Can you hear us? Public Meetings and the NHS in times of austerity
Those of us who work locally commissioning and delivering health services can be certain of one thing – the next five years will bring more cuts and we will be involved in making decisions about what actions we should be taking in response to these.
This was brought into sharp focus for me recently when the CCG governing body that I am a member of held a meeting in public to discuss making changes to funding to some GPs in the City . The meeting was attended by some 80 people from these practices – with many coming from some of the poorer parts of the city.
What I learnt
Its crucial to allow people to express their concerns first. Many of the people attending had clearly given a great deal of thought to what they wanted to say and had genuine anxieties about their service that they wanted the governing body to hear. It was the case that people who were not used to speaking in public had spent time working out what to say – some writing it out in preparation.
It can lead to a much better meeting if people are given their opportunity to have their say at the beginning of the meeting – this way they help set the agenda – and they are not left sitting there waiting for their allotted slot and wondering if they are will be allowed to speak. Its about respect – we talk about our role being for the public good – when members of the public take time out of their busy lives to turn up we have an obligation to respect their contribution.
Most of us just cannot grasp the scale and complexity of the NHS and its funding. If we are going to move to genuine engagement we need to be really sharp when it comes to describing how the decision that is being discussed fits into the wider context.
We need to:
- set out the relationship between specific funding changes and the wider financial situation.
- explain how the changes that we are considering will practically affect the services that they are concerned about specifically and services as a whole
- explain the role and purpose of the organisations concerned – NHS England, the Clinical Commissioning Group and so on
Some local authorities have realised that they need to be much better at providing information to the public as they seek to manage the awful government cuts to their budgets. I think that the infographics and video produced by Sheffield City Council are good examples of this – others clearly agree – Leeds City Council have used the Sheffield model for their own budget information.
In the NHS – CCGs in particular we need to be doing the same.
People come to public meetings – giving their time – because they are concerned, anxious and committed to an issue. It is crucial that the meeting is managed in a way that not only gives them a chance to have their say but also gives a clear view about what will be done to respond to concerns that have been raised.
It is important that when people leave they go away not just feeling that they have had their say but are clear about what actions will be taken next.
I am not aware of any good practice guidance produced by NHS England on holding meetings in public. I rather liked his piece from the USA Journal of Extension on The Do’s and Don’ts of Working with Local Communities: Tips for Successful Community-Based Public Meetings.
I do not think that NHSE should produce guidance – I think they should fund an expert organisation with a track record of supporting powerful exchanges between citizens and public services to produce it.
What do you think?