Surrey Heartlands Sustainability and Transformation Plan STP Shaping

Surrey Heartlands Sustainability and Transformation Plan (STP) Shaping the place – the role of local area intelligence 22 May 2018

Who are you listening to… • Rich Stockley – Senior Research Manager at Surrey County Council & Strategic Lead for Citizen Engagement Surrey Heartlands STP • Background – Social Researcher with 18 years’ experience mostly gained in the private sector providing research services for central government • David Chong Ping – Head of New Business at M·E·L Research • Background – Social Researcher with 20 years’ experience gained in the private sector providing research services for the public sector, including local authorities, housing associations, police and fire services, etc

Where, who, what is Surrey Heartlands? • Royal Surrey, Epsom & St Helier and Ashford & St Peter’s Hospitals NHS Foundation Trusts • North West Surrey, Surrey Downs and Guildford & Waverley CCGs • Central Surrey Health • South East Coast Ambulance NHS Foundation Trust • Surrey and Borders Partnership NHS Foundation Trust • Surrey County Council • Virgin Care • Surrey Heartlands GPs http: //www. surreyheartlands. uk/

Why can engagement go wrong? When our organisations speak to citizens what do we hear them say? “We’ve been here before and we told you the same thing last time but you obviously didn’t listen because now you’re back again and you’re asking the same question and we’re going to be giving you the same answer. ” This is because we see evidence of engagement as more important than using the evidence from engagement

What did we want to achieve? • Move from a system of tokenistic engagement to one that’s more meaningful and influences change within the system • Ensure that our system has the right evidence to undertake this work • Ensure that resident / patient engagement is both robust and representative

How did we achieve this? • Formative stage: qualitative research • 7 Deliberative workshops; covering different Districts / Boroughs in the Surrey Heartlands area • Involved 129 residents broadly representative of Surrey Heartlands residents • Core themes discussed included quality, access, location of services, emergency care, prevention and self-care • Clinicians also participated enabling deliberative and open conversations

Using scenarios to promote discussion

How did we achieve this? • Findings from qual stage used to design a face-to-face survey • Representative and random sample of 1, 524 Surrey Heartlands residents • Broad quotas were set for age, gender, ethnicity, and ACORN geodemographic segmentation groups • Needed to have some form of ‘trade off’ questioning to gauge preferences • The trade off questions covered four care topics: general practice (GP), maternity care, urgent care and mental health • Interested if any other segmentation possible

• Provides clearer information about order of preferences than multiple-choice or ranking questions Series 3 • To better understand the importance placed on care features by different types of people Latent Class Analysis (LCA) was undertaken. Series 4 • LCA identifies underlying sub-groups of residents within the survey sample who share a similar set of views in terms of the importance they place on different care features. Series 5 • Features were repeated multiple times in different combinations across 5 or more series of questions Series 2 • Presents respondents with a series of questions, in which each question contains a list of alternatives and they are asked which alternative they like the most (best) and which the least (worst) Series 1 Best Worse Scaling

Example results

What impact did the data have initially? 1. Strong evidence that couldn’t be challenged without more strong evidence 2. Data that was based on what our residents thought was really important in relation to health and care

How have we continued to use the M·E·L data Diagnosed with / at risk of specific condition Representative of those diagnosed with or at risk of a condition within a specific clinical area Broadly representative of the general Surrey Heartlands population and the diversity of the views held there in Pathway / condition: Deep dive into a specific condition. Co-design specific services and understand specific barriers and enablers Workstream / general clinical area: Understand the patient pathways, problems, best practice and desirable solutions Foundation / system: Qualitative and quantitative research with our population to understand what their informed health and care priorities are

What does this process look like for a pathway? 1. Review our existing knowledge 2. Understand the pathway 3. Workstream co-design research and workshop 4. Developing solutions 5. Service co-design research and workshop

How has this changed the way we engage with our residents? We’ve stopped thinking of ourselves as an organisation that works for our residents with fewer… And started to think of ourselves as an organisation that works with its residents doing more… • Hollow Consultations • Tokenistic bits of engagement • Stakeholder ‘management’ events • Co-design methods • Work with groups that are representative • Involving our stakeholders in planning

Our engagement architecture

Rich Stockley – Senior Research Manager e. richard. stockley@surreycc. gov. uk m. 07738 756 659 @The. Naked. Citizen linkedin. com/in/richstockley David Chong Ping – Head of New Business e. david. chong-ping@melresearch. co. uk m. 07885 154536 linkedin. com/in/davidchongping