National Priorities 2003-04

NHS Lothian – Public Involvement Final

(a)Title of Service:PUBLIC INVOLVEMENT

(b)Local Position

Over the past year we have taken the following steps: -

Each of the three NHS Trusts in Lothian has drawn up plans on how it intends to involve patients and the public more fully in decisions which affect them.

In preparing the Local Health Plan for 2003/04 Lothian NHS carried out an extensive consultation programme with local community groups and partnerships throughout Lothian. At the same time a leaflet was sent to every household in Lothian giving a summary of last year’s Plan. Building on the experience of last year’s consultation we are consulting even more widely on the draft plan for 2003/04.

A successful stakeholders’ day was held on the needs of patients with diabetes. This was well received by users of the service and set a model for future events focussing on specific conditions.

NHS Lothian played a very active part, with each Local Authority, in consultations on Community Plans. This brought a health perspective into the wider arena of local community issues, issues which often influence people’s health.

Building on the experience of the Patients’ Council these have been set up at a number of other hospitals in Lothian. The success of the Patient’ Council at the Western General Hospital has been developed into a structure for Trust wide patient involvement which is currently being implemented.

Patient surveys have been undertaken in several hospitals across Lothian and the results followed up to improve the patient’s experience of the services they receive. In LUHT systematic patient surveys have been undertaken. Repeat surveys have been completed in the autumn and the results of these, when known will illustrate improvements with services since the original surveys in 1999.

£50,000 was invested in the establishment of Patient Involvement Workers in local communities under the guiding management of the Local Health Council.

In 2002 we worked with our partners to develop a framework for Advocacy services across the health service in Lothian. Also we invested £50,000 of recurring funds in further developments in the Advocacy Services, which has been used as agreed with the Advocacy planning group.

Patient involvement workers have played an active role identifying patients/carers from Lothian who are willing to be involved in developing services. In cancer this has extended to the whole of the South-East of Scotland through the SCAN network.

(c) Changes to Improve Services

Develop and secure approval for a Framework for Patient Focus and Public Involvement throughout the NHS in Lothian through a wide ranging participative process.

Working with patients, carers and their representatives and with our partners, voluntary and statutory, draw up and agree an action plan to implement the Framework.

Consolidate good practice in the NHS in Lothian where it is already in place and working well.

Improve partnership working by :

  1. working with and through existing partnerships, networks and contacts;
  2. strengthening participation and partnership where there are gaps;
  3. working with partners at all key stages in taking forward the Health agenda in Lothian.

Promoting public participation by :

  1. improving means of communication and consultation with patients, carers and the public;
  2. sharing learning throughout NHS Lothian and with partner networks and organisations;
  3. training staff to build capacity for securing public partnership and providing appropriate training and information for patients, carers and the public.
  4. providing information and feedback on the outcomes of participation.

Some of the measures NHS Lothian expects to take next year, once the Framework has been agreed, are as follows: -

The Board will hold its meetings in different parts of the Lothians during the course of the year and will publicise its meetings more effectively.

We will review the extensive consultative process on the Local Health Plan, which has been carried out jointly with the LHCCs this year, with a view to engaging the public more effectively, including bringing consultation forward to include the formative stages of the Draft Plan.

All Strategic Planning Groups, or their equivalent, to involve patients in their planning process using existing user and carer groups and representatives where appropriate.

We will review NHS Lothian’s procedures for involving patients and the public in service change and re-design and establish a more participative approach in accordance with the HDL (2002) 42.

Patients will be encouraged and enabled to share in decisions about their treatment and care and this will be incorporated into routine clinical practice.

Patients will not be asked for consent to treatment until they are absolutely clear about what they are agreeing to.

Services will be based on patient-centred care, tailoring services to each individual patient’s needs, not fitting patients into predetermined administrative structures

Patients and their carers will be fully involved in planning their discharge.

The development of the New Edinburgh Royal Infirmary has provided an excellent opportunity to engage with the public through open days and other events hosted by the Trust. This spirit of public involvement is being carried through into the culture of the new hospital.

(d)Outcomes

To have completed a successful, wide-ranging and inclusive consultation on a Framework for Patient and Public Involvement in the NHS in Lothian by May 2003.

To have agreed, in consultation with the public and all our partners, including patients and carers, an achievable action plan to implement the Framework, once it has been approved by the Scottish Executive.

Improved patient satisfaction with the service reflected in the next patient survey NHS Lothian undertakes.

Positive feedback from those patients, carers and members of the public who engage in the patient involvement process. They will be a useful touchstone of whether we are involving them in a meaningful way. Their feedback will be secured by a range of consultative methods including surveys, group discussions and one-to-one interviews.

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