year. We also plan to run a training session '10 steps to even better engagement' as part of the NHSE/ I roll out 'Train the Trainers'.
As part of our on-going improvement programme, the CCG has a formal process of assessing all our activities in terms of patient and public engagement, quality, equality and privacy using an established Joint Impact Assessment Panel (JIAP).
The purpose of JIAP is to:
- Provide a reliable and consistent approach for assessing current and future impact assessment submissions in relation to QUIPP CCG programmes, initiative or projects across Quality, Equality and Data Protection Impact Assessments in addition to ensuring Patient and Public engagement.
- Provide a consistent and formalised process for conducting reviews of all submitted impact assessment paperwork, relevant evidence and/or associated reporting.
- Provide a resource efficient and robust process that supports Croydon CCG's statutory, governance and quality commitments and
- Provide for a wide and inclusive participation platform for panel membership and assessment decision making.
In practice this means that JIAP brings together leads in these areas to explore how our transformation plans will impact on patients and carers and ensures that robust patient and stakeholder (our partners in health and care) engagement is undertaken by all commissioners across the organisation.
The Quality Committee is a sub committee of our Governing Body and has been established to oversee the application of quality in our commissioning. It looks at governance, patient safety, clinical effectiveness and patient experience. It is responsible for making sure that the CCG is compliant with the NHS Constitution and our duties to consult. The quality committee ensures that there are mechanisms in place for seeking feedback and that this feeds into the planning and delivery of health services.
How we work with partners
One of the ways we hope to achieve our vision of the best possible services for the people of Croydon is to work closely with our partners in health and care. One Croydon is a partnership including six alliance partners: Croydon Council, Croydon CCG, Croydon Health Services, South London and the Maudsley NHS Trust, Croydon GP Collaborative and Age UK Croydon. In addition our key partners Croydon Voluntary Action and Healthwatch Croydon work closely with us including being members of the Croydon Transformation Board. Some formal ways we work together to make sure we all engage appropriately are listed below:
Croydon Communications and Engagement Group
We have established a professionals Croydon Communication and Engagement Steering Group with representation from our health and care partners. The group supports the work of the Croydon Transformation Board and works in parallel to similar groups in each of the six boroughs in the South West London Health and Care Partnership. We are working together to develop consistent and best practice engagement within Croydon and to make sure that national and south west London plans are appropriate for local people. Working in this way means we can support each other's work as well as having a consistent approach to engaging with local people and evaluating our efforts.
The group is made up of heads of communications and engagement from Croydon CCG, South West London Health and Care Partnership, Croydon Council, Croydon Health Services, One Croydon and Healthwatch Croydon. It sits in One Croydon governance as a 'Responsible Enabler Group'.
The objectives relating to engagement are that we will use our limited time and resources to work smarter together and engage better with the local population; strengthen voices of local people, carers, professional staff and clinicians and our stakeholders and share insights so that we can iterate the work of key decision makers in Croydon.
To deliver this strategy the South West London Health and Care Partnership has offered a robust training package including using social media to engage with local people and consultation law for NHS services and local authorities.
Community Leadership Programme
The Community leadership programme is a collaboration between the CCG and Croydon Voluntary Action and supports the recruitment, training and on-going development of a wide and diverse group of patient representatives to support the CCG's commitment to improving representation within our decision making committees and governance. The voluntary sector representatives have been co-opted onto the Autism Partnership Board and the Proactive and Preventative Care Engagement Group. We have finalised roles for the Croydon Safeguarding Board (including three subgroups: neglect, missing children and safeguarding children with disabilities priority group).
Members of the engagement team met with a group of the representatives in December 2019 to discuss the south west London CCG merger, review the proposed structures and gain feedback on how we can ensure that Croydon representatives retain a strong voice within the merged southwest London CCG.
In December 2019, we held an inaugural engagement summit bringing together engagement professionals from statutory health and care organisations, including NHS partners (the CCG, CHS, SLaM), the council and representatives from One Croydon PMO to discuss our respective statutory duties and to map our existing engagement groups. We plan to repeat this and to involve our partners in the community and voluntary sector, including Healthwatch Croydon throughout 2020 to support development of shared monitoring, evaluation and assurance processes.
South West London Health and Care Partnership
While locally based, the engagement team in Croydon CCG have been working since April 2018 in a matrix way with the South West London Health and Care Partnership meaning that they benefit from the support of a wider team of communication and engagement specialists. The South West London Patient and Public Engagement Network is made up of Engagement staff from all six borough and meets on a monthly basis to discuss and review shared engagement work, progress professional development and offer peer support around challenging issues.
We have agreed a common approach for evaluating specific PPE activity Finishing properly – evaluating engagement.
Patient and Public Internal Review
In spring 2018 the CCG began a process of internally reviewing its engagement function. The process includes our One Croydon stakeholders and is discussed at the local Croydon Communication and Engagement group as part of the assurance process.
We use the NHS England and Improvement IAF framework to check that our engagement and involvement function is following positive practice. Using the IAF framework also allows us to map our year on year improvement.
This year the review focussed on NHS England's assessment domains highlighted to the CCG that domain D, Feedback and Evaluation, was an area which required improvement following the 2018-19 assessment.
The review focused on discussing with partners, patient and public representatives, Healthwatch Croydon and stakeholders how to best ensure that the CCG seeks patients' and publics' views on our approach to engagement and involvement.
The audit also focused on training and support for patient and public voice partners and commissioners, as a previous internal review indicated that, while the CCG was assessed as good in this area we wanted to do more.
You can read more about how we work together, including peer review of our work, here.
The Patient and Public Engagement Steering Group (PPESG) brings together engagement professionals across south west London to ensure there is effective lay involvement and patient and public engagement across the health and care partnership. Membership consists of PPE lay representatives from the six CCGs; Healthwatch representatives from the six south west London boroughs and community and voluntary sector representatives from the six boroughs.
The main purpose is to oversee PPE and act as a strategic adviser to the programme board and communications and engagement team, to provide two way communication between the programme and key stakeholders and community representatives, ensuring that all parties are kept up to date with developments; to provide representatives to sit on all relevant governance structures such as the Programme Board and the Clinical Board and to advise on targeted engagement activities with diverse groups and the priorities of the various workstreams.
PPESG has been instrumental in reviewing and advising the partnership in how to embed patient voice in the soon to be formed SWL CCG governing body and in developing an agreed set of underlying principles for engagement moving forward.
Future ways of working
One Croydon whole population approach
The One Croydon Service User Experience Group (over 65s) continues to ensure that engagement activity influences the development of new models of care. We are in the process of developing a structure to include more people who are representative of Croydon's diverse communities to support this piece of work as we expand it across all ages.
Croydon Engagement Steering Group (name to be decided)
It is anticipated that we will formalise the work from our engagement summit and form an engagement steering group with representatives from all health and care organisations in Croydon. We are in the process of designing this with our partners.
As we develop plans for the year 2020/2021, we are in the process of working with partners to use the EDS2 framework to assess our engagement work to date to help us to identify any potential gaps in engaging with those with protected characteristics.
As part of our commitment to continuous improvement we will focus on assessing the CCGs current engagement reach using the EDS 2 system in order to identify improvements and future actions. To do this we will review and assess the CCGs engagement work between 2017-12019 against Croydon's equalities profile, using the EDS2 Framework. The aim is to identify populations where we have an adequate reach as well as identifying populations and equalities groups where we need to improve our reach.
Once this stage is completed we will work with relevant local CVS organisations to find ways to improve our engagement reach into identified communities and populations.
The review and assessment stage will be undertaken by a review panel, made up from representatives of CVS groups working with communities from protected characteristics to identify where there were gaps. The second stage will then be for local groups or individuals representing these communities to co-design methods, structures and models to enable us to be more inclusive and improve reach. We will use the outcomes of this review to shape our plans and to determine our areas of focus for the coming year.
NHS South West London CCG
As we move to a single CCG on 1 April 2020, patient and public engagement will remain based in local place (borough) based teams. In Croydon this means that we will continue our work with One Croydon, the alignment with CHS and we will continue to work with community groups across Croydon's diverse population. In addition, we will work with our colleagues across the other five south west London boroughs and NHS SWL CCG has drafted the following objectives to:
- Involve patient and public voices in our governance
- Explain and demonstrate public involvement in commissioning plans
- Promote and publicise opportunities for local people and patients to participate
- Ensure local communities shape services and decision-making
- Establish a two-way dialogue with communities - feeding back and evaluating
- Review and assure our engagement activity
- Advance equality and reduce health inequalities
- Provide support for effective engagement
- Work with providers to support patient and the public involvement in the services we commission
- Evaluate the impact of our work
We welcome feedback on these objectives, should you have any thoughts on these or on anything you have read on this page, please email Croydon-GetInvolved@swlondon.nhs.uk