Parents CAN be persuaded to give daughters cervical cancer jab

The Guardian recently published an article stating that "1 in 5 parents refuse daughters' cervical cancer jab". You may not be aware that this refers to the Human Papilloma Virus (HPV) vaccine which prevents cervical cancer. An immunisation programme will be rolled out in schools to all Year 8 (ie 12-13 year-old) girls this autumn.

To key to ensuring maximum take-up is getting parental consent. The research quoted, is based on a phone survey of @2000 parents and shows that there is a clear body of work to be done to raise public confidence in immunisation. Our own research confirms this but also provides the solution to raising confidence!

We have been using a social marketing approach in Barnsley, to test awareness of HPV vaccine among parents and adolescents but also to gain insight into the behaviours and attitudes of parents and young women so that we can develop a targeted communications programme that will get 90% take-up of this vaccine in Barnsley.

The results were fascinating (e-mail me at aline@thecampaigncompany.co.uk if you want to find out the details) but the key finding in Barnsley was as follows. If you give parents the right information AND you engage them in conversation about the issue then they WILL consent to their daughters having the vaccine. The only circumstances they would refuse would be if there were any doubts about the side-effects. So that's the way forward - reassure and engage parents in the right way. If we use this approach, 400 lives a year will be saved. 

Empowerment to the People!!

Richard Wilson Director of Involve has posted an article on the Guardian Blog about the "empowerment gap" and gives an excellent overview of how the government has sought to tackle it over the last decade.

I commented on it and made 3 points, which I expand on in much greater detail here:

  • As Richard points out there has been a lot of progress, but as a result of many of these initiatives being driven by individual government departments through the relationship with relevant local agencies there has been uneven empowerment development across public sector bodies within localities. So for example, some sections of local government (eg, planning) may be far ahead of other departments in the local authority as well as compared to other local bodies like Primary Care Trust's (PCT's). There would be nothing wrong with this if it were a conscious decision arising out of collective local priorities, but this has actually emerged through many, sometimes unconnected, decisions made at various times in separate Whitehall departments. The next stage could be to develop a combined empowerment agenda at Local Strategic Partnership (LSP) level, to enable local public sector and voluntary bodies to advance together and become collectively more accountable to the communities they serve. Ways to achieve this might include: LSP's to jointly commission single public engagement units in each local government area which would benefit from economies of scale with duplication of savings ploughed back into more engagement; agreeing common local standards to various consultations; strengthening the scrutiny function in local government as well as perhaps even developing a formal scrutiny function for MP's over their own local public services?
  • Capacity building is vital and part of this requires greater investment in community leadership support and training at a local level. This should not just be aimed at Councillors but should also be targeted at less well-off communities. TCC has already done work on developing local community champions for communities covering specific policy areas like recycling, but also in a wider role. This approach can help develop the local leaders of the future and widen their representativeness and diversity. This would be a broader approach than rely simply on the electoral process in a locality to throw up a small number of individuals who might then receive training from their local authority. Early intervention here can widen the pool of local leaders thus helping to build wider local trust in institutions.
  • TCC, in working with PCT's, has discovered that in reviewing services there is an issue around "low expectations" whereby people may say a service is fine because they have no way to compare it with the equivalent in another area: eg you may find that people say they are happy with GP services, even when they do not compare well with somewhere else. This can also be linked to the wider "Delivery Paradox" whereby people say they are satisfied with their local service, but feel the same service is as a whole declining. So far the government has generally relied on league tables and delivery incentives from the centre to drive up some improvement, but if expectations are low in the first place, there is much less local pressure from below on organisations to improve. Greater local democratic accountability is clearly part of the solution, but is probably not enough on its own. Training up "expert residents" in local communities to learn more about what is happening elsewhere and be able to assert themselves as part of a wider community champion scheme might be a way forward to help build a critical mass for higher local expectations. We have formal twinning between Council's in different countries across Europe and even with the developing world, why don't we have twinning within the UK so Council's twin with other Council's to share knowledge and good practice with much of the work being done online to ensure value for money. Most local authorities will have historic connections with many others across the country so the decision over who to twin with could be quite an interesting process in its own right. Twinning could also be taken further so good practice is shared between twinned LSP's and therefore services in areas like health are twinned too.

Increased social capital makes for a more socially cohesive society. Community Empowerment provides an opportunity to challenge complacency at the local level, whilst making people feel they can influence more at a national level.

As Richard says in his article, we don't need countless repeat measures to tell us that. What we need is to use the current broad political consensus in this area to make some clear progress in wider local empowerment in the coming years!

Private Optimism, Public Despair - What can we do?

It has been long known that there is a general perception gap between what people might think of their local hospital and what they think of the NHS in general.

Matthew Taylor, Chief Executive of the RSA, writing in the New Statesman has talked about these difficulties but goes much further with an important and insightful article which looks to the future. He says:

"This perception gap is not restricted to public services, as a recent BBC poll on families confirms. Some 93 per cent of respondents described themselves as optimistic about their own family life, up 4 per cent from the previous time the survey was conducted, 40 years ago. Yet more people - 70 per cent, across race, class and gender - believe families are becoming less successful overall."

He also adds to the point by Polly Toynbee, that we have blogged, on the lack of advocates to tell good news in the public services when it happens:

"In the burgeoning industry of reputation management, it is generally argued that people are much more likely to tell others about bad experiences of services than good ones (5:1 is the usual ratio)."

He argues that trends such as the rise of individualism and the decline of some forms of collectivism combined with the rise of pretty much self-organising global capitalism moving at a rapid pace have created this private optimism and public despair, adding that:

"Globalisation is the gravity of modern society: an unstoppable force that will knock us over if we try to defy it."

Since the collapse of the cold war two systems in 1989 no single person or authority is in control even if some parts of the world are more powerful than others.

He points out that people still see the same broad problems as they did 100 years but now see rapid change as a challenge and seek greater comfort in those close to them.

However, he strikes an optimistic note saying that people are more affluent and healthy and yet there is a danger of some missing out on the celebration:

"Progressives want the world to be a better place. We bemoan its current inequities and oppression - yet if we fail to celebrate the progress that human beings have made, and if we sound as though the future is a fearful place, we belie our own philosophy. Instead, we need to address a deficit in social optimism that threatens the credibility of our core narrative."

Addressing social optimism is clearly a project for everyone. We have previously blogged about Richard Layard's case for increasing overall happiness and David Cameron has talked about the government having a mission to improve people's general wellbeing.

Matthew Taylor makes the case for a New Collectivism to tackle what he describes as the social optimism deficit:

"It is in working with others on a shared project of social advance that we can be reconnected to the sense of collective agency so missing from modern political discourse. It is the attitude of the spectator that induces pessimism, the experience of the participant that brings hope. The problem is not that change brings fear and disorientation (there's nothing new in this), it is that we lack the spaces and places where people can renew hope and develop solutions."

It was challenges like this that brought TCC into being and where we try to assist organisations. He then refers to the sort of change making we should all be attempting together:

"The institutions of the new collectivism must be devolved, pluralistic, egalitarian and, most of all, self-actualising."

This is the sort of approach that this blog argued for and it good to see the arguments so well set out here. He gives a number of examples of where this happening:

"Today, there are signs of a yearning for new ways of working together. There is the growing interest in social and co-operative enterprise and the emergence of new forms of online collaboration. Gordon Brown's citizens' juries are a tentative step in the right direction, albeit without much fun or risk-taking..."

and

"Tackling climate change offers a fascinating opportunity to interweave stories of action at the individual, community, national and international levels."

TCC is working in places like EC1 in London on increasing recycling whilst linking it firmly to the whole issue of climate change through initiatives that engage with young people.

He concludes by making a call for people to build the institutions of the new collectivism:

"Despite the huge impersonal forces of the modern world, people are prepared not only to believe in a better future, but to work together to build it......This potential will be fulfilled only when we provide spaces for collective decision-making and action that speak to the same vision of collaboration, creativity and human fulfilment that progressives claim to be our destiny."

Many of these new institutions of this new collectivism already exist: NHS Foundation Trusts, New Deal for the Communities (NDC's) aspiring to run community assets, social networking sites like Ning, Facebook and Myspace. These are a different set of institutions to perhaps those of the 1945 welfare settlement, but they are a potentially strong mixed economy of institutions nevertheless, and they and other new institutions need support to build a collaborative new collectivism for the future.

In addition there is also challenge for long established institutions, such as local government, to respond to this agenda and to ensure they can relate more effectively to the places where people are optimistic such as within the family unit, whatever size or shape it now comes in. That also means they have to make themselves more accommodating to the places that people are optimistic so they can engage within that space.

Institutions, in whatever form they come and new or old are the arguably finest piece of (social) technology we have created. The Saturn 5 may have put men on the moon, but it was the institutions of the state and their agencies and contractors that put that immense machine together, and educated and trained the men for that mission. Institutions or whatever age encourage collaborative and collective action so as Matthew Taylor has stated the more we strengthen them through peoples involvement in them the more likely we are to rebuild trust and social optimism.

Spieling about health

A fascinating article in today's Times ''Spiel at the wheel?'' discusses how taxi drivers are being harnessed as word of mouth marketeers, with an interesting example about one cabbie promoting the delights of a holiday in Bangkok following a 5 days all expenses trip to Thailand! And - as people become more and more overwhelmed by traditional forms of advertising confronting them in every aspect of their day to day lives - new and different approaches such as 'word of mouth' marketing are having increasing appeal.

This is absolutely our experience at The Campaign Company. In our work with NHS organisations - particularly foundation trusts - we have done considerable work helping Trusts build their membership communities. (Working with over 50 Trusts we've recruited over 160,000 public members - about 1 in 5 of the current public membership) We've found that traditional forms of advertising - the leaflet, the poster, the join on-line form have limited impact. People are much more responsive to a direct ask - particularly one-to-one. And we take this a step further by encouraging 'member get member' recruitment and the development of 'Membership Champions'. Someone who has already joined will be be a powerful advocate to their friends, family and those in groups and organisations they belong to. They'll know how and when to get attention and be able to hone the message to the person they are talking to - because they know them well. And they will be listened to - because they are trusted and known to them - the 'word of mouth' approach in the FT context!

And in their foundation trust members, NHS Trusts have a fantastic resource at their disposal - these people are so well placed to become the 'word of mouth' advocates not just about membership but about the Trust itself - health marketeers! And as 'Patient Choice' becomes more of a reality - Trusts must embrace their FT members as a key element of their marketing mix. These are the people out there in the community; they are the people in the pubs, clubs, workplace, playgroups, bus queues, school gates. Of course - not every member is a 'word of mouth' marketeer - the trick for the Trust is to learn more about it's members - segment and stratify - and find those who are. Then it's about building the relationship - giving them the information and then sinply 'getting them talking'!

And taking this a step further - these people are just so well placed to pass messages back - let the Trust know about the things going well - but more importantly provide quick feedback about things not going so well.  Bad news always spreads so much faster than good news - so Trusts need as many mechanisms as possible to get that valuable 'early warning'! 

Hospitals need advocates!

Interesting statistic referred to by Polly Toynbee in the Guardian last week:

"Research shows patients tell at least 10 people about a bad treatment but only one or two about a good experience. Bad anecdotes ricochet around for years, yet polls show 80% of hospital patients report good treatment."

This illustrates the problem a local hospital might face in promoting the good work it does for the community. One problem can obscure the masses of good work we all know they do.

TCC has worked with many hospitals to recruit members as they become Foundation Trusts. However we believe members role should not just be passive. Foundation Trust members have the potential to sing the praises of their local hospital to everyone they know as well as expressing their general support for the NHS as an institution.

The research that Polly Toynbee refers to shows the need for Foundation Trust members to be engaged and, along with staff and patients, act as a strong advocate for the good experiences that hospitals deliver day in, day out.

Closer to Home - Taking to the Streets!

Last week, we took to the highways and byways of north Cumbria to find out what local people thought about the proposed changes to the healthcare services in their area. 

After a successful day in Carlisle, the team travelled south to Penrith on Tuesday, before making our way through the lakes to Millom on Wednesday.  This was followed by a beautiful coastal drive to Whitehaven and then Workington before finishing up the week in Maryport.

While many claim society is becoming more apathetic by the day, we were met with the same response we get in all of our engagement with local communities : people want to be consulted!!  They are pleased - and sometimes quite surprised to be asked for their views - are are keen to find out what changes are planned and have their say.

We spoke to hundreds of local people in GP surgeries, libraries, shopping centres and hospitals about health issues ranging from acute hospital reform to GP home visits.  The overwhelming sentiments were:

  • People in Cumbria want services closer to their homes
  • People do not want to travel as far to visit their relatives in hospital
  • People support the PCT's commitment to Community Hospitals

Above all, it was fascinating to talk to interested local people about issues that affect them so closely.  Thanks to everyone who found the time to talk to us - it's much appreciated!

In line with the PCT's commitment to engage with as many people as possible, we will be returning to north Cumbria in January to visit some even more rural areas such as Brampton and Keswick - Watch this space!!

What about the FT Governors?

The Local Government Association is today calling for 'NHS Trust directors (to be made) accountable to the elected representatives of the area' - Call for council power to fire hospital and police chiefs .Tonight Gerry Robinson is once again fixing the NHS in Rotherham on BBC2. What these two stories have in common is that they both ignore the potential role and mandate of the elected Governors of NHS Foundation Trusts. And who can really blame them? It must be a cause of anxiety for all FT enthusiasts (of which TCC is one) that FTs are finding it difficult to establish themselves as reference points when it comes to either democratic accountability or as an instrument to drive up service standards.

'Closer to home' gets closer to the people of Cumbria

We have been working with Cumbria PCT over several months now on their 'Closer to Home' consultation for the future of healthcare services in north Cumbria. This week our team, led by Matthew Upton, are taking to the streets of north Cumbria to give local people their opportunity to have their say about the proposals.

Today - Monday - it was Carlisle! Among the places our team have visited - The Lanes Shopping Centre; Age Concern and the Spencer St and Grosvenor House GP surgeries. And so far - so good! People, who would not normally get involved in such a consultation, have welcomed the opportunity to learn more about the ideas and options for the future and have been more than willing to share their views.

What did they learn today?

  • people are concerned about the future for everyone in Cumbria - not just what might benefit them in Carlisle with real recognition of the clhallenges faced in providing 21st century healthcare in a very rural county;
  • people are keen to hear more about service improvements in Cumbria and especially Carlisle that can mitigate the need to travel to Newcastle - especially in the winter!

And - two of the people Matthew and the team spoke to had featured in the DVD we had filmed for the PCT in September - now that makes it a very small world!!

See the DVD and learn more about the consultation at www.closertohome.org.uk 

The end of "Business as Usual"?

Polly Toynbee in today's Guardian comments on Gordon Browns speech to the National Council of Voluntary Organisations in London on Monday where he said politics could not be "business as usual".

The Prime Minister's Speech was made at the same time as the announcement of plans to  to set up independent citizens juries to help the Government formulate key policies - the first jury will meet later this week on the subject of children with a second on Crime and Communities - and a citizens summit to help formulate a "British statement of values".

He also announced a cross-party Speaker's Conference to help tackle the issue of low voter turn-out. Mr Brown said that this rarely-used device would "address the problems of the political system itself" to tackle the problem where "once 84% of people voted, and that was 17 out of every 20, in the last election it was less than 62% - 12 in every 20. In the 1950s 1 in 11 people joined a political party, today it is 1 in 88. Once political parties aggregated views from millions of people, now they need to broaden their appeal to articulate the views of more than the few. In 1987 nearly half the electorate identified fairly, or strongly, or very strongly with a political party, now only 1 in 3 do so. 20 years ago 4 in 10 people trusted the government to put the needs of the nation above those of political parties, more recently it has been only 1 in 5."

The speech itself again reiterated the commitment to greater local involvement where people will influence their beat policing, their local NHS, the help carers get and what schools offer.

Polly Toynbee commented today that, "Brown is right to point to vibrant expressions of civic life in parallel but apart from the political process. Millions of people do good things that never intersect with the waning life of local political parties, joined by only one in 88 voters".

She cautions that, "These promises are tricky. Will each participant protest when not all their views are acted on?"

However she also criticises those who, "dismiss this ambition to reach outwards, the obvious riposte should be: "What would you do?" Now that only 62% bother to vote and millions say Westminster is out of touch, doing nothing is not an option. Let the sceptics offer their own solutions."

Whilst her comments cover the overall proposals, something that she did not refer to was the Prime Minister's answer to questions after the speech where he was challenged to commit to provide more training and support to enable the less articulate to engage. His response was to say, "The Commission on Volunteering in England is proposing, as I think people here know, that we do far more to help train people. I want us to provide some more finance to enable that to happen. It is clearly a challenge for the future that more training funds are available for this and I think we should see it as a central part of what we can actually do to back up the great work that different voluntary organisations are doing and we will try to do that."

If this commitment is significant, then maybe we can say it is the end of "business as usual"?

A lot done...a lot to do?

As we move to a significant change with a new Prime Minster it is perhaps right to take stock of what changes we have seen over the last 10 years.

It is an opportunity to ask the question, to paraphrase our Company strap-line: "Does Democracy work better?"

Inevitably for any government managing a complex developed society the results will always be mixed, but it is arguable that simply on the basis of significant constitutional change enacted early in the present government that there are far more opportunities for the public to vote and to engage.

The fact that the people of Scotland can have a significant debate on their future as they are currently doing is something that would not have been able to happen 10 years ago!

So what are the areas we have seen change and what are the challenges for the future:

Health

We now have an increasing number of large membership Foundation Trusts. TCC has done a lot of work helping Trusts to develop the representativeness of their membership base. For the future it will be interesting to see whether Gordon Brown takes up the idea of an Independent National Health Board and whether we see a directly elected element on Primary Care Trusts?

Education

The development of Academies and Foundation Schools is slow. Governing bodies still have difficulty attracting people to stand. It will be interesting to see whether remuneration will be introduced and whether local membership schemes for schools or more likely for groups of schools similar to Health Foundation Trusts will ever be piloted.

Citizenship Education was introduced. This is likely to have a significant impact but probably over the longer term. TCC has developed initiatives in this area such as its Young Mayor Schemes, which enable young people to take much greater responsibility locally.

Crime and Justice

The Freedom of Information Act and the Human Rights Act were landmarks as the government itself knows having lost cases under them. At the same time modern threats such as trans-national terrorism are forcing an ongoing debate on civil liberties.

For the future, the direct election of Police Commissioners may go up political agenda.

Constitutional Issues

The establishment of the Scottish Parliament and Welsh Assembly are having a significant impact not just on their own areas but on how the English define themselves. It is likely there will need to be further review on these relationships, with the previously fringe issue of an English Parliament moving further into the mainstream.

The use of proportional representation has increased with Euro elections, the Scottish Parliament, GLA and Welsh Assembly now being joined by the Scottish Local Government Elections. It is likely that as the possibility of a hung 2009/10 Parliament looms that further extensions such as English Local Government will be considered with even a possible referendum on Westminster elections on the agenda.

The Good Friday Agreement in Northern Ireland has with many false dawns slowly led to a long-term power sharing agreement in Northern Ireland, which should be in place the day before Tony Blair announces his resignation.

The slow pace of reform to the House of Lords may at last be resolved with the House of Commons coming to a likely settled view that 80% of it should be elected. However it still likely to be years before any reform is complete.

Party Funding whilst made substantially more transparent is clearly still controversial with no clear consensus as to future change in terms of local and national capping and donations, however reform of the Honours System is likely to be due for an early review once the current Police investigations are resolved.

Another possible change for the future is the possibility of future Parliamentary votes on the deployment of British troops.

Local and Regional Government

There was change with more unitaries, the establishment of the GLA, a power of general competence and the abolition of CCT. However elected Mayors did not take off (perhaps because they were seen as to "top-down") and the move to strengthening the local role of Councillors as "Mini-Mayors" is, if resourced, likely to be more significant in developing a bottom-up approach in this area. Local Government Finance, remains an area of caution and whilst that is the case it is likely to hold back further local devolution.

There was significant investment in regeneration with numerous communities benefiting. However these is still a lot to do and TCC has worked closely with the New Deal for Communities (NDC) to raise the profile of very deprived communities.

Environment and Culture

Free entry to museums has contributed to many more people visiting them, which is surely good for a civilised and engaged society. Winning the Olympic bid is likely to see substantial redevelopment in the Thames Gateway area, however TCC's work on community engagement in this area demonstrates the need for ongoing communication with communities affected by rapid change.

Climate Change is increasingly an important part of political debate. As the recent online petition on congestion charging and the furore on fortnightly bin collection has shown many in the public express concern, but still do accept the need for significant lifestyle change. This is an area for much wider engagement and TCC is working on practical projects in this area to raise public awareness.

Economy and Trade

Trade Unions as large members organisations operating in the economy are increasingly seeing the need to break out of traditional ways of working. The merger of Amicus and TGWU to form Unite with the aim to create a global union in response to globalising economic trends is a significant development. The Government has invested in the development of Union Learning and Union Modernisation and TCC has worked with many unions to improve the way they work in the modern workplace.

International

Both EU and UN institutional reform have been very slow despite all the efforts of the government to move things forward. This is an area where change is measured over more than a long-serving prime-minister's term. More effort now seems to likely to be invested in "soft-power" and "cultural projection" after liberal interventionism, successful in Kosovo, was found to be not enough on its own in Iraq. As a result the expansion of the work of the Westminster Foundation for Democracy is an area the government needs to look closely at. TCC has also worked in helping to build democracy in a range of transitional and developing countries and knows the benefit of this work.

Conclusion

In the words of the song, from democracy's point of view, after many years of mainly market led and individualist reform, "things could only get better". However as illustrated above whilst a lot has been done, there is a lot more to do. The fact there is much greater consensus between the major parties in this area compared to the 1980's is likely to ensure that the changes that do exist are likely to survive and that further change is likely to happen.

That is a "legacy" that some people might even want to be proud of!

'Wicker' alternative

What do you do when you are sick? Easy question, I go to a doctor – most people would say. Sometimes, however, it is not so easy after all – when you have a full-time job, it just seems too much hassle to take a day off and spend hours waiting in a line for a 10-minute doctor’s examination. Most of us would probably seek help after working hours in A&E departments or simply grit our teeth and wait for the problem to go away.

However, in some places it is possible to get medical advice on the spot which, in those cases where the health problem is mild, saves the time we would have to spend waiting for appointments and takes a lot of pressure off the strained healthcare system.

The Wicker Pharmacy in Sheffield is an example of how sometimes healthcare can be made readily available to people. The pharmacy provides a wide range of services for which we usually would turn to a doctor or a clinic. It operates a minor ailments scheme where the pharmacists can diagnose problems and provide treatment right away. It also provides services such as smoking-cessation program, drug addiction treatment program, free emergency contraception, screening services for diabetes and cholesterol – to mention just a few. This practice, if replicated in other pharmacies, could enable doctors to give more time to medically urgent cases. Perhaps in the future when we really have to see a doctor, we will not have wait for ages.

NHS Trusts: Service usage and govenorship

Meetings with a new prospective client have generated some interesting research and discussion at TCC about the potential linkage between service usage of Trusts among BME communities and the development of their govenorship structures.

Underusage of hospital services by BME groups can be a factor for Trusts, similarly Trust govenorship structures often suffer an under representation of BME groups. It is vital for the success of democracy in Foudation Trusts that all sections of the community see themselves represented at all levels within it's govenance.

TCC are hoping to work with these communities in future in partnership with Trusts to show that these issues go hand in hand. Participating in a Trusts govenorship will give leaders in BME communities the opportunity to shape Trusts policy to ensure its services are fully available to their community. It will also give the opportunity to learn about and promote Trust services within their communities.

This is set in a context were BME communities tend to have a significantly worse self reported health than the average for the general population (see ONS report)

Who else wants to deliberate on health?

We've been working with the Sheffield Primary Care Trust (PCT) helping them with their 3-month consultation on the future of health services in Sheffield. Last Saturday we ran a 'Deliberative' consultation drawing in a diverse group of 80 'seldom heard' citizens of Sheffield.

We prepared for the event by undertaking a telephone survey of 1000 people. This helped us gauge levels of physical health and well-being as well as a sense of the numbers of people using primary and acute care services across the city and their experiences of them. We found people generally well satisfied with their experiences but our survey absolutely confirmed a major concern of the PCT - that of very heavy usage of both primary and acute services.

These issues - and that of major inequalities of health across the city - were taken forward into the 'Deliberative' consultation. Following 2 scene setting DVDs filmed in the city earlier in the week, a range of ideas about alternative ways of delivering health care and attitudes towards them were considered. We used a combination of qualitative and quantitative techniques:- expertly facilitated 'round-table' discussions to gather qualitative feedback and 'Who wants to be a millionaire' audience participation software for the straight quantitative feedback.

Our participants were delighted - and many quite surprised - to have been consulted in this way. They worked incredibly hard for the four hours they were with us and came up with a number of really excellent ideas:- like 'street doctors'; making better use of existing community facilities by having 'walk-in centres' in schools and 'workplace nurses' to mirror the 'school nurse'. What was one of the biggest factors to be overcome in getting a very realistic audience to stop 'cutting out the middle-man by going direct to A&E'? - greater understanding of the skills, training and experience of other health care professionals so they can 'trust' people other than 'the doctor'.

And the early conclusions we drew from the event - there was an understanding of the need and willingness to accept 'redistribution of resources'; partnership working was essential give many of the causes of ill-health require non-health service solutions; personal responsibility was an important factor - but people need help to help themselves; people were willing to see and take advice from other 'health professionals' but they need to know more about them in order to 'trust' and finally - good and targeted information about what is available - but not too much of it!

'Writing on the Wall' at the Liverpool Womens Hospital

Last Wednesday Kasia and I were in Liverpool running a 'Writing on the Wall' event for the Liverpool Womens Hospital (LWH). The event was part of a public consultation on the future provision of breast cancer services in the city.

Govener_and_staff

Currently the breast cancer services are split betwen the LWH and the Royal Liverpool Hospital (the Royal). The PCT is proposing to unify the service at the Royal, prior to making this decision they are undertaking a public consultation.

We had a great day meeting staff, goveners, patients and visitors to the hosital, talking about the issues involved, giving people the PCT consultation document and asking people to write thoughts on our wall about the LWH and the issue of the breast cancer service.

Staff_writing_1Everyone we talked to had a view on the issue, many of which where passionately held. Within a few hours the wall was filling up with peoples comments. Some of the quotes included:

'Keep a womens service in a womens hospital'

'LWH is a safe place for women which delivers great care'

and

'Let our cups runneth over with support for the Breast cancer service'.

Goveners_and_kasia

The LWH feels that as the citys womens hospital it is best placed to deliver the breast cancer service, it will be continuing to argue it's case at a series of public meetings through January.

Patient choice - interim results in..

The department of health has just published the results of a recent survey carried out to assess the impact of patient choice at primary care level, view here. Some interesting threads have come out of it - seems a lack of awareness of patient choice is one of the main barriers to people feeling they have real choice over their treatment. Also, transport links and location of hospital is the main factor for people when choosing a hospital currently, but obviously when patient choice and websites like patient opinion get up and running, this may change. What does everyone else think about this??

Healthy Democracy

I've just received a copy of ‘Healthy Democracy: The Future of involvement in health and social care’ which was launched last week. Produced by Involve and the NHS Centre for Involvement, it includes chapters by Anna Coote of the Healthcare Commission, Harry Cayton, Director for Patients and the Public, and Sue Slipman of the Foundation Trust Network,  amongst others. It can be downloaded at: www.involve.org.uk/health

Member recruitment TCC style

As friends and clients alike will know, we at TCC do a lot of work on behalf of applicant Foundation Trusts and any organisation in the health service wishing to engage with their local community.

One product in particular seems to have sparked some controversy - the recruitment of FT members. The TCC method includes a mixture of face-to-face, telephone and affinity partnership work. Either talking to someone directly or tapping into organisations with a Papworthrecruitment real interest in the Trust's work yields fantastic results. And the numbers we achieve support this. Joining an organisation is not just about ticking a box; it's about being aware of the organisation's work and supporting what it does. And contact in the initial stages with a Trust representative is really important to ongoing success.

We feel we provide a really cost-effective service. And furthermore, we guarantee the members. But others might not agree – could we do anything to improve the service? Are we too expensive? Let us know…

Have you Seen & Heard about this...?

Pict0329 I’ve previously blogged on these pages about our youth engagement work with BarnsleyHospital. Last night the Lord Mayor of York presented David Brannan and Brian Whitaker, two of the Trusts’ public governors, with an award recognizing these efforts.

The BT ‘Seen and Heard’ Awards are all about recognising young people that have made their voices heard and adults and organisations that have listened to young people. Barnsley Hospital was in the adult winners group for being 'a great example of how organisations can effectively listen to young people and act upon what they have heard'.

See and Hear Barnsley young people giving their views here. For more info on the BT Seen and Heard Awards click here.

You can't scare people into getting fit or going green

New research published today by the Economic and Social Research Council shows that positive, informative strategies which help people set specific health and environmental goals are far more effective when it comes to encouraging behaviour change than negatives strategies which employ messages of fear, guilt or regret. Click here for more info on the report.

Trust Youth

Trustyouth_cover_small Clients such as NDCs, NHS Foundation Trusts and similar organisations may find ‘Trust Youth’ helpful. In partnership with CRAE and the Governance, the British Youth Council has launched Trust Youth, a guide on what being a trustee means for children and young people and how to recruit them. The guide has been developed which children and young people; it explains what the National Occupation Standards for Trustees and Management Committees mean in words that children and young people can understand, as well as outlines the practical steps organisations can take to recruit young trustees.

Ft Consultation on the road #2

The roadshow has now come to an end with Cumbrian towns of Barrow, Kendal, Penrith, Workington and Carlisle safely under our belts. And what a roadshow it's been....!

Our team were fantastic - working hard to talk to as many people in these town centres as possible, explaining the Trust's Foundation Trust application, recruiting members, P1010220_1advertising the public meetings, getting people involved in the graffiti wall, doing vox pops, editing short films...! It was a mad few days but the team succeeded in talking to over 400 people during the week and organising five public meetings in the evenings.

We gave out almost 200 consultation documents and got feedback on the application from loads of the people we spoke to. The local press also were also keen to get involved, with photographers and reporters turning up in Barrow In-Furness and Workington - see examples of pieces in Carlisle and  Whitehaven.

One of tP1010216he most successful aspects of the roadshow was the vox pop filming we did in town centres. During the day we asked shoppers to tell us their views on the proposals and put their thoughts to camera. Every evening we previewed a rough cut edit of the week's vox pops. People loved seeing themselves on camera and loved even more the different backgrounds of each town centre! You can view the final film here:

The Trust were fantastic, they had a real 'presence' at the meetings and  it was clear that they were really passionate about the values behind the application. And the consultation doesn't end there - we are conducting four focus groups with stakeholders next week and holding telephone interviews until the consultation finishes on the 16 October.

Remember when August was a quiet month...

Time was, that August was the opportunity to sit back and relax, and think about the previous months' hard work and autumn's challenges.

No longer!  This week sees TCC undertaking a major consultation exercise in Cumbria, working in London with the Department of Work and Pensions, Ministers and a collection of young people from all over the UK developing strategies for combatting child poverty and undertaking focus groups for the Bakers' Union in Guisborough and laying the foundations for a Democracy Wall in North Yorkshire.

Look out for regular updates on all of these in the blog!

Sports Clubs encourage healthy living amongst young people

Footballers are not always the greatest role models, but this paper outlines a few examples of initiatives working to ensure that young people and children get a healthy start in life. For example, North Manchester Primary Care Trust has worked with Manchester City FC, getting its players and staff to talk face to face with young people about their health, including tackling the issue of STIs amongst young people and working alongside parents and teachers to encourage children and young people to eat more fruit and vegetables and to exercise more. The sports charity, Saracens Foundation has also workeding with St Albans and Harpenden Primary Care Trust, Watford and Three Rivers Primary Care Trust, and Dacorum Primary Care Trust to tackle childhood obesity by encouraging school children to do one hour of physical activity each day for six weeks and introducing a Saracens’ approved packed lunch.

Barnsley Hospital - Sees and Hears Young People!

Barnsley Hospital NHS Foundation Trust has been highly commended by the judges of this year's BT 'Seen and Heard' Awards and awarded a regional award for providing 'a great example of how organisations can effectively listen to young people and act upon what they have heard'.

We recently worked with the hospital, Barnsley Youth Service and Connexions to involve young people more effectively and to boost NHS Foundation Trust membership amongst young people in the area. This included a series of facilitated meetings with one of the subgroups of the Trust's Council of Governors - the Futures group - and young people from the Youth Council and Connexions to discuss their concerns about health matters and their local health service. As a result of these meetings there were immediate changes, e.g. changing terminology from 'adolescent' to 'Young People' at young peoples' request, and involving them in the design of leaflets aimed at young people, thus ensuring an effective peer-led approach to communications. We also organised with the Youth Service an event for 13-19 year olds that raised awareness and promoted involvement in the Trust. 'The Session', held in a local nightclub, featured live bands and DJs, as well as various stalls and workshops on health issues. TCC also produced a DVD of 'vox pops' of young people giving their views on the hospital - watch the video online here. The boys talking about hospital telly are my favourites!

More information on the Seen and Heard Awards on the BT 'Am I listening?' pages here.

Easy Read Guide to Voting

Applicable to all sorts of situations where elections might form part of the process- http://www.electoralcommission.org.uk/files/dms/EC-Easyguidetovotinglow_22216-16478__E__N__S__W__.pdf

Foundation Hospitals

This is a paper commissioned by our freinds in HSLP-good basic briefing note on FTs

http://www.hlspinstitute.org/files/project/102631/Foundation_Trusts.pdf

New era of patient involvement in the running of health services

When we talk about user empowerment it is often in the context of Local Government-or when we do consider the NHS it has been through the prism of Foundation Trusts.

But yesterday saw the publication of plans of to give patients more power and more say over how their local health services are organised and run. Primary Care Trusts (PCTs) will for the first time be required to formally respond to public petitions if more than one per cent of the local community are unhappy with a particular health service. http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4137226&chk=D2YSig

Further as part of the reforms to put patient preferences at the heart of the decision making process, Patricia Hewitt also announced new arrangements for organised patient involvement. These changes will build upon the existing 'patient forums' by establishing new Local Involvement Networks (LINks) designed to have more clout to influence services both in hospitals and in community settings. http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4137040&chk=U6PSmq

The new guidance - Health Reform in England: Update and Commissioning Framework sets out how PCTs will work with local clinicians to:

* improve the health and well-being being and reduce health inequalities;
* secure access to a comprehensive range of services;
* improve the quality, effectiveness and efficiency of services;
* increase choice for patients and ensure greater responsiveness to people's needs; and
* achieve best value for the resources allocated to them.

In delivering each of these objectives, PCTs will be required to involve patients in how services are organised. In addition, PCTs will be expected to publish prospectuses that set out an assessment of the local needs and the quality of current services, patient satisfaction levels and plans for future investment.

How Green is the NHS?

Interesting speech by Anna Coote - http://www.sd-commission.org.uk/publications/downloads/Greening_the_NHS_by_AC.pdf. It's looking at the role of the NHS in the sustainability aggenda,drawing attention to how large a force it is in the world of procurement,how many journeys its activities generate etc etc.It also highlights that whilst global warming is the biggest Public Health issue ever,sustainability hasn't really managed to climb as high as it should on NHS Trusts and managers priority lists.

60% of NHS trusts admit failings

Can't help but feel a little depressed by the slant of the Guardian lead story today - 60% of NHS trusts admit failings.  Here we have a system of self assessment introduced to encourage self diagnosis of any service shortcomings - presumably this is an essential first step to improvement, and those trusts that take the excercise seriously are pilloried for their honesty.  As the Chief Executive Brian Aird,  told the Guardian: "The trust's failure to meet 19 standards for better health is a cause of grave concern for us. However, we have found the [commission's] health-check process extremely useful as it has quickly and accurately identified every area needing improvement." Hospital placed itself on critical list.Far from being attacked you might hope that trusts would be congratulated for being transparent about their shortcomings and being seen to take action to deal with them.

FT Governors under pressure and this won't be the last time

On the local news tonight was a story about a 'many thousand' signature petition being delivered to the Governors at Chesterfield NHS Foundation Trust. The concerns of the signatories was around proposed staffing and budget cuts - an unfortunate reality for many NHS Trusts. I wonder just how well these Governors - and others who will come under similar pressures - feel they are prepared to deal and respond to this? The move to Foundation Trust status shifts the accountability from the Department of Health to local people - members and Governors of the Trust. So of course - the concerned public and staff are quite within their rights to lobby Governors. But how do Governors respond? I'm an FT Governor too (in my spare time) and it really struck me how this demonstrates the inward / outward facing role of Governors and the very unique situation they are in. Here at TCC we do a lot of training and development work with FT Governors and we need to look at how we can further develop our training to ensure we prepare and equip Governors (and Trusts) to face and deal with such situations with confidence. Are there any other Trusts and Governors out there who have had similar experiences?

Welcome to the TCC Blog

The Campaign Company (TCC) is a communications consultancy. 

We believe that the success of organisations depends on their ability to connect with people. This connection can only happen when there is a lasting and genuine dialogue between themselves and the communities they serve.

This connection ensures that organisations make good decisions that lead them to thrive – because better decisions are made when people have had the opportunity to participate more fully in the decision making process.

We work with many local authorities, health trusts, New Deal for Communities, Trade Unions and other bodies to increase member or public participation in decision-making processes.

We have extensive experience in community engagement, membership development, strategic communications, issue-based campaigns, political management, youth engagement, fundraising, democracy development, public opinion research, event management and marketing

Our experience and record of success in encouraging and increasing public participation, coupled with our agility and unique package of skills puts us at the cutting edge.

We have decided to launch a blog to better engage with our clients.  We hope that you will find it useful and feel able to contribute to it.