sarah picWhen I go to meetings for Involve, there are a few points that I find myself making time and again. One of these is the need for decision-makers to engage both individual members of the public and community and voluntary organisations. These two sets of stakeholders are not the same, and engaging one of them is not a proxy for engaging the other.

Usually I make this point because a project is only engaging local organisations. But when it comes to the health sector and Patient and Pubic Engagement (PPE) the opposite can be true; there is so much focus on individual patients and residents that civil society can be forgotten.

This is a missed opportunity. Yes, like all sectors, the community and voluntary sector has imperfections. But community and voluntary groups can often be a vital resource for organisations like clinical commissioning groups and health providers in seeking to improve services and health and wellbeing outcomes. The ways in which they can do this through PPE are at least fourfold:

  1. Helping engagement projects to reach people who may not otherwise engage: The strength and quality of community and voluntary groups’ links with local people varies by organisation. Many however run events and/or services and are trusted figures in the community. By involving these organisations in PPE, commissioners and providers can increase their reach, particularly to people who might not otherwise engage. This might involve asking local organisations to run engagement activities or co-host events. The community and voluntary sector is also often well-placed to advise on how to engage a community – the most appropriate methods, language, framing and messengers required. This knowledge is invaluable.
  1. Identifying potential engagement partners and advising on take-up: As well as individual organisations’ expertise in reaching particular communities, the community and voluntary sector can also play a strategic role. When I recently reviewed Newham Clinical Commissioning Group’s PPE, one interviewee suggested that key figures from the sector could form an advisory panel. At the beginning of planning engagement work, CCG staff would go to the panel to tap into their knowledge about which local organisations were working on the relevant issue and how much civil society interest their might be in the project. This would provide intelligence to inform the engagement strategy and method choice for the work.
  1. Sharing their reflections on, and experiences of, services: Community and voluntary organisations are likely to have reflections on existing health services, particularly if they support a community with accessing health care, or people talk to them regularly about their health issues. This is a valuable body of knowledge, which should be recognised and accessed. It is however important to use it in the right way and with care. Information from organisations with weaker ties to the community may need corroboration. Even organisations with strong links can only provide certain, critical, inputs – about the situation as they’ve perceived and heard it, and their own views on potential solutions. This is different from running a workshop for patients and residents to hear about their ideas, preferences, experiences and needs in their own words and from their own perspective, to get them to prioritise changes (if relevant) and understand the reasons for their choices. As already stated, engagement of both the community and voluntary sector and the public is needed.
  1. Flagging problems early: One appropriate use of local organisations’ knowledge and experience is as a warning system, to flag emerging or existing problems. The community and voluntary sector is often the first port of call for individuals facing significant and/or multiple challenges. Partly as a result, it can have a wealth of information on how policy and services are affecting people locally. Building an early warning based on this knowledge could be done in various ways. There could, for example, be an annual workshop or survey for the sector to feed into decision-makers’ priority setting, , and/or quarterly meetings of a smaller group to provide more frequent input. The appropriate mechanism would depend on decision-makers’ ability to act on any issues raised; a quarterly meeting would be meaningless if nothing could change as a result of the feedback received.

In seeking to work with the community and voluntary sector there are a number of key issues for health organisations to consider. These include the need to recognise the context within which community and voluntary groups operate – as regards funding, timescales and so on – and not to treat them as a free resource. These considerations should not however be difficult ones to address and balanced against them is the real drive of the sector to improve the lives of the people they work with, the wealth of expertise they hold – and their willingness to work with health organisations and others to achieve change.

Image credit: Nancy White, flickr creative commons