1. Public & Patient Engagement
Training – Session 2
9 & 24 May 2013

2. Welcome
Your trainers:
• Anna Hynes, Health and Social Care Officer, CVAT
• Ben Gilchrist, Policy and Participation Manager, CVAT
• Peter Denton, Healthwatch Tameside Manager
Community & Voluntary Action Tameside (CVAT) is the lead
development and support organisation for community and voluntary
action in Tameside.
Healthwatch Tameside is the local consumer champion for health
and care issues in Tameside.

3. Refresher – from session 1
• Ladder of involvement
• 4 step process (next slide)
• What may change?
• Who may be affected?
• What do we already know?
• What is ‘given’ and can’t be changed?
• Thinking about one activity to inform several processes (e.g.
AoE)
• What is the potential impact of NOT engaging effectively?

4. NHS T&G CCG Framework for engagement
Focuses on
commissioning, in 4 steps:
1. Checklist – thinking about your
engagement
This is about determining the scope of
your project, background research &
getting the ‘green light’ to proceed.
2. Impact of proposal – how does this
relate to scale/type of
engagement?
This is about understanding the scale
of potential impact and what level of
engagement is appropriate.
3. Planning the public and patient
engagement activity
Support and guidance are available.
4. Evaluating – both the engagement
itself and the impact/changes that
have resulted.
How successful were you?
What did you learn?
What changed?
Steps 2 & 3 may cause you to revise assumptions in step 1

5. Planning your engagement
FRAMEWORK – STEP THREE

6. Your recap
In the groups you were in for session 1:
• Briefly remind yourselves about the project you used in
session 1:
• What is the service?
• What is the expected change?
• Who accesses it/may be affected?
• What do you already know?
• What impact level is it?

7. Exercise 1 – Scale of engagement
What are the main target
Think about protected
audiences for this service/activity? characteristic groups and people
who don’t currently access it
Do you need qualitative or
quantitative data (or both)?
What might the barriers to
engagement be?
Do you need the same data from
each target audience group?
Is statistical significance
important?
Approx how many people from
each target group do you need to
engage with?

8. Cognitive stages for getting responses
The respondent goes through four stages:
1. Comprehension – do they understand you?
2. Recall – can they remember/imagine the
scenario you are giving them?
3. Judgement – are they able to form an opinion
on this?
4. Response – what they actually tell you

9. Exercise 2 – Type of engagement
Thinking about your answers in
session 1 of the training, produce:
• A list of no more than 3 headline
topics you want to find out about
Try to avoid formulating questions
at this point – it’s about what you
want to find out, not the words
you will use to find it out
Check whether or not everything is
• For each headline topic, no more relevant to all your target groups
than 5 specific things you want to
find out
Think about:
When you have done this, think
about the different engagement
methods you could use – and
choose no more than 2 for your
project.
• Questionnaires
• Face to face interviews
• Focus groups
• Public meetings
• Online engagement

10. Exercise 3 – Reaching your audiences
For each of the target groups you
have identified, write a short
statement that:
Think about your answers in
exercises 1 & 2
What do you know (or can you
• Lists the specific things you want reasonable assume) about these
to find out from them
groups?
• Identifies the tool/technique you
will use for engaging with them
Is anyone in any of these groups
• Identifies the time and
likely to need support to help them
geographical considerations
engage (e.g. literacy, IT
relevant to them – so you can
literacy, physical
engage in a time/place that
access, interpreters)?
works for them

11. Exercise 4 – Secondary data
What secondary data do you have?
What good practice materials can
you refer to?
Who can you ask for assistance?
What other research has the CCG
done – and who has this?
What have colleagues in other
CCGs done – and how does their
local population compare with
ours?
What national good practice is
there?
What other partners might have
data?

12. Please return in 5 minutes
COMFORT BREAK

13. Exercise 5 – Defining your questions
You will see a series of questions from real questionnaires.
For each question, discuss:
• Do you think it’s a good question?
• What aspects of the question are good?
• What aspects of the question are poor?
“It is natural to have an inquiring
mind: asking the right people the
right questions in a way they can
understand will
provide useful answers.”

14. Sample question 1
What was the medical
problem or reason for which
you most recently saw your
family doctor?

15. Sample question 2
Example from Research into Stroke Patients in a UK city
Q4
WHERE DO YOU LIVE AT PRESENT?
(Cross one box)
Own home (owned or
rented), not alone.

Own home (owned or
rented), alone.
With relative or friends

In sheltered accommodation 
In a residential home

In a nursing home
THIS FORM WAS COMPLETED ON: ___/___/____ (Date)



16. Sample question 3
Example from UK Patient Satisfaction Survey
4.The doctors have done everything they can to make me well
again
Strongly Agree 
Agree 
Disagree 
Strongly Disagree 
Not applicable 
11.I had good support at home when I needed it
Strongly Agree 
Agree

Disagree

Strongly Disagree 
Not applicable 
13.The ambulances have been reliable
Strongly Agree 
Agree 
Disagree 
Strongly Disagree 
Not applicable 

17. Final one on health & care
Example from Caregiver Burden Scale questionnaire
This question was asked of the wife of someone who’d had a stroke
six months previously. The person could not go out of the house
unaided and the carer felt unable to go out for more than an hour
at a time.
Do you sometimes feel as if you would like to run
away from the entire situation you find yourself in?
Not at all 
Seldom 
Sometimes 
Often 

18. Some basic guidelines
Try to avoid:
• Long, complex questions
• Complex terms and concepts
• Asking more than one question at once
• Making assumptions
• Asking by proxy
• Vague quantifiers
• Hypothetical questions
• Agree/disagree questions

19. Some basic guidelines
Aim to:
• Be clear about what constitutes an adequate answer
• Think carefully about mid categories and ‘don’t know
options
• Think carefully about whether rating or ranking are
likely to get the most useful responses
• Think about how the information in your question may
affect the answers you get
• Check how easy the question is to understand

20. Analysis of Effect & Exercise 6
• This is a core requirement enabling the CCG to meet it’s
statutory obligations
• What are the 9 protected characteristic groups? Do we have
any extras in the CCG?
• Anticipatory duty – not just about responding to issues – need
to demonstrate that potential impacts have been thought
through and reasonable adjustments/mitigating factors put in
place
• Check your case studies to see if there is anything else you
want to ask when you engage people
• Would it be useful to collect data about demographics?

21. Informed consent
Discussion about:
• Voluntary participation
• Informing people about what it expected – and what will
happen if they do/don’t participate
• Confidentiality v. anonymity
• Trust:
• Use of people delivering service
• Use of arms length CCG people
• Use of external agencies

22. Exercise 7 – Unexpected responses
In the context of your case
Are there any potential objections
studies, discuss what you can do if: that you can predict in advance?
• People disagree with your
proposals/ideas but the
disagreement is about something
you can’t change.
• People disagree with your
proposals/ideas but there is a
clear evidence base that what
they want isn’t good practice.
• People disagree with your
proposals/ideas and what they
suggest is practical, supported by
evidence but requires you to
rethink your solution.
Are you really being clear about
what is up for discussion and
within your power to change?
What is your timescale – how much
scope do you have to rethink at
the time you end your engagement
and how critical would a delay be?

23. Feedback – Why?
This is about:
• Trust
• Respect
• Honesty
• Openness
• Value
Make sure you tell people how, when and where you will
feedback.
Even if you don’t do what people have asked for, they want to
know what you are doing and why…

24. Evaluation
FRAMEWORK – STEP FOUR

25. Why is evaluation of impact important?
Think in terms of:
• Quality of service
• Cost effectiveness
• Public confidence
• Media and public image
• Evidence for statutory processes
• Building a local knowledge base

26. What do you know about these?
Here are some evaluation techniques and tools:
• Customer satisfaction measures
• Benchmark and tracking studies
• Self-reported outcomes
• Service-recorded health outcomes
• National performance data
Be careful – this is about focus on the patient/population

27. Exercise 8 – The impact of your project
In the context of your case studies, discuss:
• What will be the impact measures you can measure?
• What data do you have (or can you collect) at the start of the
project? Have you built this in to stage 3 (Planning)?
• How long is it likely to take for the impact to be measurable?
• What is the most cost-effective way to gather this data?
• What external data sources are relevant?
• What longer-term follow-up would be beneficial?

28. In conclusion
Action-packed 2 days – hopefully now feel better equipped to
do this by:
• Ensuring clarity of purpose
• Understanding target audiences
• Being clear about what is up for discussion – and what you
want to find out
• Knowing what data sources, colleagues and external
organisations can help with this
• Having a clearly structured process
• Giving feedback to the people you engage with – so they are
more likely to feel positive about the process
• Evaluating the impact of your changes

29. ANY QUESTIONS?

30. Tracy Turley
PLANNING AHEAD

31. THANK YOU