Engaging and communicating to deliver better care

Strong engagement and communication with a wide range of people and organisations throughout the health and social care system is vital for the successful delivery of Better Care.

Meaningful involvement of staff, people who use services and their carers can help ensure that new approaches are well informed and sustainable.

Create a narrative for coordinated care

Many places have used stories about how integrated care will offer individuals a better experience and outcomes. One example is Torbay’s Mrs Smith. Other places have developed their own versions, but most have in common a clear description of what the change means for the individual and the benefits it brings. Good narratives tell a clear story of why the change is required, what will have to change and what improved outcomes will arise by when.

To develop a strong narrative:

It is important to create a compelling story which everyone at all levels across the economy can associate with and take themselves back to when they are facing a challenging situation to remind themselves that this is why we are on this journey.

Cheshire Local Vision project: developing multiagency response to social isolation

Use a common language

Develop clear measures of success

Understand your stakeholders

“We work in a knotted ball of string, where you have to be comfortable talking to chief executives one day and patients and health care assistants the next, and where you know it is not linear like a railway track. There are lots of branches off on the way. It is about persuading, not ordering, asking not telling, everybody’s equal – that sort of thing. You have to be comfortable with chaos. And it does need a different sort of manager with different skills, not the tub-thumping showman who needs to be centre stage. You need to have people who can make connections and relationships, and that’s a totally different set of skills.

Jan Vaughan, Associate Director, Cheshire and Merseyside Strategic Clinical Networks

Source: System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities, The King’s Fund (2014)

Equip people with the right communication skills

Engage local people

... in terms of success, one in North West London has been genuine coproduction with lay people … So that is a big success. And more people seeing that whole system integration as the way that we are going to solve the problems that we are in. So in terms of critical mindset changes, I think that those are successes. Failure would be if we don’t let go and allow our enabled local areas to move forward at a pace that is right for them – so the fastest move forward more quickly.

Thirza Sawtell, Director of Strategy and Transformation, North West London Collaboration of Clinical Commissioning Groups

Source: The practice of system leadership: being comfortable with chaos, The King’s Fund (2015)

Engage local politicians

Understanding how to create a public narrative that works to secure buy-in and support from local politicians – usually elected local councillors – is essential. Consider the following:

Ensure engagement and communications are joined up

Presentations should be delivered jointly by leaders from across the health and social care system, with engagement of people who use services and carers wherever possible. Communications need to look and feel joined up.

Leaders in this role should:

Checklist: effective engagement and communications

Effective engagement and communications strategies can draw on the following tools:

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Ladder of Engagement and Participation

Reproduced from NHS England

There are many different ways in which people might participate in health, depending on their personal circumstances and interest. The ‘Ladder of Engagement and Participation’ is a widely recognised model for understanding different forms and degrees of patient and public involvement (based on the work of Sherry Arnstein). Patient and public voice activity on every step of the ladder is valuable, although participation becomes more meaningful at the top of the ladder.

Tools and resources

Engaging local people – a guide for local areas developing sustainability and transformation plans (NHS England, 2016) addresses expectations on stakeholder involvement, in particular patient and public participation.

Integrated care: local partnerships to improve health and care (NHS England, 2018) includes information about sustainability and transformation partnerships and integrated care systems.

NHS England’s involvement hub includes a variety of resources on patient and public involvement, including bite-sized guides to participation, governance, payments and expenses, and engaging with specific groups.

A new relationship with people and communities (The People and Communities Board, NHS England) describes how individuals and communities can be more closely involved in developing person-centred health and social care.

Integrating health and care – a must know guide (LGA) highlights the key issues for elected members on integrated care.

A year of integrated care systems: reviewing the journey so far (King's Fund, 2018), examples and case studies from existing integrated care systems.

How to lead and manage better care integration guide
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