by Caroline Latta
The pandemic has seen major services transformed in a matter of weeks but more work is needed, not least to protect the BAME community. NHS communicators must continue to gather data across all demographics and educate why this information is crucial to enhancements in healthcare provision.
You’ll learn:
• How COVID-19 is driving NHS service improvements
• The importance of equality monitoring and how this improves user engagement
• Tips for better data monitoring collection
Coronavirus has profoundly changed the NHS, social care and local government. In days, major service transformations have been achieved that would previously have taken years.
Many of those service changes have offered significant benefits – for example, telephone and video appointments are quick and convenient, and referring patients for tests before they see a consultant can save valuable time.
The message from national leaders at NHS England and NHS Improvement, as well as local service leaders, senior nurses and doctors, is clear: Let’s lock in those benefits, while seeking to rebuild local services that meet the needs of the local communities they serve.
The NHS is legally obliged to involve its communities in how services in the NHS are organised and this gives us an important opportunity to build on a new openness around issues of race, community, health systems and inequalities in a way that has never been done before.
This is critical. Data from the pandemic leaves us in no doubt that people from BAME backgrounds have been disproportionately affected. The NHS recognises it has to act now and quickly. Local health and care systems need to rethink relationships with staff, patients, the public and local communities and existing approaches to listening.
Engaging with people who use NHS services is a crucial step for service transformation programmes. But, in the main, data about the backgrounds and protected characteristics of patients can be poor - a huge challenge for service change leaders.
Go digital first and blend in offline methods
The COVID-19 socially distanced world has created a new norm in how we involve people in discussions around what is important to them. A large majority of ‘traditional’ face to face consultation activity has had to be replicated online.
One positive consequence of the pandemic is that many are now better equipped with technology and more familiar with the online process.
However digital alone is not likely to meet the legal duties regarding public involvement and equalities, so a blended approach to include offline methods should always be taken to target specific communities of interest.
NHS Boards need to be assured that engagement methods still reach those who are digitally excluded, and in particular BAME communities at this time of need.
Data on protected characteristics is key
The starting point for any service reform activity is to check the data around patient flow, gender, age, postcode and key protected characteristics – all the questions you’d usually find in standard data monitoring information.
This provides the evidence that we are reaching the people who need particular services and helps identify when we are not.
Equality monitoring by itself does not explain why a service is under or overused by some, but provides a starting point for highlighting issues. This enables us to set realistic targets on how we can improve services to make them more inclusive.
Unfortunately, while protected characteristics information (for example race and heritage data) are included as standard questions, all too often they are not completed.
The NHS needs to better explain why this information is important (some conditions are more prevalent in ethnic backgrounds) and engage with BAME communities to gain their support to provide the information when asked.
Using that data we can identify and target people who are most likely to be affected by a change in service and as a result we can build new ones that meet more of the needs of the widest possible section of our population.
Socially distanced methods of engagement
Many existing engagement methods can and will have already been adapted for social distancing.
Websites support a variety of engagement methods. Take content management systems adapted for discussion forums, wikis (to gather ideas, co-draft or comment on documents, plans or maps), videos and hosted surveys etc.
Zoom, Microsoft Teams, Google Meet and Skype can be used for webinars to share information, but also focus groups and online co-production methods.
Telephone interviews always have a useful place, especially if supported by a community sector or social research supplier.
A stakeholder relationship management (SRM) system is a single digital repository for all stakeholder communications and can be invaluable.
This is a data store of activity (interactions), feedback (from all channels – digital and non digital) and allows you to store, recall and analyse information quickly and easily. It can also be used as a database and some have stakeholder mapping functionality, enhanced reporting functions, surveys and event management built in.
Unlike CRM, SRM is concerned with what is being said as well as who is saying it. This is a must have when using a digital first approach to ensure feedback from key groups such as BAME are captured and used in reform planning.
Finally, working with community organisations and partnering with them can also help reach new people. COVID-19 has seen a surge in volunteers who can act as trusted brokers to reach particular target communities and this should not be overlooked.
Key actions to update engagement in a COVID world
• Update your involvement strategy
NHS duties requires continuous involvement, so it’s crucial to update your strategy to take account of digital methods, how you plan to involve digitally excluded communities and include internet use locally. The latest information from ONS can help.
• Ensure better data monitoring collection
Once agreed, the same monitoring information should be collected in all partner organisations, with an extra onus on working with BAME communities to educate them on why it’s important to provide the data.
Whichever service is under review, build a profile of service users in relation to age, gender, BAME and protected characteristics, population heat maps and key health conditions. This data should underpin your engagement plan.
• Go digital first for engagement
If you don’t already have a stakeholder management system, get one. It’s the best way to understand who you are engaging with and crucially what is important to them.
• Work with local community and voluntary organisations
These organisations have been the glue between the NHS and local authorities in their response to COVID-19, and we have seen record numbers of volunteers come forward to support the vulnerable, many of whom are a protected group.
They often reach much further into communities than public bodies can, so ask for their help in running discussion groups, taking surveys or brokering introductions to other key community leaders.
Always have a plan
As engagement and communications professionals, our strength is our planning abilities, having a clear purpose for the engagement project and appreciating what can and can’t be influenced.
Our measurement and evaluation is key. To make change we must continue to build our insight evidence base and feedback to local communities. It helps all of us to show how the data provided was used to make services better for patients and staff alike.
Caroline Latta is a leading strategic communications, public involvement and consultation specialist. She’s an expert in health, care and public health service change. She’s also the co-writer of an NHS service change legal duties guide, produced for NHS England and NHS Improvement.
Twitter: @carolinelatta
LinkedIn: linkedin.com/in/carolinelatta/
Web: wearestand.co.uk