When all eyes were focused on preparing for the pandemic, a number of short-term service changes were put in place to help the NHS cope with the peak of COVID-19.
Temporary changes have provided unique insights into new ways of providing services and the new behaviours this can lead to, such as online GP appointments and a reduction in visits to health service premises.
As we move into recovery mode, commissioners will be looking at what has worked well and what changes should be retained. However, when making changes permanent, the NHS’s statutory obligations to involve stakeholders in service changes remain the same. Moreover, the requirements of the Public Sector Equality Duty (PSED) remain in force, with the Equality and Human Rights Commission saying that the PSED is “critically important in ensuring that public bodies consider the needs of people with different protected characteristics as they respond to coronavirus”.
With social distancing and managed social interactions likely to remain in place until a vaccine is found, we need to find creative ways to seek feedback from all affected stakeholders, including protected and seldom heard groups, if we are to successfully transform services for patients.
Finding consultees during partial lockdown
The scoping part of a consultation is generally the most challenging part, and never more so than now.
Traditionally, we have relied on a mixture of engagement methods, including:
- face to face, through focus groups or targeting high footfall areas such as supermarkets or community hubs
- online, through established networks or social media
- and telephone and paper-based research.
When combined, these techniques can successfully tap into traditionally harder to reach groups, often by proactively going out to our stakeholders – reaching them through their own networks.
With social distancing in place, it’s easy to assume these groups have become unreachable. However, while not everyone is online, many offline groups have found ways to connect digitally during lockdown. Baby and toddler groups are ‘meeting’ via social platforms, churches are delivering sermons online and some charities have lent computers where needed to keep the lines of communication open. So reaching people through their existing groups is still a good approach during COVID, provided we are prepared to be flexible.
There are, of course, some groups for whom online engagement doesn’t work, such as those in the most deprived communities or individuals with learning disabilities or who are blind or partially sighted. As with any service change, it is essential that these groups are not overlooked and that appropriate options are in place to maintain easy access to vital services for all. But even during lockdown, options to reach offline groups exist. For example, when recently researching opportunities for engagement on translation services, Healthwatch colleagues told us about a community of asylum seekers who are meeting in small groups with social distancing in place. Thanks to partnership working with Healthwatch we will now be able to engage with and gain feedback from this seldom heard group.
Where direct engagement is genuinely not possible, consultation via advocacy groups can help to fill any voids.
Delivering meaningful engagement
COVID-19 has prompted an increase in digital skills across all age groups. Many of those who may have been less technically proficient are now using video calls for everything from reading bedtime stories to grandchildren, to maintaining exercise routines. This growing confidence with digital tools offers new opportunities for the NHS to engage.
The increasing use of systems such as Teams and Zoom has opened up focus groups to a much wider audience. Where we were once restricted in the number and location of groups we could offer, we can run several digital sessions in one day. This will help reach those in full time work or with caring responsibilities and may encourage those who are frail or vulnerable to get involved from the comfort of their living room.
Flexibility is key in reaching our stakeholders. Where community groups are familiar with a particular type of software, we need to approach them in the environment they are comfortable with. In recent weeks we’ve found that joining existing Zoom meetings run by charities or support groups has helped to build trust and encourage two-way discussion, with the NHS representatives positioned as guests rather than leading the event.
We are anticipating a significant amount of consultation being required in the coming weeks, affecting both recent service changes and those that were already in consultation when the lockdown hit. Commissioners and communications professionals will need to think creatively about the best way to reach all our target groups, and work together effectively across health systems to avoid information overload for patients as we clear the consultation backlog.
This blog was written by our Head of Engagement, Communications and Marketing, Andrea Clark for NHS Reset - NHS Confederation's campaign to help shape what the health and care system should look like in the aftermath of the pandemic. You can read the original version on their website.
NHS Arden & GEM CSU is hosting a free webinar, in partnership with NHS Midlands and Lancashire CSU, titled ‘Engaging virtually with impact’ at 11am on Thursday 23rd July. The recording will be available after the event.