Engagement, Experience and Communications Strategy

Engagement, Experience and Communications Strategy 2012 – 2015 CONTENTS

SECTION PAGE/S

1 Introduction 3 2 Vision and Values 3 3 Our Approach to Engagement, Experience and 4 – 6 Communication 4 Engagement, Experience and Communication 6 – 8 Objectives 5 Tools and Tactics 9 5.1 Active involvement 9 – 10 5.2 External Communications 10 – 12 5.3 Internal Communications 12 – 13 5.4 Media Relations 5.5 Crisis Communications 14 – 15 5.6 Horizon scanning 15 5.7 Brand Management 15 15 - 16 6 Stakeholder Analysis 17 7 Risk Assessment 18 7.1 SWOT Analysis 18 7.2 Risks 19

Appendix A Delivery Plan 20 - 26 A1 - Action Plan A2 - Roles and Responsibilities A3 - Budget and Resources A4 - Evaluation and Monitoring Appendix B Media Protocol 27 - 34 Appendix C Key Messages 35 - 37

2 1. Introduction The 2010 NHS White Paper ‘Liberating the NHS’ signalled a significant change for the NHS, and placed a clear focus on moving to a system built around clinical leadership. This new system would see the development of Clinical Commissioning Groups, taking over the leadership and commissioning role from PCTs.

“No Decision about me without me” is a clear statement right at the very heart of the White Paper and Warrington Clinical Commissioning Group (CCG) is committed to making this a reality.

Representing each of the towns 28 GP Practices, the CCG is built around well established clinical leadership, effective partnership arrangements and has strong foundations in terms of patient and public engagement.

The CCG has already developed close working relationships, and joint commissioning arrangements with the Local Authority and is a key member of the Shadow Health and Wellbeing Board, in addition to playing an active part in a range of other strategic partnership boards.

As a first wave pathfinder, the CCG took the lead responsibility for commissioning the majority of health care services for the people of Warrington with effect from 1 April 2011. It has an established governance structure and board, which includes membership from each of the town’s four federations and is a formal sub committee of the Cheshire, Warrington and Wirral Cluster Board, who remain the statutory accountable body until April 2013.

In April 2012 Warrington Clinical Commissioning Group will enter the final phase of development before becoming, subject to authorisation, the new statutory body responsible for the local health budget. Progress to date has been excellent and the CCG has already established itself as the lead with provider and partner organisations.

2. Our Vision and Values

Warrington Clinical Commissioning Group has described its Vision as “Excellence for Warrington” and have committed to;  work in partnership to develop the best health services for people in Warrington  contribute to a healthier Warrington for all  focus on our Patients  work in partnership with the local population  recognise external constraints whilst striving for quality

This vision is underpinned by seven key values, these being;  Excellence  Valuing patients and partners  Accountability  Partnership in everything  Honesty and integrity  Openness and transparency  Courage. 3 3. Our Approach to Engagement, Experience and Communication

The NHS Constitution signalled a move away from targets and central direction towards a system of rights and responsibilities relating to the quality of care, “the NHS aspires to the highest standards of excellence and professionalism in the provision of high-quality care that is safe, effective and focussed on the patient experience” (para 3, p3). This now gives patients legal rights to certain aspects of their care.

The 2010 NHS White Paper reinforced the rights of the constitution and the need for NHS commissioners and providers to ensure that services are built and provided around personalised patient care.

The NHS Constitution also states that one of the seven key principles that guide the NHS is that it works across boundaries and in partnership with other organisations.

Warrington Clinical Commissioning Group has made a firm commitment to not only fulfil the requirements of the NHS Constitution and the 2010 NHS White Paper, but to really embrace the principles and make ‘no decision about me without me’ a reality for the people of Warrington.

We already have established relationships with a range of groups, which feed into the organisation, however, we are aware that many of the current groups with which we engage with are ‘activity specific’ such as the Older Peoples Forum and Warrington Disability Partnership. We fully recognise the importance of these relationships and the value they bring to the organisation and we are committed to continuing to build on these relationships, at the same time as seeking to widen our span of engagement.

Patient Participation Groups (Patient Participation Groups) are one of many ways in which we can increase our engagement with patients and offer a greater opportunity to maximise our contact with patients and carers.

We are already working to develop Patient Participation Groups in every practice and intend to establish a Warrington Health Forum, with representation from each Patient Participation Group, in addition to Links and others. Similarly, there are great opportunities in further developing our relationships with the voluntary sector, charitable sector, local faith groups and other community fora.

We will continue to further develop our existing mechanisms of engaging with patients and the public and have already launched a membership scheme, which although in its early stages, will go some way to support our engagement activity and provide a mechanism for wider involvement. Recognising that other key providers also have membership schemes we will seek to work co-operatively with them in our engagement processes to avoid confusion for the patients and public of Warrington.

As commissioners we want to ensure that patients feel that they are included in their care and we know that our providers are committed to providing excellent quality services and have made strategic commitments to improve the quality of their services and we share an understanding that this means improving patients’ experiences of their services. 4 The CCG is committed to improving patient experience and fully recognise the importance of patient experience data. The proactive capture, analysis, triangulation and interpretation of information about the experience of patients and carers will be used to inform all planning and commissioning decisions. We have an established patient experience programme (SEE – Safety Effectiveness and Experience), which is widely publicised and provides a means for people to provide their patient experience feedback through a variety of channels. Through this programme we actively seek patient stories, and the Governing Body prior to each Meeting hear first- hand, from a patient their story.

We also have an established Patient Experience and Quality Group, which reports into the Quality Committee, which is a sub committee of the CCG Board.

This groups reviews patient experience data on a system wide basis, agrees on actions to improve patient experience and steers the development of quality improvement across the health economy. It is our intention to extend our capabilities around the collection of patient experience feedback, to ensure that the data being reviewed at the Patient Experience and Quality Group is well rounded and from a diverse range of clinical areas.

In terms of communication, it is recognised that engagement and communications are intrinsically linked, and that effective communication is a key enabler to support optimum engagement and involvement.

Warrington Clinical Commissioning Group is committed to a culture of openness, transparency and honesty, and effective communication will be a key enabler in facilitating this.

We will ensure that our communication mechanisms are fit for purpose. We will continually look to improve our ability to communicate effectively, we will capitalise on our opportunities and will work with our partners and providers to utilise already established routes.

We also recognise the importance of the media and we will continue to develop our media relationships, taking a proactive approach to dealing with the media and will, when necessary defend the organisation and challenge mis reporting.

We will also enhance our capabilities in terms of the use of social media, will invest in new technologies, which will further enhance our capabilities in terms of effective engagement and communication and will strive to put in place as many mechanisms as possible to actively seek the views and experiences of local people.

The 2011/ 12 Warrington Health Consortium Communication Plan set the foundations for how the CCG would develop in terms of engagement and communication and this strategy builds upon what the 2011/12 plan delivered.

This strategy also takes into consideration and reflects the principles of the NHS constitution and the CCG’s statutory obligations around Section 242 – Duty To Involve in the work of Warrington Clinical Commissioning Group.

5 We have developed clear achievable engagement and communication objectives, as detailed below, which will be supported by the required resources in terms of tools and time.

This strategy provides the framework for developing the engagement and communication activities during the transition period and beyond. The detailed delivery plan in Appendix A describes how the strategy will be implemented, including roles and responsibilities, a detailed action plan, and evaluation process.

The successful implementation of this strategy will ensure that the CCG progresses through the authorisation process successfully and becomes a leading clinical commissioning group. 4. Engagement, Experience and Communication Objectives

The strategy is built around four key objectives, with clear aims and identified desired outcomes, as detailed below; Objective One

To continue to build continuous and meaningful engagement with our public, patients and carers to influence the shaping of services and improve the health and wellbeing of people in Warrington.

This will be achieved by:

 Ensuring the public voice influences and is directly involved in the decisions made by Warrington Clinical Commissioning Group  Actively seeking out patient experience data from a range of sources.  Ensuring that patient experience data is systematically collected and embedded into work programmes.  Using the most appropriate means of communications for the requirements of the audience  Using a wide variety of methods and innovative approaches to engagement  Working closely with hard to reach groups to ensure they have a voice  Using patient experience data and information to inform our work and to work with provider organisations to listen to patients more and act on their feedback  'Closing the loop' by reporting on the impact of public feedback on Warrington Clinical Commissioning Group decisions  Learning from good practice and tried and tested examples of engagement

Outcomes of this objective:

People in Warrington feel they have a voice in the decisions made by the CCG and will be able to identify how they have influenced local NHS services. There will be improved patient experience and a reduction in complaints and negative media attention.

6 Objective Two

Increase confidence, with patients, public, provider and partner organisations in Warrington Clinical Commissioning Group as an effective and responsive commissioning organisation

 Protecting the reputation and promoting the Warrington Clinical Commissioning Group and NHS brand  Developing good media relations and addressing any inaccuracies to prevent misunderstanding and confusion  Ensuring internal and external audiences are aware of CCG and locality developments as well as issues facing the Warrington Clinical Commissioning Group  Providing consistent and timely messages internally and externally to various audiences  Working collaboratively with partners and other NHS organisations in and around Warrington

Outcomes of this objective:

Stakeholders are confident that the Warrington Clinical Commissioning Group is successfully taking over as the lead, with responsibility for commissioning healthcare services and is operating in the best interests of the people of Warrington.

Objective Three

Develop and maintain effective communication channels to ensure that the people of Warrington have the information they need to enable them to access the right care at the right time, helping them to look after themselves and improve their health and wellbeing.

 Working with member practices, providers and partners to ensure that public information is accurate and up to date.  Working collaboratively with providers and partners to ensure that messages are consistent and timely.  Working closely with our community groups, including hard to reach groups to ensure that messages and information are being received and are understood.  Continuously scoping new and innovative ways of communicating, making best use of new technologies and digital communication.  Regularly testing out the effectiveness of communications  Making language meaningful for staff, public and patients in all communications

7 The outcomes of this objective will be:

The people of Warrington will be well informed and will have a good understanding of services and what is available to them. People will have the information they need to help them to improve their own health and well being. Reduction in inappropriate use of services, reduction in Did Not Attends (DNAs) and increased use of self-care.

Objective Four

Develop a culture within Warrington Clinical Commissioning Group that promotes open engagement and communication within and outside the organisation.

 Developing and maintaining good media relations  Developing internal two-way communications channels with member practices, staff and federations.  Ensuring internal and external audiences are aware of services developments and successes  Ensuring internal and external audiences are able to feedback information on successes and achievements through accessible routes  Making language meaningful for member practices, staff, public and patients in all communications

The outcomes of this objective will be:

The CCG will have the support they need to ensure effective relations with the media and clinicians will understand their role and what is expected of them in terms of engagement and communication.

CCG member practices and staff feel they can express their opinions and judgment and they feel their contribution is valued. The public will feel valued and informed and will be aware of how they can feedback to the CCG.

In order to achieve our objectives, a detailed ‘rolling’ action plan has been developed, as detailed in the Delivery Plan in Appendix A . This action plan details the planned engagement and communication activities that will be undertaken to deliver on the objectives.

It should be noted that this is working document as it is recognised that we are working in a dynamic environment which is continually changing, therefore the action plan will change and flex to meet potential changes.

8 5. Tools and Tactics

Warrington Clinical Commissioning Group will utilise a mixture of approaches, as detailed below to actively seek out the views of our local population and we will ensure that our methods are evidence based and work for our intended audiences.

We will ensure that we have the right systems and communication methods in place to ensure timely, relevant communications with each of our internal and external stakeholder groups. This will require a number of different approaches, including:

 Events, including partnership engagement events, national events.  Focus groups  Community forums  Meetings (internal and external)  Workshops strategies, plans, reports and other formal publications  Written communications  Face-to-face, interpersonal communications  Meeting papers and minutes  Newsletters  Briefings  Website / intranet  Online Social Media  Press releases  Paid media and advertising campaigns  Digital Media

Warrington Clinical Commissioning Group also recognises the benefits of information technology and will strive to use electronic communications, where appropriate.

Warrington CCG will also fulfil its statutory obligations to provide information in differing formats on request (e.g. large print, other languages, Braille or audio).

5.2 Active involvement

We will proactively seek and will continue to build meaningful engagement with all our stakeholders, including patient and the public and will ensure that relationships are managed and maintained during the transition process and beyond.

We will establish a new Warrington Health Forum, with representation from each of the practice Patient Participation Groups, in addition to other members and we will actively seek the views and support of this group in all our engagement activity.

We will not only ensure that we comply with our statutory obligations under Section 242 – Duty to Involve but will proactively seek involvement and engagement, through both formal and informal routes.

We will utilise our Patient Participation Groups, Health Forum and membership scheme to collect feedback on a qualitative and quantitative basis and will expand on the traditional

9 paper based methods, utilising new technologies to collect real time patient experience data.

Working with our providers, we will embrace the opportunities which technology and social media bring and will actively collect first hand, real time patient experience feedback , for example, we will utilise vox pops as a means to ask patients about their experience, rather than relay on a set of written questions and answers. It is our ambition that wherever possible, we will be able to hear, directly from patients, in their own words what their experience was.

We will further develop our SEE patient experience programme and will continue to work with the many groups and forums to actively seek feedback.

We will also ensure that we continue to utilise and respond to feedback via PALs and complaints and will utilise this data, along with all our other patient experience date to drive and inform our commissioning decisions.

5.2 External Communications

Patients and the Public

General communication with the public will be facilitated via the media, public events and the attendance at the various networks and meetings. We will utilise written, face to face and e-communications and will always ensure that the mechanisms fits the requirements of the audience.

In order to ensure clarity of message around what the transition means to the public we have developed a suite of key messages, which will ensure consistency of message throughout all our communication and will ensure clarity on what the reforms mean to patients and the public.

We have already introduced a monthly newsletter which is issued to our members, which will be used to provide members with updates and information and as a means to encourage feedback.

We will utilise the annual general meeting as a means to promote the CCG and encourage engagement in the business of the CCG.

We will work collaboratively with partners and providers to have a presence at a range of events and forums.

We will utilise the existing communication mechanisms with in our partner and provider organisations, for example the Local Authority Wire Magazine and will, where appropriate work collaboratively with provider organisations to utilise their mechanisms in relation to their members.

Partners and Providers

We will continue to utilise existing meetings and forums to communicate with our partners and providers. To provide key updates and ensure consistency with messages and information relating to the CCG’s business, we will develop and implement a high level

10 “spotlight” brief, which will be issued each quarter to all external stakeholders in addition to being published on our website.

Publications and literature

We will only produce new printed collateral when absolutely necessary and will utilise existing mechanisms within health, Local Authority, provider and community publications to communicate key information.

We will, where possible, only produce documents and publications in electronic format.

When there is a need to produce information in relation to work streams, this is likely to be low volume and will be produced locally where possible.

Web Site and Digital Media – Look Local

Increasingly, people use the Internet to seek information about an organisation, where to obtain help and advice and how to access services. Equally, websites are being used more and more as the means for people providing feedback.

We acknowledge the power of web based communications and how we can use the website to help to facilitate involvement in addition to being a means of collecting patient experience data.

The CCG has an established high quality, easy to navigate website, we will ensure that as new technologies and capabilities are identified the website if further developed. We will also ensure that the website is regularly maintained and quarterly full reviews will be undertaken.

We will continue to develop the website in conjunction with staff and other key stakeholders as appropriate. Key messages and information, news and media releases and important publications such as the statutory annual report and duty to involve report will all be published on our web site.

We will ensure that the website is accessible to all and that we continually review and test out the functionality to ensure it meets the needs of the public.

E-communications

We will develop and maintain our electronic communication mechanisms - managing web content and providing content for use on partner and provider sites. We will further develop our capabilities around social media, developing the established Face book and Twitter sites.

We will, where possible communicate via visual form, replacing hard copy products with video media.

Events

11 We will plan and deliver public events, where required in line with our statutory obligation in terms of public consultation. We will also utilise existing planned events, including events hosted by our partners and providers to communicate key messages and to take advantage of any Public Relations opportunities.

Members of Parliament

Political support for the CCG is important in raising and maintaining the CCG’s profile and creating awareness. MPs will be regularly briefed on successes and issues within their local constituency.

Face to face meetings with the CCG Accountable Officer and Chair will ensure that relationships with our MPs are maintained and that they are provided with information first hand. We will also ensure that ad hoc briefings are prepared in relation to emerging issues to ensure political support and minimise the risk of MPs being misinformed.

We will also continue to ensure that we respond quickly and effectively to requests from the Ministerial Briefing Unit in relation to parliamentary questions etc and will continue to monitor activity around local issues, Parliamentary Questions and responses. This information will be shared with board members within the weekly communication update.

Shouting about what we do

We will ensure effective marketing and communication of successes, demonstrating and highlighting improvements in health outcomes as a result of commissioning activity.

5.3 Internal Communications

CCG Member practices

We will continue to utilise the weekly Commissioning Brief to communicate to member practices, GPs and practice staff and will look to further develop this and to continue to encourage two way communication and feedback.

We will support the facilitation of events and where required will co-ordinate briefing sessions with federation members on behalf of federation leads and the CCG board.

We will further develop the ‘protected’ internal facing area within the CCG website to provide a means to share information with federations and members and to enable federations and members to share information between themselves.

CCG Staff

Our staff and our member practices are our ambassadors and are well placed to promote the work that we do. It is essential that they are kept well informed and up-to-date on developments and initiatives, and are able to contribute to decision making.

12 To be fully effective and achieve the highest success, communications throughout the organisation should be bottom up as well as top down approach. All our staff have a responsibility to promote communications and play their part in this process.

Managers will be encouraged to lead by example to ensure individuals are empowered to improve the way they communicate and share information with others.

The Communications Team will ensure that all communication supports a culture of open, honest and effective two-way communications.

We will continue to develop our internal communication channels and will ensure that all internal communication channels have effective feedback mechanisms. We will ensure that staff receive timely updates and, will strive to ensure that staff receive important information first hand via face to face briefings and that they are informed of any issues before they are reported in the press.

We will utilise the intranet to share key messages from the Accountable Officer, Chair and other board members.

We will reintroduce the weekly face to face briefing, encouraging the senior management team to take an active part in sharing information and news. We will also utilise this to encourage staff feedback and as a means to rebut rumours. This weekly briefing will be open to staff who will be employed within the Community Support Service but have identified roles in supporting the CCG.

We will also ensure that face briefings are arranged to engage staff directly around plans that affect them directly.

We will utilise the global email system to share information with staff which is time critical which is critical and will publish a weekly update directly after the weekly face to face briefing to reinforce what has been briefed and to ensure that those staff not in attendance are made aware.

All communications will encourage feedback on an ongoing basis from our staff and members to ensure they remain effective.

Board Members

It is crucial that the CCG board members are kept up-to-date of key developments, media coverage and issues. The Communications Team will provide CCG Board members with a weekly communications update, which will include all media activity, political issues (Parliamentary Questions etc) and a high level brief on any emerging issues which may impact on the reputation of the CCG (Serious Untoward Incidents etc).

Intranet site

We have developed a new intranet site, which allows the CCG to share information with staff and federation members and will enable staff to access information including policies and protocols. The intranet will be used as a platform to support a common corporate culture, as every user will have access to the same information. 13 The site will be used to host the communications ‘how to toolkit’ to enable staff to access templates, guidance notes etc. The site will also host all corporate information for staff, including policies, procedure etc.

5.4 Media Relations

A proactive approach

We fully recognise the power of the media and the media, if managed proactively can be one of the most effective means of engaging with the wider public.

When working with the media will always be proactive and make best use of every opportunity to secure positive coverage in a wide range of publications, local, regional and national, in addition to trade press, online and broadcast.

A significant amount of effort has been made towards building and strengthening relationships with editors and local health reporters and we will continue to build on these positive relationships. The communications team will provide local media with weekly updates on topical issues and will ensure that one to one weekly contacts are made.

We will also hold monthly meetings with local editors and health correspondents, including members of the CCG Governing Body and other senior officers when required.

The continued effort on the exposure of positive news stories will not only enhance the CCGs external reputation, it will also minimise the impact of negative coverage, securing a more balanced view of the CCG in the eyes of the public.

Reacting effectively

When dealing with reactive issues we will adopt the following principles when dealing with reactive media enquiries:  We will strive to be helpful when meeting media deadlines  Where possible, we will produce any required statement within their required timescales  We will not comment on individual personal details, we will only confirm facts.  We will agree responses with the key staff involved  We will not lie or intentionally mislead the media but will seek opportunities to get our message across  We will challenge inaccurate reporting.

Media Training

We have developed a robust Media Protocol (see Appendix B), which ensures the Communications Team are informed of and involved with all media contact. Media training will be vital in broadening the number of spokespeople available to the CCG who have the appropriate skills to maximise media opportunities and protect or enhance the CCGs reputation. We will develop and deliver basic media training and will, where required source specialist media training.

14 Media Monitoring

Given the media’s influence and potential impact to the CCGs reputation, it is important that the CCG Governing Body, senior officers and federation members are kept informed of positive and negative media coverage, proactive media releases and reactive enquiries that have not resulted in negative coverage for the CCG.

We have put in place mechanisms for monitoring the media and have developed a weekly media brief which will be circulated at the end of each week. Any urgent media issues will be briefed immediately by the communications lead.

In order to benchmark and fully understand public perceptions, we will explore, with colleagues from other regional CCGs, opportunities to introduce a more in-depth media monitoring process.

5.5 Crisis Communications

In the event of a crisis situation or major incident, effective, timely communications are critical.

During transition we will continue to work to our major incident and emergency plan communications plan to meet any generic crisis and will, with the lead for emergency planning develop our communication plans around, business continuity, major incident and pandemic and heat wave requirements.

We have developed a media handling protocol which provides detailed guidelines for dealing with the media both proactively and in a crisis situation. It is important that all staff, CCG Governing Body and federation members adhere to this protocol.

5.6 Horizon scanning

We will horizon scan for forthcoming or potential negative or difficult issues and will prepare appropriate responses for any emerging problems. Anticipating how the CCG will need to deal with criticism, for example about financial pressures or contentious commissioning decisions, and ensuring that the CCG are well supported to manage any crises.

We will ensure that there is a whole system overview in terms of complaints, MP letters, Parliamentary Questions, negative patient experience feedback and other non regulatory communication in order to ensure that we are aware of potential emerging issues at the earliest opportunity.

5.7 Brand Management

As leader of the local health economy, the reputation of the organisation is critical to successful relationships.

Effective management of the CCGs identity and house style is an important element in protecting the organisations reputation and it is important that the CCGs identity is not used inappropriately.

15 In line with our authorisation process the Department of Health have issued the CCG with their official NHS logo and identity – Warrington Clinical Commissioning Group and new templates have all been developed to incorporate the new logo.

The CCG have also considered the organisations wider identity and have taken on a ‘house style’ which compliments the branding and gives the CCG a local identity that links them to public health and local authority partners. The interwoven ring design also reflects the identity of the ‘It's all going on in Warrington campaign’ which was launched in 2011 to promote the rich cultural activities that Warrington has to offer. The interwoven rings have been adapted to incorporate the CCG colours and the CCG vision of Excellence for Warrington has been embedded within the circles.

A full suite of templates have been developed as part of a ‘how to toolkit’ which will ensure that the branding and house style are being used in accordance with the Department of Health Brand Identity guidelines.

The Communications Team will be the keepers of the CCG brand and will work with staff and teams to ensure the corporate style is implemented in an appropriate manner at all levels.

Consistency of message, house style and branding will be monitored through all corporate communications.

16 6. Stakeholder Analysis

h Keep satisfied: but not so Manage Closely: these are the g i

H much that they become bored people to fully engage and make

with messages: the greatest efforts to satisfy.

 WHHFT Members  Member Practices

 5BP Members  WHHFT – Board

 Local Medical Committees  5BP Board

 Local Pharmacy Committees  Bridgewater CT Board

 Local Authority Exec Committee

 MPs

 Local Council Members  Local Overview and Scrutiny Committees  Health and Wellbeing Board  Warrington Local Involvement Networks (LINks)/Health Watch  Third sector and patient support groups (via local CVS organisations)  Media  Local Office of National Commissioning Board R w Monitor: do not bore with Keep informed: and engage to E o L

excessive communication: ensure no major issues are W

O  Other NHS Staff (providers) arising P

 Local Social Enterprises (if  Patients, their carers, families

and when established!) and the general public

 Local Chambers of  CCG Staff

Commerce

 Housing Trusts and other

public sector organisations

Low High

INTEREST

Red – High Power, High Interest – fully engage and satisfy Orange – High Power, Mod Interest – inform, seek approval and satisfy Gold – Mod Power, High Interest – inform and engage Green – Low Power, Low Interest – monitor and inform

17 7. Risk Assessment

7.1 SWOT Analysis

Having reviewed our situational analysis, a number of areas have been identified as being ‘weaknesses or threats’

Strengths Weaknesses Established Governing Body with high Limited capacity and resource for level of strategic expertise and a varied communication activity skill set. Continuously changing environment Skilled engagement and communication resource

Good clinical engagement

Opportunities Threats Resource within local media organisations Further enhance member practice – lack of ‘named’ health link. engagement Political challenge Further enhance staff engagement Loss of public and clinical engagement and Further enhance clinical engagement confidence. between provider and commissioner organisations. Loss of staff engagement and confidence, negative affect on staff morale. Enhance robust working arrangements with partners and providers Diverse and competing demands on time to undertaken the necessary work.

Further reduction in engagement and communication resource.

7.2 Risks

There are several risks attached to the success of the engagement and communication strategy, as detailed below. Consideration has been given to these risks and the successful implementation of the engagement and communication strategy will contribute to the mitigation of all the risks identified:

18  Negative media attention around the health bill and the privatisation of the NHS

 Political spotlight drawing NHS finances in to the political debate locally and nationally.

 Confusion due to the amount of information being communicated at any one time via provider and partner organisations.

 Loss of local engagement and inability to maintain relationships during the transition period due to reduction in resource and changing roles and responsibilities.

 Competing demands on media space by public sector organisations.

 The impact of the transition on staff morale and staff retention.

 Resource within engagement and communication functions to implement and deliver on the strategy.

19 Appendix A

ENGAGEMENT, EXPERIENCE AND COMMUNICATION DELIVERY PLAN

Roles and responsibilities

Effective engagement and communication is everyone’s responsibility and the CCG Governing Body, member practices, staff, including clinicians and practice staff all have a key role in promoting the work of Warrington Clinical Commissioning Group, the services which it commissions and in raising awareness of health campaigns and initiatives.

The engagement and communication lead will ensure that all Warrington Clinical Commissioning Group members and staff are well informed and supported to do this.

Key responsibilities

The Senior Communications Lead will be responsible for:

 Developing and managing delivery of the communication & engagement strategy and action plan.  Providing the CCG board with progress reports and will also ensure that the Governing Body is made aware of any significant issues which will impact on the effectiveness of the strategy and any risk in terms of achieving the objectives.  Providing strategic input to the work of Warrington Clinical Commissioning Group, providing strategic advice on engagement and communication requirements.  Identifying, planning for and responding to emerging issues which may have a detrimental impact on the reputation of the CCG and / or the NHS brand.  Handling of all communication, including crisis communications in relation to serious and untoward incidents.  Handling of all communication, including media activity in relation to major incidents as part of emergency planning arrangements. (this includes on call out of hours support)  Handling of reactive media activity, ensuring appropriate response and timely escalation of issues and where required co-ordinate responses with communication leads from partner and provider organisations.  Oversight of all proactive media activity, and, where required co-ordinate media activity with communication leads from partner and provider organisations.  Co-ordinating activity, where required with communication leads across the partner organisations.  Having a system wide overview of all incoming communication (formal and informal i.e. complaints, MP letters, Parliamentary Questions) and identification and response to emerging issues.

20 The Patient and Public Involvement Manager will be responsible for:  Delivery of all engagement operational activity identified in the engagement and communication work plan.  Acting as the first point of contact for community and third sector groups in relation to public engagement activity.  Delivery of all patient experience activity identified  Provide regular update reports to Warrington Clinical Commissioning Group Governing Body, Quality Committee and patient experience and quality group and any other committees and meetings as required  Alerting the communications lead with information around any emerging issues in relation to engagement activity which may impact on the organisations reputation.  Attend a variety of third sector and community group meetings and present updates as and when required  Attend a variety public events across the borough  Development and maintenance of the membership scheme  Continually monitor the SEE Website, Patient Opinion and patient choices  Supporting and advising commissioning leads and CCG senior officers with practical engagement support, including the development and implementation of engagement plans.

Warrington Clinical Commissioning Group Governing Body members will be responsible for:

 Taking the lead and fronting media activity when required, both in relation to proactive and reactive issues.  Lead on the delivery of high level communication to staff, member practices, federation members, partner and providers.  Alerting the communications lead with any emerging issues  Supporting the CCG by attendance and involvement in public events.

Warrington Clinical Commissioning Group Clinical Leads, Commissioning Leads and Senior Officers will be responsible for:

 Alerting the communications lead with any emerging issues.  Providing updates to the communication lead for inclusion in briefings etc.  Leading on engagement and communication activity in relation to specific work programmes.

The communications officer will be responsible for

 Delivery of all communication operational activity identified in the engagement and communication work plan.  Acting as the first point of contact for media enquiries.  Supporting clinical leads, commissioning leads and CCG senior officers with practical communication support, including the development and implementation of communication plans.

21 Budget and resources

Much of the engagement and communication activity can be delivered at nil additional cost through use of existing resources and channels of engagement and communication. Activity which has been identified as requiring additional budget has been detailed in the action plan.

Any activity in relation to specific workstreams which has not yet been identified will be fully costed and submitted to the appropriate work stream lead for approval before any activity is commissioned.

Consideration needs to be given to the level of resource available and there may be potential in sharing resource across a wider geographical footprint, reducing staffing costs and making best use of resources, expertise and time. This would also provide an opportunity to reduce non pay costs by shared commissioning of engagement and communication products and services.

During the next six months we will work with our neighbouring CCGs and commissioning support organisation to scope the options available to us.

Evaluation

It is important for us to monitor and benchmark performance of engagement and communication activity so that we can ensure that the activity is appropriately tailored and targeted to the relevant audiences, messages and method. The following criteria are suggested as being ways in which we should be able to track performance:

 formal and informal feedback from stakeholders, to include; o Patient experience feedback and patient surveys o levels of awareness of the work of Warrington Clinical Commissioning Group o public perceptions of ability to get involved and influence the future shape of these services o high level 360 degree feedback – federation members, partner and provider organisations.  formal and informal feedback from employees o views sought through team meetings, staff briefings and other engagement events o staff survey o intranet feedback  number of attendees at engagement and consultation events o internal audiences o external audiences  favourable media coverage o media evaluation  political temperature o positive political support vs level of political noise (MP letters Parliamentary Questions etc)

22 ACTION PLAN

It should be noted that this high level action plan is supported by a detailed operational workplan (embed), which identifies the specific operational activity and timescales. The operational workplan is reviewed and monitored and updated on a monthly basis.

ACHIEVED IN PROGRESS OVERDUE / DELAYED

Action / Notes Lead / Target Date Support for delivery Develop Membership Newsletter VN / PS Dec 2011 Visioning Event - Year one NA / PS Feb 2012 Develop engagement and communication operational workplan – linked to quip MA / PS April 2012 programmes and other commissioning workstreams (plan on a page) Develop and implement Media Handling Protocol MA April 2012 Website refresh – update MA / VN April 2012

Intranet development MA / VN April 2012

Brand and House style development (incl development of Marketing Kit) MA April 2012 Develop high level engagement and communication weekly brief MA April 2012 Develop and implement the how to toolkit – including all templates VN End April 2012 Development of the CCG authorisation materials MA / VN May 2012 CCG Brochure (pre annual report doc) MA / VN May 2012 Develop and publish calendar of events PS May 2012

23 Implement quarterly press briefings MA / VN May 2012 Annual Marketplace event MA / VN / May 2012 PS Develop and implement communication, engagement, experience awareness raising and MA / PS May 2012 training programme (including Equality & Diversity and dealing with the media) Review commissioning bulletin – audit and refresh NA / MA May 2012 Support the development of Patient Participation Group groups within every practice PS / June 2012 Practice Managers Develop and launch Warrington Health Forum MA / PS June 2012 Public Deliberative event MA / VN / June 2012 PS Develop and implement quarterly stakeholder ‘spotlight brief’ NA / MA / July 2012 VN Develop and implement a marketing programme for the Patient Experience (SEE) VN / PS July 2012 resource and membership scheme Develop media monitoring process MA / VN July / Aug 2012 Produce Duty to Involve – Real Accountability Report (statutory document) MA / PS Aug 2012

Review Communication, Engagement and Experience Strategy MA / PS October 2012 Warrington Health Day MA / PS / June 2013 VN Engagement and communication audit MA Feb 2013

Visioning Event – Year one review and Year Two NA / MA / Feb 2013 PS / VN Review Membership scheme – audit membership PS / VN March 2013

24 CCG Annual Report MA / VN April 2013 Audit / review Patient Experience SEE programme. MA / PS / July 2013 VN

25 Appendix B

MEDIA PROTOCOL

Introduction

The NHS is constantly under intense media scrutiny, the public has a vested interest in the NHS and its performance. In addition to being a political issue, health is often an emotive one. Whether attracting commendation or controversy it consistently makes headline news.

In the interests of effective media relations, both proactive and reactive, it is important that all staff directly or indirectly associated with Warrington Clinical Commissioning Group, including federations and member practices adhere to the agreed guidelines set out in this protocol when dealing with the media

Efforts should be made to maintain and develop the CCG’s relationship with local and regional media and to improve connections with professional and specialist publications.

It should be noted that anyone likely to be linked to the CCG, including CCG staff, member practices and CWW CSS staff who expresses his or her own personal views to the media (whether through the lay press locally or an international peer review journal) should make it clear that these are personal opinions and not necessarily shared by the CCG.

Information from any item of printed material could theoretically find its way into the hands of the press (who are also entitled to attend public meetings) so it is recommended that the potential implications of any CCG communication (including correspondence with patients and staff) are carefully considered in advance.

It is important to channel all media handling initially through one central point (The Communications Lead), to avoid confusing journalists and ensure messages are consistent.

The CCG should be made aware of national and professional media issues, which may be localised by the Warrington press. Local newspapers, web- based media and radio and television stations should be closely monitored and cuttings or taped records kept of coverage relating to the CCG, to be made available to CCG senior officers.

26 Proactive media

Press releases will be issued as and when required to actively promote the work of the CCG in a positive light through relevant media, which is one of the most important means through which the organisation’s profile can be raised and understood.

Their contents can also be re-focussed for other communications tools, such as the weekly commissioning brief or on the website www.warringtonccg.nhs.uk

Press releases and other media work should always be co-ordinated through the CCGs communications lead.

It is advisable to treat all media as equals when issuing information. Showing preference to one title or organisation risks antagonising rivals, who may attempt to discredit the original story by canvassing the views of critics.

‘ Off-the-record’ briefings may be attributed or traced back to the briefer, unless the journalist is expressly told otherwise – and even then there are no guarantees that the confidence will be kept. An ‘off-the-record’ arrangement has no legal standing.

Even being proactive around negative issues can often have its benefits. It should earn the respect of journalists and the public for taking an honest, open and accountable approach to a difficult or uncomfortable subject. It should also help ensure that the CCG has more control over the way in which the story first enters the public domain and reduce the need for a reactive stance. It should also be recognised that even a negative issue can contain key messages.

Reactive media / crisis management

All media enquiries will be responded to in the first instance by the Communications Lead.

The Communications Lead will respond immediately to all media enquiries relating to the CCG. They will take full details of the nature of the enquiry and context in which it is being set, to avoid an inappropriate response.

It is important to recognise that not all enquiries are negative, however when they are, by taking a proactive approach it is possible to limit the damage caused.

The communications lead will negotiate a ‘reasonable’ timescale with the media in which to respond adequately to media enquiries. However, it should be recognised that there are times when a speedy response to media enquiries is vital and that a deadline means a deadline. The Communications Lead will ensure that the media are kept informed of progress on their enquiry

27 at regular intervals, so that they know whether they can expect an interview or a written statement and what that is likely to contain. This may influence their handling of the story.

The CCG should always exercise its ‘right to reply’ to media stories. Although the ‘right to reply’ is not legally enforceable, it is universally accepted by the media as good practice to grant individuals the opportunity to comment on issues affecting them.

CCG should avoid using ‘no comment’ at any time. It is important to note that “no comment” may be regarded as a tacit admission of liability by many journalists. Refusal to comment may give journalists licence to portray the CCG in a pejorative light – as does being “unavailable for comment”.

Even if a negative situation is in its early stages or inconclusive and more information is required, journalists should be given a ‘holding statement’ to that effect, to avoid pre-empting the outcome. This could, for example, refer to the CCG being “in the process of conducting an investigation, whose findings will be made public once it has been concluded.”

It’s important to note that in some circumstances, i.e. if the matter involves legal action it would be prejudicial to comment further, however, a ‘no comment’ should still be avoided.

If something has gone wrong, which indisputably finds the CCG at fault, it is better to admit the organisation is in the wrong, apologise if appropriate and explain what action has been taken to prevent a repeat of the situation. This should be better received than a non-committal response, which could be seen as the CCG not accepting its responsibility.

Responses from the CCG should be accurate and timely, using plain, concise language and avoiding jargon or any points which may be open to misinterpretation. A good journalist should check anything which is unclear.

The most important messages in a written statement should be contained in quotes from an appropriate, named individual, which are less likely to be edited or paraphrased. That person should make themselves available for interview if required following the issuing of the statement.

The CCG should not attempt to answer to the media on behalf of other organisations, which should be given the opportunity to speak for themselves.

If an item criticising the CCG is published or broadcast presenting one side of an argument or inaccurate, then the Communications Lead will seek redress in the first instance with the appropriate editor. It may also be necessary to take prompt action in informing other news organisations of the facts before they ‘lift’ the incorrect information and perpetuate it.

News organisations file published or broadcast material which can be published or broadcast again at a later date as ‘an accurate record’ if it goes

28 unchallenged. The communications lead will therefore make a request that the response from the CCG or a correction to be used in the next available bulletin or issue and given equal prominence to the original coverage.

Failure to do so should be grounds for representation to media watchdogs such as the Broadcasting Standards Commission or Press Complaints Commission on the basis that the issue has not been handled in a fair and balanced way.

Long-running, high profile or multi-agency issues may require a separate, comprehensive communications strategy, including media handling arrangements.

Early Warning System

The Communication Lead is responsible for and will ensure that the Accountable Officer and Chairman are kept fully informed of and updated on any issues which are potentially damaging to the CCG’s reputation.

Equally, it is important that the communications lead is kept appraised of any adverse issues – whether during the working day or out of hours, whether common knowledge or confidential - in order to advise and support accordingly.

Whenever a new policy or procedure with wide reaching consequences is due to be introduced, or a change in leadership is due to be announced CCG staff, federation leads and practice members should be notified first, before any announcements are made in the media.

In the event that information concerning such a policy or procedure or announcement is leaked to the press, it is likely to be presented in a subjective and unconstructive light, which may also be mistaken. It is important, therefore to ensure that every member of CCG staff is given the facts as quickly and accurately as possible – preferably before publication or broadcast.

It is vital that the CCG observes the Strategic Health Authorities notification mechanism for serious untoward incidents, namely the Strategic Executive Information System (StEIS.) The communications lead will also ensure that the procedure for notifying the North of England Director of Communications before an issue hits the press and detail the proposed action.

Where appropriate, other partner organisations should also be alerted and a joint approach adopted and the communications lead will co-ordinate any joint response.

29 Media release approvals process

All information being released to the media should always follow the agreed approvals process.

Proactive media

All routine, non-contentious press releases should be approved by:  the source of the information  their ‘line manager’ or equivalent if appropriate  the communications lead

Reactive / Crisis media

Press statements relating to crisis management issues, which could threaten the CCG’s reputation, should always be handled at the most senior level with professional advice and approved by:

 the source of the information  their ‘line manager’ or equivalent  the CCG’s communication lead  the Accountable Officer or another senior manager if appropriate.

Spokespeople

In certain circumstances, where an interview is required on a non-contentious matter, it may be possible for the interviewee to be the member of CCG staff, an individual from a member practice, who are closely associated with the subject matter, once briefed.

For more challenging issues, with wider implications, the Accountable Officer, Chair or member of the Senior Management Team should be designated as media spokespeople for their specific areas.

Confidentiality and the use of case stories

Warrington Clinical Commissioning Group is committed to preserving service user/patient/carer confidentiality and respects the privacy and dignity of individuals, to which public interest should always be secondary.

However, there may be some circumstances in which media coverage would be significantly enhanced by the use of real – life ‘case histories’ – that is personal stories relating to service users/patients/carers, which normally involve a photograph or film footage. Indeed, there are many instances in which the media will not carry a story – particularly one which is heavily based on strategic issues – without a case history, however important the story. Such details add colour and can make an issue more relevant and accessible to the reader or viewer.

30 Any use of case studies, whether in a press release or sourced by the CCG as a result of a press enquiry - would be based on full, informed consent of service users/patients/carers and/or their family members for them to be featured in the media.

The consent form at Appendix B1 covers the use of film footage or photographs at a future date by either the media organisation or the CCG.

In the event of patients or members of the public actively seeking media attention, it is important to note that they have not waived their right to confidentiality and the CCG should not discuss their case openly even if they choose to. In many cases, any discussion would be prejudicial in the context of an official complaint or legal proceedings.

Emergency Planning and Major Incident communications The communications lead should be among the first people notified in the event of a major incident and will follow the actions required by the Major Incident Plan.

The communications lead will be responsible for co-ordinating timely and accurate responses to the media in line with the Major Incident Plan – which could include important public information and appeals for off-duty staff to come into work.

Out of Hours media calls The proliferation of media titles and the speed of modern news gathering mean that out of hours calls are increasingly becoming the norm. Bank holiday working is also routine for many titles.

It should be noted that out of hours calls from the media are no longer restricted to urgent issues.

Where communications support is required out of hours the On Call Manager will contact the communications lead. It should be noted that although there is no formal on call arrangements, informal arrangements are in place and the communications lead will respond in the event of an urgent media enquiry which can not wait until the next working day or in the event of a serious untoward incident or major incident.

The communications lead, via the local network of communications leads will ensure that there are ‘mutual’ aid arrangements in place.

31 MEDIA PROTOCOL FLOWCHART

STEP ONE All media enquiries, either directly into Warrington Clinical Commissioning Group or via a federation member practice should be directed to the Communications Lead: Maria Austin – Tel Mobile 07917738659.

Is the enquiry Warrington CCG specific or does it impact on a provider / partner ? The communications lead will YES alert the relevant provider / NO partner communication leads and agree handling arrangements

STEP TWO

The Communications Lead will log the enquiry and will inform the Accountable Officer

STEP THREE

The Communications Lead will liaise with the appropriate staff members to formulate the response. The response will be approved via the internal approval process. If the enquiry involves a partner / provider organisation the communications lead will co- ordinate the approval process with the appropriate communication lead/s

STEP FOUR

Response will be provided to the media organisation, with if appropriate supporting information. If appropriate an interview will be offered and the communications lead will have oversight of all arrangements.

STEP FIVE The communications officer will monitor the publication. If there is an issue with the publishing of the information the Communications Lead will ensure a timely response to the media organisation and will ensure that the Accountable Officer is informed. The communications officer will include the summary in the weekly communications update for board members.

32 Appendix B1 PHOTO/FILMING CONSENT FORM

PLEASE TICK APPROPRIATE BOXES BELOW TO INDICATE YOUR APPROVAL.

I, the undersigned agree that my / my child photograph may be used for a range of media (for example: newspapers, newsletters, magazines, television, and websites

I have been given a full explanation about possible uses of my:

We will not disclose any photographs or information about you without your consent, unless we have a statutory duty to do so in preventing harm to someone else, or to protect you or to prevent or detect crime.

We will only store and use information in accordance with our registration under the Data Protection Act 1998.

Photograph Name (in caption) Film Footage

I therefore understand that my:

Photograph Name in caption Film Footage may be used for legitimate purposes i.e. (Annual Reports, website, and exhibitions to promote the work of Warrington Clinical Commissioning Group both now and in the future.

I also understand that my:

Photograph Name in caption Film Footage may be used by a range of media titles in press articles/TV broadcasts / websites which are seen by the general public, now and in the future.

I hereby grant consent, freely given, to the use of my

Photograph Name in caption Film Footage

Name (Please print) ……………………………………………………………..

Name of child (if applicable)

Signature: ………………………………………………………………………..

Date: ……………………………………………………………………………..

33 Appendix C KEY MESSAGES

Overarching Key Message:

The government has designed a new system around local decision making to lead to more effective outcomes for patients and more efficient use of services for the NHS.

Local decision making  GPs will be working together in groups of practices called clinical commissioning groups. Each CCG will be responsible for its own commissioning and financial decisions.  GPs and other primary care staff have the most regular contact with patients and have the best overall understanding of people’s health and care needs. They already play a key role in acting as their patients’ advocate and coordinating care on their behalf.  By extending this role and giving them the freedom to decide which healthcare services to commission on their patients’ behalf, GPs will be able to use resources in the ways they believe will achieve the best and most cost-effective outcomes.

Working in partnership  GPs will not be working in isolation. Health and wellbeing boards will be set up in local authorities to provide a way to bring together GP consortia with other health and care partners.  Health and wellbeing boards will give a stronger role to local government. Councils and be able to better influence their local health services and make sure the commissioning decisions reflect local priorities and needs. They promote shared decision making between health care, public health and social care.

The NHS Commissioning Board  The system of local Clinical Commissioning Groups will be overseen by a national NHS Commissioning Board, which will sit at arm’s length from the government. It will make sure that CCGs have the capacity and capability to commission successfully and meet their financial responsibilities. The Board will also commission some services directly.  In addition, the NHS Commissioning Board will provide national leadership to improve quality for patients and make sure there is a consistent delivery of outcomes.

What does it mean for the patient?  ‘No decision about me without me’ will be the principle behind the way in which patients are treated – patients will be able to make decisions in partnership with their GP about the type of treatment that is best for

34 them. Patients will also have more control and choice over where they are treated and who they are treated by. They will be able to choose their: - GP - consultant - treatment - hospital or other local health service.

 Patients will be able to get the information they need, such as how well a hospital carries out a particular treatment, to help them decide on the best type of care. If patients are unhappy with their local hospital, or other local services, they will be able to choose another one to treat them.  Patients will be able to rate hospitals and clinics according to the quality of care they receive, and hospitals will be required to be open about mistakes and always tell patients if something has gone wrong.  Patients will have a strong collective voice through a national body, Health Watch, and in their communities through arrangements led by local authorities.

What does it mean for the public?  The public will be able to have more influence over what kind of health services should be available locally. They will also have greater opportunities for holding to account local services that are not performing well.  They will be able to get more information about how their local health services are performing, such as how well their local hospital carries out a particular operation or treatment.  There will be more focus on preventing people from getting ill – the Public Health Service will pull together services locally to encourage people to keep fit and eat more healthily.

How will the new health and care system be run?  Local authorities will be responsible for local health care priorities, while central government will have much less control over health services.  The NHS will be measured by how successfully it treats patients – for example, whether it improves cancer survival rates, enables more people to live independently after having a stroke or reduces hospital acquired infection rates.  An independent and accountable NHS Commissioning Board has been established to: o lead on the achievement of health results o allocate and account for NHS resources o lead on improvements in quality o promote patient involvement and choice.

35  The Board will also have a duty to promote equality and tackle inequalities in access to healthcare.  Monitor will become an economic regulator to promote effective and efficient providers of health and care, encourage competition, regulate prices and safeguard the continuity of services.  The role of the Care Quality Commission will be strengthened as an effective quality inspectorate covering both health and social care. HealthWatch will represent the views of patients, carers and local communities.