Power/Interest grid for stakeholder prioritization
10 minutes on slides, 20 minutes on the role play, and 15 minutes summarising?
Provides focus to the group and stimulates discussion to encourage constructive debate between group members. Supports the group to bring out information from introverted members of the group and to allow new ideas to be submitted. Participates when the group is interacting poorly or in the wrong direction to promote new discussion. Acts as a team builder to form a cohesive, interactive and productive team. Referees group discussion, discouraging participants from talking at the same time, or dominating the floor. Protects participants to ensure that all contributions to the discussion are treated equally and that no-one is rebuffed for their input. Controls problem people within the group allowing everyone to participate freely. Time keeps to make sure everything on the agenda is covered Neutral Is pragmatic and neutral and frees the facilitator to concentrate on the group rather then the content of the discussion and hence they can ask pertinent and stimulating questions Encourages feedback to promote discussion of each point raised, by all members of the group.
Discussion around how facilitation is important within a focus group. Overall tips:
Sadaf to speak to MR to see if we have examples from any focus groups we may have conducted in the past Maybe include examples of questions NCS have used in previous focus groups to seek opinions of neurology/epilepsy services
CP and SA to discuss Cards to be printed off with each type of person- quiet person, angry person, emotional person, Possible topics for group debate: Do women make better politicians than men? Advertising creates artificial needs- true or false? Do celebrities earn too much money? Should the government have a say in our diets? Epilepsy related discussion topics: Possibly around stigma/medication/attitudes of health professionals
The art of engagement…A practical guide to turning patient views into meaningful data
Aims of the day• To turn information into relevant key messages tailored to engage different stakeholders (e.g. local commissioners, providers, people with epilepsy)• To understand the process of service user engagement and be equipped to carry it out• To practice the facilitation skills needed to collect qualitative data from service users in a local area• To analyse information mapped to identify gaps in service provision• To understand the different types of health data within a local authority area or health economy and how to access public domain and UCB data• To understand presentation of numerical and graphical data• To collate relevant data to map existing service provision
Programme9.00- 9.30 Arrival and coffee9.30-9.40 Welcome, introductions and expectations for the day9.40-9.50 The importance of baseline data – setting the scene, Charlie Peel9.50- 9.55 Questions9.55-10.05 Introduction to the workshop – what we’re doing and why10.05-10.35 Step 1: Finding your stakeholders Step 2: Deciding how to access them10.35-10.40 Break10.40-11.20 Step 3: Gathering the information11.20-12.00 Step 4: Analysing your findings12.00-12.50 Step 5: Presenting your findings12.50-13.00 Opportunity for any burning questions13.00-14.00 Lunch14.00-16.00 UCB session on data16.00-16.30 Reflection on original hopes for the day Agreement of future action, and close
Understanding an area:the importance of baseline data Charlie Peel Project Manager
Overview• What does ‘data’ mean?• Why is it important and what can it tell you?• How can we use it?• Discussion: – what sort of data is available to you? – How can you use it?
Data – what it means• Dictionary definition: ‘Factual information, especially information organised for analysis or used to reason or make decisions.’• Anything which: – tells a story, – demonstrates experience, – provides insight, – helps understanding.
Why do we need it?• To reinforce anecdotal or suggested evidence• To understand the reality of local services and support from all angles• To highlight discrepancies or possible problems in current systems• To measure progress• To understand if changes made are positive
What constitutes as data?• Qualitative • Quantitative – Patient opinion and – HES and SUS records user experience – Service user info – Professional opinion of gathered through services survey or en masse – PROMs – What services are actually purchased and – Hospital / services delivered surveys – Financial records and – Individual’s case study budgets – Audit and mapping – Waiting times – Audit and mapping
What counts as a service?• Baseline data of an area is essentially trying to get a picture, in as many colours as possible, of local services• ‘Services’ can mean: – Healthcare services within acute setting – Healthcare and social care services in the community – Personal assistants – Equipment, adaptations, suitable housing or accommodation – Vocational support – Leisure and sport facilities – Financial support and benefits advice – Complementary medicines such as acupuncture or massage
How can we use it?• The mapping triangle: core elements to understanding services National policy, guidance and agreed best practice What services are What local people are actually in place experiencing
How can we use it?The mapping triangle – what servicesshould be like What NICE / other regulatory bodies say Positive Positive National practice practice policy, guidance and What the What the agreed best national national practice charities say charities say What the Royal Colleges say
How can we use it? How teams, sectors and What services What data What data levels of care are in place indicates indicates are working together What professionals What say they’re providing commissioners think they’re planning & purchasingThe mapping triangle –what services are like
How can we use it? What service users What people say they’re receiving think of the support available What local What information What information people are people can people can experiencing access accessHow families view theservices and support The mapping triangle – how available people experience those services
Gaps that can be unearthedWhat commissioners think V. What is actually deliveredthey’re planningWhat HES / SUS data V. How systems areshows actually workingWhat services are V. What are available toavailable to one person another person with the same condition… V. What service users are What professionals think actually able to accessthey are delivering
Baselines that can beestablished• What services are in place, where they are and who can access them?• What referral routes are in place and how they are used?• How many elective and non-elective admissions there are for a specific client group?• What are waiting times for services and equipment?• What is the satisfaction level with any given service?• Information currently available and format• Current spend on existing services
How can you use this info?Finding Use1.High volume of 1.Improved selfunplanned epilepsy management; ‘Message inadmissions a bottle’2.Public transport is 2.Changes to publicaffecting people’s ability transport; increased vocational supportto work 3.Regular meds reviews3.Individuals don’t feel specifically commissioned;confident that their community pharmacistsmeds are correct trained to provide reviews
Introduction to the workshop: What we’re doing and why Angie Pullen
Finding your stakeholders anddeciding how to access them
Case StudyA neurology audit has taken place in Norfolk, Great Yarmouth andWaveney from July to December 2012. At the same time, someinvestigative work into epilepsy services was being undertaken bythe local epilepsy specialist nurse and the Head of Long TermConditions for West Norfolk.They feel that epilepsy services are under resourced locally and thatpeople with epilepsy are not able to access the services they needto best support them. The neurology audit findings largely back theanecdotal evidence that was being gathered around epilepsyservices. These findings have created an opportunity to highlightepilepsy service provision as a specific stream of work needed.You have been asked to work with the Head of LTC and the epilepsyspecialist nurse to gather views and experiences from people livingwith epilepsy and those caring for people who are, across youngpeople and adults. The data you gather on individuals will be usedalongside the existing audit data, and the additional data beinggathered by the professionals. It will all be drawn together to make acase to the commissioners for epilepsy to be focussed on as ansingle condition.
The data you gather on individuals will be usedalongside the existing audit data, and the additional databeing gathered by the professionals. It will all be drawntogether to make a case to the commissioners forepilepsy to be focussed on as an single condition.
• What is a stakeholder?• How would you begin the task of identifying stakeholders in a certain area?• What approaches and strategies would you take in communicating with new stakeholders?
Part 1: Identify your stakeholdersPeople withepilepsy CCG Commissioners Epilepsy Action branchLocal GPs Carers NeurologistLocal authority Health and Wellbeing board
Part 3: Understand your key stakeholders You can ask the following questions which will help you to know how best to engage with your stakeholders and how to communicate with them:• What financial or emotional interest do they have in the outcome of your work? Is it positive or negative?• What information do they want from you?• What is their current opinion of your work? Is it based on good information?• Who influences their opinions generally, and who influences their opinion of you? Do some of these influencers therefore become important stakeholders in their own right?• If you dont think you will be able to win them around, how will you manage their opposition?• Who else might be influenced by their opinions? (Do these people become stakeholders in their own right?)
What does a facilitator do?• Provides focus and stimulates discussion• Supports the group• Participates to promote new discussion• Acts as a team builder• Referees group discussion• Protects participants• Controls problem people within the group• Time keeps• Is pragmatic and neutral• Encourages feedback
Understanding the role of the facilitator• Stay neutral. Your role is to create the process and conditions that enable a group to enter into a discussion.• Conduct the discussion without trying to direct the group to a particular outcome.• What objectives do you want to achieve by the end of the session you are facilitating?
Provide structure to the discussion• Use questions to control the flow of focus group discussions• Preparing introductory questions• Open questions• Linking questions• Probes
Guiding discussion• Focus on group process. Is the group repeating itself? Are all members who wish to participating? Is the discussion staying on track and on time?• Explain what you see happening, and ask participants to confirm if their experience is the same. Be factual and specific.• Summarise what is being said.• Ask questions to open up discussion, to help the group to decide whether their process is working, or to think about new directions.
Recording the discussion• This is not the same as taking minutes, though you may use the recorded discussion to supplement the minutes• Having the discussion visible helps the group to see the progress its making and to refer back to earlier comments• Whenever possible, use the speakers own words, and be sure to record everyones comments to avoid creating tension and resistance
Ensuring group is productiveWe are now going to do a role playexercise. Each of you will be given a card,which will contain instructions on whatkind of participant you will be playing. Twoof you will have the facilitator card.Facilitators will have five minutes to lead adiscussion on the topics printed on theircards.
Discussion• Was it productive?• Did everyone get to contribute?• How did the facilitators do?• What were the positives and negatives of each method of running the discussion?
Summarising the discussion• Share with the group a brief and concise summary• Do not introduce any new points, or share your own personal viewpoint alone• Capture the important themes of the discussion• Tell the group how their comments will be used
Theming and weighting :Analysing qualitative data• Familiarisation: read the transcripts of the interviews and familiarise yourself with the data. Literally ‘label’ the data so it can be easily identified and categorised as common themes emerge. Depending on your consultation, it could relate to age, gender, postcode or for example, whether a view was prompted or based on actual experience.• Organisation: structure the data by collating all the data under different labels. Start building up an outline of the issues and begin compiling them under common themes.• Interpretation: issues and themes can then start to be developed and tested. This stage - and your ability to develop explanations - lies at the heart of analysis. Most data is very rich in the levels of explanation it can offer. You need to think about drawing out and explaining why patterns, linkages or apparent contradictions are found in the data.
Questions to ask• What patterns and common themes emerge in responses dealing with specific items? How do these patterns (or lack) help to answer your key questions, aims and objectives?• Are there any deviations from these patterns? If yes, are there any factors that might explain these atypical responses?• What interesting stories emerge from the responses? How can these stories help to illuminate your broader questions?
Things to avoid in reporting qualitative data• Don’t quantify - that’s not the point of focus groups• Don’t overuse certain transcriptions/ respondents• Don’t duplicate quotes• Don’t misapply quotes• Make sure quotes are in context and easy to understand• Don’t ‘sanitise’ quotes - tell it how it is!• Don’t overdo quotations- use them to illustrate, rather than tell the story• Be careful not to compromise confidentiality
Group activityWe are now going to split you up into twosmall groups. You will each be given acopy of one of the discussions we havehad as a group. Your task is to pick outthe themes and rank them in order ofimportance.
Feedback• How did you find it, generally?• How did you choose to analyse it?• What were the challenges?• How did the way the information was captured help or hinder you when doing the analysis?
Presenting your findingsYou have been asked to write a report with thelocal epilepsy specialist nurse and the Head ofLong Term Conditions for West Norfolk to makea case to the commissioners for epilepsy to befocussed on as an single condition. Working asa group, use the statistics document, examplesfrom the commissioning booklet, a transcriptfrom the focus group and the Epilepsy Lifecyclediagram to put together a five minutepresentation for the commissioners.
How did you find the task?• How did you find using and synthesising the different types of information?• How did it feel to present in front of a group?• Is there anything you feel could have improved your presentation?
Presenting your findings Charlie Peel Project Manager
Forms of presenting findings • Powerpoint presentation • Formal written report • Published document • Pictures / graphics • Flyer / short bulletin • Website • Social media
Presentations• Keep info top line – use bullets to prompt the info you have to share• Use key words, phrases, stats, quotes, tables and graphs to make your points – then talk around them• Be positive – and if the message is negative, have positive solutions to lift it• Keep slides ‘clean’ – too busy and you’ll lose them
Written report• Less text, more info – Use graphs and tables for numbers or info where there are links to make – Use bullets to list – it’s easier to take in• Plain English – it doesn’t need long words – Short, clear sentences – Simple words 20 people – Active, not passive were interviewed We interviewed 20 people
Written reports Tables display info succinctly Bullet points: •are clean, •are easy to read, •help you stick to your point
Displaying informationTry a table:National standard Current service Possible solutionsEveryone should • Some people have • Review nurse provision tohave access to a access to a neurologist ensure all people with epilepsymedicines review annually who also access a nurse annuallyannually reviews their medication. • Consider telehealth options to • Others access the nurse. remind individuals to seek their • Some people have not own review had a medicine review • Roll out training to community for 3+ years pharmacists to perform medicines reviews locallyEtc
Pictures and graphics Graphs show data and numerical info simply – and save you lots of words
Quotes• People living with epilepsy are the experts and what they say is your evidence• Capture it and use it to illustrate your points• Or better still, use it to make the point for you
Flyers, web & social media• Even more succinct!!• Choose your top three to five most interesting / important• Add your evidence: a couple of quotes or stats• Short sentences, bullet points and graphics instead of words where possible
Starting points• A template report has been made for you• Epilepsy Action have powerpoint templates• Look at the sort of thing EA produce – and follow suit• Use formats that you know have worked – what catches your eye when someone’s giving you information?
See your packs for templates, examples and other usefuldocumentsThank-you