CCGs strain to hear voice of patients

9 January 2013

CCGs understand the need to engage with patients but questions remain about their ability to translate good intentions into effective plans and to hold their nerve when unpopular decisions need taking.

These are among the findings of a new report based on interviews with 18 people from six CCGs including the clinical lead (usually the chair), accountable officer and lay board member.

Commissioned by the Department of Health for the NHS Commissioning Board, the study* found a high level of awareness and enthusiasm for the principle but underlying anxieties about PPE in practice.

The report’s authors deliberately talked to CCGs in the second and third waves of authorisation to get a picture of the average. They found most of the sample able to produce examples of engagement initiatives targeted to particular conditions (for example dementia and HIV) or around particular services (for example urgent care). They also found CCGs starting to have “productive discussions” about investment priorities and the need for service change.

These examples should not be mistaken for what the report calls an “embedded engagement culture”.  Acknowledging that CCGs are still barely formed, the report expresses concern about the “few specific examples of PPE in the authorisation process” and the lack of involvement of lay members.  Only one of the CCGs had involved a lay member in the authorisation process.

Despite signs of engagement activity, there is less evidence of shared understanding and “a lack of understanding about what it might mean to be ‘patient-focused’ or ‘patient-centred’”.

The report also raises questions about whether CCGs are engaging people at the right time. Engagement tends to be concentrated on the middle phases of the commissioning cycle (planning and service design), but should start earlier with “needs and aspirations”, the authors suggest. Similarly, patients and the public could be involved in the later procurement and monitoring phases of commissioning, allowing them to influence the choice of provider and the quality of the service.   

The report found evidence that some CCGs see potential for conflict in their roles as patient champions and effective commissioners. “Many…aim to be responsive ‘listening organisations’. This does not always sit comfortably with the need to make tough commissioning (and decommissioning) decisions.”

The report’s co-author Andrew Craig of Moore Adamson Craig Partnership, said: “These CCG leaders know that embedding engagement in everything they do is essential if they are to make commissioning decisions and service changes with broad user and carer understanding and community support. 

“They are hungry for metrics to measure the impact of their engagement efforts.  With the right support and encouragement they should quickly become local organisations that listen and engage well.”

Interviewees acknowledged concerns that patient participation groups (PPGs) were not representative of the wider population and related concerns about their ability to scale up communication to large numbers of people.  The authors concede that these groups may be the “primary building blocks” for engagement, but point out that CCGs have yet to tackle the problem of how to use PPGs as part of bigger engagement structures.

Article Type
Leadership and engagement

Latest News

How local health and care plans overlook the needs of dying people

25 May 2016

This report found that 34% of local health planning and needs assessments by health and wellbeing boards fail to take into account end of life care needs.

Also, 27% of CCGs do not have a strategy for addressing end of life care for adults in their area, with the figure rising to 71% for children and young people. The report calls for greater collaboration in order to better cater for local palliative and terminal care needs.

Read More

Dispensing health equality

25 May 2016

A report from pharmacy representative body Pharmacy Voice argues that closures of community pharmacies in deprived areas could lead to extra demands on local GPs. Based on a survey of over 2000 people, research commissioned for this report found that if faced with closure, one in four people who would normally seek advice from their local pharmacy on common ailments, would instead make an appointment with their GP. The report urges the government to take note of this in context of proposed funding cuts and seeks reassurance that in areas of high deprivation, access to community pharmacies will be protected.

Read More

Poor practice performance linked to funding

24 May 2016

The new report examined the amount of funding each GP practice in England received per patient and cross referenced this with the recent ratings given to the GP practice by the CQC. This research demonstrates a link between CQC ratings allocated to GP practices and the level of funding they receive. It found that GP practices that scored an "outstanding" or "good" rating received £152 and £140 per patient respectively; whereas those who scored "inadequate" or "needs improvement" received £128 and £111 per patient.

Read More

Reshaping the workforce to deliver the care patients need

24 May 2016

A report NHS Employers, argues that equipping NHS nursing, community and support staff with additional skills to deliver care is the best way to develop the capacity of the health service workforce, and will be vital to enable the NHS to cope with changed patient demand in the future. But the report notes big organisational challenges for NHS trusts, including the current state of NHS finances.

Read More

College of Optometrists reports on visual impairment and dementia event

24 May 2016

The College of Optometrists published a report on outcomes of an event to identify priorities for research into concurrent dementia and visual impairment.

The event brought together expert opinions from people living with concurrent dementia and visual impairment, their carers, clinicians and organisations providing services to people in this group.

Read More