PPI Standards Workshop Report Introduction The Public Health Agency (PHA) invited a wide range of people to attend a workshop to develop PPI Standards, focused on outcomes. Participants came from a range of backgrounds in health and social care and those with experience of receiving health and social care services as patients, clients and carers. A set of Personal and Public Involvement (PPI) process focused standards have previously been developed and have now been endorsed by the DHSSPS. These cover: • PPI Leadership • PPI Governance • Opportunities for Involvement • Annual Reporting The workshop on the 7th November 2013 was held to support the development of additional PPI Standards focusing specifically on the outcome of PPI. These cover: • Knowledge and Skills • Information and Communication • Measuring Outcomes

This report outlines the feedback received on the proposed Standards and KPI’s presented and how we used the comments received to shape the Standards. Background The development of PPI Standards was highlighted as a regional priority by the Regional Health and Social Care (HSC) PPI Forum. The PHA engaged with the Department of Health, Social Service and Public Safety (DHSSPS) and secured agreement to progress with the development of draft standards for their consideration. Once agreed these PPI Standards will be used as a basis to measure the implementation of PPI on a consistent regional basis. As a legislative requirement, set out in sections 19 and 20 of the 2009 Health and Social Care Reform Act, the implementation of PPI is a priority for HSC bodies; however with the introduction of this statutory duty to involve there were no clear and definitive standards or measures of progress agreed. This important piece of work was progressed by the PPI Standards Subgroup of the Regional Forum. The group consists of service users, carers and health and social care PPI staff. The first stage in the development of Standards looked at PPI process standards, as the first step to embedding PPI into the structure and governance of HSC bodies.

The subgroup have also developed a set of draft outcome based PPI Standards and KPI’s which aim to measure the outcome of PPI across HSC organisations in Northern Ireland. The PPI Standards workshop was organised to gain the views of stakeholder groups including service users and carers, HSC staff and the community and voluntary sector. Format of the workshop The workshop was designed to gain input from a wide range of stakeholders and hear different perspectives on what a successful outcome in PPI looks like as well as the draft PPI Standards and KPI’s. Michelle Tennyson Assistant Director for Allied Health Professionals and Personal and Public Involvement introduced the workshop. This was followed by a series of round table discussions where attendees were asked a number of questions about the proposed Standards and KPI’s. The questions we asked each group were: 1. Does the proposed standard for support better outcomes for Personal and Public Involvement and ultimately for people who use health and social care services? 2. Do the proposed Key Performance Indicators (KPI’s) give a good indication of how well the standard is being progressed? 3. Do you have any suggestions to strengthen this proposed standard or the Key Performance Indicators?

How feedback was gathered Members of the PPI Standards subgroup facilitated discussion, each focusing on one Standard, with each of the workshop groups. Feedback was gathered by the facilitators from each group and key issues were identified, this information was then used by the PPI Standards Subgroup to help review and shape revised Standards and KPI’s.

Feedback Received The Standards and KPI’s were welcomed as a useful tool for staff and service users to have an agreed benchmark against which to measure PPI progress. Feedback also suggested that having visible PPI Standards and KPI’s is important from an organisational point of view, identifying PPI as an integral part of how HSC services operate. Overall participants agreed that the standards chosen were appropriate and adding to the existing four standards will provide a comprehensive basis for measuring PPI across HSC services. Participants raised the importance of service user and carer involvement in the monitoring and review process of the standards and in the performance management of PPI using the standards as a basis.

What we have done based on the feedback During the workshops a number of key issues emerged, these are highlighted below with an explanation of what changes were made or how the feedback will be used as part of the ongoing process. Knowledge and Skills

You said

We did

The Standards should look at

We reviewed the Standard and KPI’s

number of training opportunities,

and developed a new KPI to capture

staff trained, number of training

this information.

courses, and % of staff. What is the definition of

We reviewed the wording of the

comprehensive?

Standard and revised to provide greater clarity, removing the subjective word comprehensive.

KPI’s should be about how many,

We reviewed the KPI’s to include

by when and should be able to be

more quantifiable data.

evidenced. Develop a range level of training

A regional PPI training programme is

Add on to already existing learning. being designed to include a range of PPI training at different levels.

We added a KPI which asks for information on the level of training undertaken by staff. Service users being part of the

We included a new KPI asking for

delivery of training.

evidence of service user and carer involvement in training (not only in PPI training).

Standard wrong-does not include

Reviewed the Standard and included

everyone.

mandatory training for all staff.

Information and Communication You said

We did

Clarify two-way communication –

Reviewed the wording of the

between whom? Public and HSC

standard and included clarification of

staff.

who the communication was between.

The use of the term ‘timely’ - this

Reviewed the wording of the

would need to be improved as there

Standard and kept the word timely in

are currently long waiting times to

the standard, but added a new KPI

receive any

that requires HSC organisations to

communication/feedback-if any

publish PPI feedback within an

provided at all.

agreed timescale.

That what we actually communicate

We reviewed all the standards and

is very important, for example, the

in line with comments from the

sharing of good practice helps

monitoring outcomes standard we

people learn by example as well as

included the requirement for HSC

keeping updated.

organisations to record and publish all outcomes of PPI (positive/ neutral/negative) to encourage learning and sharing of best practice.

It is important to demonstrate to the

Reviewed the standard and KPI,

public how the communication

included a new KPI requiring HSC

methods are working – again by

organisations to demonstrate that

exploring the use of assistive

they must communicate with service

technology/social media

users, carers and the public in a clear, understandable way when planning, implementing and evaluating all PPI activities.

That a general centralised area for

The PHA is taking forward a

information would be most

proposal to DHSSPS to re-develop

beneficial. The ‘ENGAGE’ website

the ENGAGE website.

was mentioned and could be used as a repository for PPI activity and examples of good practice across the Trusts and HSC Organisations.

Measuring Outcomes You said

We did

These indicators are hard to

Reviewed the wording of the

measure due to the wording - what

Standard and KPI’s to reduce

is effective to one person may not

subjectivity and focus on measuring

be effective to another.

PPI outcomes.

Service users and carers should be

The PHA has established a PPI

involved in the monitoring process.

Performance Management Group which has only Service User and Carer membership (facilitated by the PHA). It is planned that service users and carers will be involved in the development

Revised Standards

Knowledge and Skills HSC organisations will provide mandatory PPI training to enable all staff to deliver on their statutory PPI obligations.i Proposed Key Performance Indicator: HSC organisations will record and report on: • Baseline of staff trained in PPI • The number and grade of staff trained to undertake PPI on an annual basis. • The type and level of training offered and the type and number of service users and carers involved in the delivery of training • The number of service users and carers involved in the delivery of all staff training (not just PPI).

Information and Communication HSC organisations will provide timely, accurate, user friendly information to facilitate effective two way communication with service users, carers and the public. Key Performance Indicator: • HSC organisations will demonstrate that they communicate with service users, carers and the public in a clear, understandable way when planning, implementing and evaluating all PPI activities. • HSC organisations will provide and publish feedback on all PPI activity to service users, carers and the public within an agreed timescale.

Measuring Outcomes HSC organisations will measure the outcome of PPI activity. Key Performance Indicator: HSC organisations will record and publish: • The outcomes (positive/ neutral/negative) achieved by using PPI approaches. • The number of service users and carers involved in the monitoring and evaluation of PPI activity.

i

HSC Reform Act 2009 HSC Guidance on strengthening personal and public involvement in health and social care 09/2007 HSC Guidance for HSC organisations on arrangements for implementing effective personal and public involvement in the HSC 09/2012