Self-assessment report September 2024
Argyll and Bute Council · 25 September 2024
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 25 September 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 ARGYLL AND BUTE HEALTH & SOCIAL CARE PARTNERSHIP Self-Evaluation of Engagement and Planning with People SUMMARY This report outlines a self-evaluation process undertaken by the Health and Social Care Partnership (HSCP) in the summer of 2024 to review our engagement strategy and processes. This process was in-line with Healthcare Improvement Scotland’s Quality Standards for engagementi. The value of working effectively with everyone with an interest in health and social care is recognised by the HSCP. A number of methods have been utilised to identify areas where engagement approaches can be improved. An iterative improvement plan for engagement has been prepared with oversight provided by the Strategic Engagement Oversight Group and engagement colleagues at Healthcare Improvement Scotland.
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2 BACKGROUND The Scottish Government published guidance in March 2020 for health and social care providers to effectively engage with anyone with an interest in service delivery, for example staff, partners, people who use services, unpaid carers etc. This is titled Planning with People and has since been updated in April 2023 and again in May 2024ii. The HSCP published an Engagement Framework in September 2023 which is available to view, along with supporting guidance on the NHS Highland website here - Public engagement | NHS Highland (scot.nhs.uk) Engagement approaches in Argyll and Bute are overseen by the Strategic Engagement Reference Group. Members are listed in Appendix 1. This is led by the Associate Director of Public Health with membership from the Third Sector Interface (TSI), Integration Joint Board (IJB), Healthcare Improvement Scotland (HIS) and community representatives. This group is accountable to the HSCP’s Strategic Planning Group. The 2023 edition of Planning with People included a self-evaluation process for organisations to benchmark their engagement approaches and implement a continuous improvement approach. The IJB endorsed the decision to initiate the self-evaluation process in Argyll and Bute and this took place in spring 2024. Self-evaluation is iterative and there will be ongoing improvement activity in the coming months and years. METHODS The Strategic Engagement Reference Group oversaw an action plan for the self-evaluation, this included identifying the priorities to focus on and approving a longer term action plan to improve engagement approaches in Argyll and Bute. The Planning with People quality standards are comprehensive with three distinct domains for self-evaluation. These are: Domain 1: Ongoing engagement and involvement of people (15 questions) • The organisation undertakes ongoing engagement with people and communities to ensure that services meet their needs, identify sustainable service improvements and to develop trust. • The approach to engagement is inclusive, meaningful and is evaluated to identify learning and the impacts.
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3 Domain 2: Involvement of people in service planning, strategy and design (13 questions) • The involvement of people and communities has had a positive impact on service change and strategy development and has been planned as part of the organisation’s wider engagement strategy. • People representing communities have been involved throughout the development, planning and decision- making process for service change and strategy development. Domain 3: Governance and leadership - supporting community engagement and participation. (12 questions) • Robust corporate governance arrangements are followed for involving people; founded on mutuality, transparency, equality, diversity and human rights principles. • To engage effectively and inform decision-making, the organisation supports and improves the participation of people by dedicating resources (both in people, time and budget). HIS provided advice and guidance to break these domains down into separate segments and it was decided to focus on Domain 2 during 2024. A range of methods were utilised to review domain 2, as follows: Description Date Notes Engagement and expert advice from HIS Engage Team April – May 2024 Ongoing via Strategic Engagement Reference Group Education session with HIS attended by Strategic Engagement Reference Group and recorded session shared widely via Team May 2024 Approximately 8 attendees at the live session with recorded session shared widely Online questionnaire for Domain 2 with questions on the 13 sections May 2024 13 responses received Face to face session to explore the findings May 2024 Eight in attendance Sense checking recommendations with Strategic Engagement Reference Group September 2024 Iterative and ongoing Sign off engagement improvement plan by Strategic Planning Group Winter 2024
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4 FINDINGS Online Survey A survey was conducted using MS Forms with the 13 questions from Domain 2. This survey was shared with a defined group including: Locality Planning Groups members, Integration Joint Board members and the Health and Social Care Partnership leadership team. A total of 13 responses were received. Figure 1: Breakdown of responses by setting Figure 2: Breakdown of responses by area Table 1: Rating of the 13 sub-domains by respondents Domain Rating Comments 2.1 The people and groups who are affected by the focus of the engagement have been meaningfully involved in planning and designing the engagement process to ensure it is inclusive and timely Majority rated this as SOMETIMES (n = 9 of 13) Sometimes seems an accurate rating as some engagement activity does meet this standard 2.2 The organisation has meaningfully involved people and communities throughout the development, planning and decision-making process for service change and strategic planning Majority rated this as SOMETIMES (n = 7 of 13) Sometimes seems an accurate rating as some engagement activity does meet this standard
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5 2.3 The people and communities who may be affected by a proposed change to a service or strategy, have been involved in developing and appraising options that are robust, evidence-based and person-centred Less than half rated this as SOMETIMES (n = 6 of 13) Sometimes seems an accurate rating as some engagement activity does meet this standard but this is an area for improvement 2.4 Are you confident that the organisation, Board members, and senior leaders can show how they have taken account of the views of people and communities when making decisions on policy and services by fully explaining the reasons for decisions? Less than half were fairly confident with the remainder less than fairly confident (n = 13) Action is required in this area 2.5 The organisation has worked together with other organisations to share expertise and structures to support community engagement on service change and strategy 6 responses said sometimes however 5 didn’t know (n = 13) There is potential to do more in this area 2.6 The organisation has taken a co-design approach to developing plans and documents for engagement on the review of services and strategies, by involving people and communities from the start of any process through to decision-making 6 agreed with this statement but the remainder disagreed or were unsure with one person strongly disagreeing (n = 13) There is potential to do more in this area 2.7 The organisation provides support to people and communities to enable people to get involved in and inform the decision-making process that affects their lives and their communities Split between agree disagree and unsure (n = 13) There is potential to do more in this area 2.8 How confident are you that the organisation’s engagement processes are accessible, inclusive and reflect the diversity of communities, and are informed by Equality Impact Assessment? 5 were fairly confident with the remainder disagreed or were unsure with one person strongly disagreeing (n = 13) There are some areas of good practice but there is potential to do more in this area 2.9 The people and communities who may be affected by the proposed service development, change or policy have been provided with relevant and accessible information, using appropriate communication methods that meet their identified support needs 6 replied sometimes and 4 didn’t know (n = 13) There are some areas of good practice in this area
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6 2.10 The organisation has undertaken an Equality Impact Assessments of how the policy or service design proposals may affect different communities, taking into consideration equality, human rights, and used this to inform the engagement process 6 didn’t know but 4 replied almost always (n = 13) It is a statutory requirement to conduct Equality Impact Assessments and there are assurance processes around this 2.11 The organisation has proactively sought participation from seldom heard, under- represented people and communities, and supported people and communities to take part in service redesign and strategy development (with reference to protected characteristics, UNCRC and Fairer Scotland) The majority didn’t know (n = 8 of 13) There is potential to do more in this area 2.12 The organisation ensures ongoing evaluation is part of the engagement process and feedback is acted on during the engagement process. 5 didn’t know with the remainder split (n = 13) The HSCP Engagement Framework outlines a feedback loop i.e You Said: We Did/Will Do 2.13 The organisation has evaluated the effectiveness of its engagement in service redesign and strategic planning and shared the learning across the organisation to inform future practice 6 didn’t know with the remainder split (n = 13) This has not been done in the HSCP Face to Face Session On 16 May 2024 a face to face event took place in Inveraray to explore the findings of the on- line survey. This session was facilitated by Alison McCrossan of the Engage Team at HIS. The invite was shared with the same people who had received the survey. A total of seven people attended the event including an IJB representative, a community representative, three members of the HSCP leadership team, a TSI representative and an NHS Highland communications representative. •
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7 The format of the session involved: • Ranking the 13 questions in the on-line survey above in order of importance. During this exercise, the participants found the 13 questions very wordy and in many cases repetitive. • Carrying out an in-depth review of the top three ranking questions with a view to informing areas for improvement The following table outlines the three priorities and initial recommendations for improvement: Domain Area Improvements The organisation has meaningfully involved people and communities throughout the development, planning and decision-making process for service change and strategic planning Theme – locus of decision making • Clarity around how decisions are made and communicated • Engagement needs to take place in stages eg before and during decision making process Theme – how to make engagement meaningful • Real challenges around the constraints on service providers so consider how honesty and transparency can improve understanding The people and communities who may be affected by a proposed change to a service or strategy, have been involved in developing and appraising options that are robust, evidence-based and person- centred Theme – what has worked before/learn where things could be better • Honesty where we haven’t done as well as we would have liked • Showcase good examples eg Cowal GP relocation • Accept proportionality, eg some engagement will be more in-depth than others • Reiterate important of feedback loop to people who have given views – you said/we did Theme – better co-production • More training and skills development for how to work in a co-productive way with communities • Involve community members and other stakeholders in training Theme – rationale for options/evidence/nothing is a bad idea • Use of evidence and how we gather this – qualitative and quantitative • Start with a blank sheet of paper when developing options • Communities/other stakeholders often have different but insightful ideas • Meaningful engagement on preferred options and clarity about why some options may not be possible • Explain options clearly The people and communities who may be affected Theme – our capacity to have meaningful conversations
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8 by the proposed service development, change or policy have been provided with relevant and accessible information, using appropriate communication methods that meet their identified support needs • Consider who has a key role in community engagement and optimise opportunities and synergies eg core services like health improvement team, community development in the council, Third Sector Interface etc. and other services like link workers • Bring in a local focus eg local people know their communities better than central functions • Incorporate engagement more in our day to day service delivery eg opportunity for informal service feedback where services are delivered Theme – focus on what is in our control and what is outwith • National Care Service is not within our control Theme – improvement of engagement materials and methods • Invest time in creating clear key messages for the issue for engagement and supporting resources The organisation has proactively sought participation from seldom heard, under-represented people and communities, and supported people and communities to take part in service redesign and strategy development (with reference to protected characteristics, UNCRC and Fairer Scotland) Theme – Ongoing conversations where people are coming together anyway • More conversations and fewer one-off events. Informal events are preferable to formal one off events • Better use of people who are having conversations in the course of delivering health and social care eg addiction and homelessness services • Same as above with partners eg foodbanks • Same as above with service user groups eg carers and people with mental health problems • Following the above theme, there are gaps in some setting eg young people and disability access forum Theme – Innovate and better ways of carrying out engagement • Go to where people are rather than expect them to come to us • Investing in the planning stage means that engagement activity will generate more meaningful feedback • Informal rather than formal • Engagement materials need to be understandable eg plain English and in different formats eg films or social media posts • People carrying out engagement need to be skilled but also down to earth and approachable NEXT STEPS Improvement Plan Objective Actions Skills development • Ongoing promotion of engagement tools on HIS website • Rerun of skills workshops from 2023 on options appraisals and Major Service Change
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9 • Widen training invite to all stakeholders including community members • Showcase examples of best practice to further support engagement delivery Improved opportunities for engagement • Recognise and promote the benefits of doing engagement where people are meeting rather than invite people to come to HSCP events • Align with ongoing review of HSCP’s Locality Planning Groups • Align with ongoing review of other Argyll and Bute area structures such as Area Committees and Are Community Planning Groups • Investigate the opportunities for developing a community reference group, for example, align with existing work in this area by the Poverty Alliance Improved engagement activity planning to join up engagement and equality impacts • Develop a checklist for managers leading engagement and add to the Engagement Specification Tool i.e Have you checked equity outcomes? How will people access services after the change? How will problems be prevented or reduced after the change? Where does decision making and accountability sit? etc. Better links between engagement planning and communications approaches • Align with the annual Communications Plan and Key Messages activity that is in development for the HSCP • Develop communications messaging that goes beyond the annual planning cycle Clearly articulated engagement support • Identify what the HSCP currently offers, where there are gaps and options for how these gaps might be filled • Consider options for having a dedicated engagement officer Engagement planning includes methods for all with particular reference to “seldom heard voices” • Better links with community groups and third sector partners • Awareness raising of the importance of this with staff and managers eg via Turas equality modules HSCP approach in line with Planning with People • Update HSCP Engagement Framework following publication of May 2024 PWP • Review next steps with domains 1 and 3 of the self-evaluation framework Clarity about what will happen and when • Develop a timeline and detailed action plan for 2025 CONCLUSIONS The HSCP recognises the importance of working effectively with our stakeholders and that information gathered via engagement adds value to how we delivery our services. The self- assessment process has been a very valuable exercise to undertake. There are areas of good
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10 practice where engagement has been undertaken well and there are areas where improvements will enable more consistency in our approach. The improvement plan will be implemented by officers of the HSCP over the next 12 months and this will be overseen by the Strategic Engagement Reference Group with further oversight from HIS.
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11 Appendix 1: Strategic Engagement Reference Group Alison McGrory and Charlotte Craig, Argyll and Bute HSCP Takki Suliaman, TSI Kenny Matheson, IJB representative Emma Churchill and Alison McCrossan, HIS Barabel Mackay, Community representative Ruth Fry and Marie McIlwraith, Communications and Engagement at NHS Highland i Quality Framework for Community Engagement and Participation | HIS Engage ii Health and social care - Planning with People: community engagement and participation guidance - updated 2024 - gov.scot (www.gov.scot)