Consultation Toolkit. August 2011

Transcription

1 Consultation Toolkit August 2011

2 Consultation Toolkit This Toolkit is a Live Document and will be continually updated with best practice! Contents Roles & Responsibilities P3 Definitions P4 Principles P7 When to Consult P9 Consultation Process P11 Stakeholders P16 Consultation Planning P19 Engagement Methods P21 Available Tools P30 Guide to the Online Consultation Hub / Database P39 Formal Consultations P49 2

3 Roles & Responsibilities Board / Clinical Executive It is the legal responsibility of Board / Executive to ensure that all decisions they take comply with the statutory duty to consult and that decisions take into consideration feedback from the consultation. Directors Directors are responsible for ensuring that any commissioning decision, policy, strategy or service review brought to Board / Executive for approval has been through the consultation process and makes recommendations based on the results of that consultation. Engagement Team The engagement team is responsible for: high level consultation on major organisational priorities and decisions advising staff on engagement and consultation techniques maintaining contacts with local groups training staff on consultation and engaging co-ordinating an annual calendar of public engagement and feeding results into Board / Executive Managers Commissioning Managers are responsible for ensuring that their work is informed by consultation. It is the responsibility of the individual manager to undertake that consultation, feed the results into the policy or service review, pass consultation output to the corporate engagement team, and feed back to the public on how local views influenced the final decision. 3

4 Definitions (i) Consultation Consultation is a very broad term, often used to describe various degrees of involvement in decision making. Involvement Section 242(1B) of the NHS Act requires that service users are involved in decision making, whether by being consulted or provided with information, or in other ways. A number of activities can constitute involvement: Informing people of your intentions, procedures and practices. Engaging groups by inviting them to express their views. Participation is when people have a significant voice in planning and decision making. Collaboration is when you partner with the public in each aspect of the decision including the development of alternatives and the identification of the preferred solution. Delegation is to place final decision making power in the hands of the public. Community Engagement Maintaining strong contacts with local people, informing them of changes, listening to their views, and conducting an on-going two-way dialogue. 4

5 Definitions (ii) Formal Consultation This is the official process where the final policy / decision documentation is posted online for a set period of time to allow people to have their say on the decision before it is adopted by Board. Extended Public Consultation Extended public consultation will be carried at all times where a change is considered a substantial variation or a major impact. This level of consultation involves a 12 week statutory consultation period with the wider public. Extended public consultation will be undertaken on: the closure of a complete service a substantial variation in services defined as affecting a large number of patients or a small number of patients significantly, and/or changes in accessibility of services (e.g. site change) a reduction in the number of referrals to a service, through demand management proposals the transfer of patients services to another provider of healthcare 5

6 Definitions (iii) Service User A service user is a person who uses a service commissioned by NHS Stockport / Stockport Managed Care. In consulting service users, this definition is extended to include: a representative of the service user, such as a carer, relative, or a representative (e.g. patient group representative, charity representing a particular community or patient group) any person who may use that service (covering people who live within the locality where the service is delivered). Stakeholder A stakeholder is any person or group that has a vested interest in the outcome of a specific decision made by NHS Stockport / Stockport Managed Care.. For the purposes of consultation, this will include: service users carers of service users local community groups affected by the decision voluntary groups of charities representing service users partner organisations whose services link to our service clinicians and provider groups who refer into an NHS Stockport service staff employed by the service. 6

7 Consultation Principles Our involvement will be: o o o o o o o Open Informed Inclusive Responsive Sustainable Focused on Improvement and Transparent 7

8 Consultation Principles Open we will be clear from the start what our plans are, what is and what is not negotiable and the reasons why Informed service users taking part in consultations will be supported by detailed information to help them give informed views and perspectives Inclusive we want everyone to have an equal say, so we are committed to ensuring our communications are clear and accessible and reach a wide range of people Responsive we want to respond to local needs and concerns, making our services relevant Sustainable we want to develop relationships with community groups and allow people to feed in their views continuously, without overloading people with information Focused on Improvement we want to work with local people to continuously improve our services Transparent we are committed to being clear why we are engaging, what we will do with your views, and to feeding back the impact consultation has had on decision making. 8

9 When to Consult Under Section 242(1B) of the NHS Act, NHS bodies are under an obligation to involve users in the following matters: planning of the provision of services; developing and considering proposals for changes in the way services are provided; making decisions affecting the operation of those services. Are you planning health service provision? YES NO service users must be involved service users don t need to be involved Are you developing / considering changes in the way a health service is provided? YES NO service users must be involved service users don t need to be involved * Would implementation impact on the way services are delivered? YES service users must be involved NO service users don t need to be involved Would implementation impact on the range of services available? YES service users must be involved NO service users don t need to be involved Are you taking a decision that will affect the operation of services? YES NO service users must be involved service users don t need to be involved Would the decision impact on the way services are delivered? YES service users must be involved NO service users don t need to be involved Would the decision impact on the range of services available? YES service users must be involved NO service users don t need to be involved 9

10 Engagement Cycle CONSULTATION N DATABASE 10

11 Consultation Process No. of people affected Under 5,000 Size of contract People 5, ,000 People Over 100,000 People Under 200,000 3 weeks 3 weeks 7 weeks 200,000-1m 3 weeks 7 weeks 11 weeks Over 1million 7 weeks 11 weeks 11 weeks 11

12 Consultation Process REVIEW FEED BACK MAP RATIFY PLAN PUBLIC CONSULT ENGAGE DECIDE DRAFT 12

13 REVIEW FEED BACK MAP Establish if consultation RATIFY is required: PLAN Does the decision impact on services? Does it have a different / greater / or negative PUBLIC impact on protected (equality) groups? Establish what information we already have: Search the consultation database and review complaints received by the service & if there are events coming up you could use CONSULT ENGAGE Are views reflective of all (potential) service users? YES use this information in formulating your paper / service / plan NO target consultation to groups whose views you don t have Are the views recent? (within the last 2-3 years) YES use this information in DECIDE formulating your paper DRAFT / service / plan NO plan your consultation to get up-to-date views 13

14 Searching the Consultation Hub Go to and click on Find Consultations. 14

15 Searching the Consultation Hub You can do a simple search by topic or geographical area. Or if you click on advanced search under the search box, you can also search by target audience, the team who consulted, past, present or future events etc 15

16 REVIEW FEED BACK MAP RATIFY PLAN PUBLIC Agree Stakeholders: CONSULT ENGAGE Who uses the service? Who does this affect? (service users, public and staff) Who needs the service but currently doesn't access it? Who are the experts in this area? Will the decision have a different DECIDE or greater impact on DRAFT any minority group? 16

17 Stakeholders Not Involved Informed of Changes Asked for Opinions Make Suggestions Take Decisions Non-Stockport Residents Providers GPs Local Community Service users Carers Frontline Staff CCG (Clinicians) Council Patient Groups (Patient Rep) General Public Interest Groups Charities when the decision has a greater or differential impact on the group LINks Disability Groups LGBT Groups BME/Faith Groups Age Groups Experts Commissioner Scrutiny Committee Gender Groups 17

18 Local Groups The Engagement Team maintains a database of over 350 local groups. The P.A.I.D database allows you to search by topic or locality. If you want to send out an invitation, poster, or a link to an online survey, Shirley.Hamlett@nhs.net can send you a mailing list of stakeholders x 5895 P.A.I.D can be installed onto your computer by the IT team and you the engagement team can add you as a user For more information on minority groups, see the Accessible Communications Toolkit 18

19 Purpose: What do you want to get out of this consultation? REVIEW What kind of influence will consultees have on the decision? FEED Are there any restrictions (e.g. budget BACK limit / legal guidelines) where local views cannot change the situation? Timeframe: When will decisions be taken? How much notice will people RATIFYneed to attend? How long should people be given to consider their views? Practicalities: What budget do you have for the consultation? Consider venues that are accessible / suitable to your audience. Will you need translation CONSULT / interpretation? How will you promote the consultation to attract your target audience? PUBLIC MAP PLAN ENGAGE What engagement methods are best DECIDE suited to DRAFT your audience / budget / timeframe? 19

20 Consultation Action Plan Commitment Gap Stakeholder Group Perceived Benefits Changes Needed Perceived Resistance (C = Current, and R = Required) Very Anti Mod Res Allow it Help it Make it Engagement / Communication Plan E.g. Patients Will be cared for at home rather than in hospital None Is community care as good as hospital? C R Full scale public consultation undertaken by CF report by DD develop marketing plan by E.g. Community Nurses Additional skills and job opportunities Skill Development Happy with job as it is C R 1.SC meet with unions in

21 Engagement Methods Stakeholder Groups Online survey Paper survey Survey in clinic / practice Text Phone survey Phone interview 1:1 interview Focus group Workshop Town Hall meeting Information stand / engagemen t boards at events Patients give out link Carers limited time limited time limited time LINks Patient Rep Groups Disabled service users BSL version difficult formats may require support good for deaf people good for blind people good for blind people may require support plan to meet needs access access Ethnic minority groups translated translated translated language problems language problems language problems may require interpreter may need interpreter translation translatio n language problems Religious minority groups on their turf Lesbian / Gay / Bisexual groups anonymous sensitive on their turf on their turf depends on event Trans groups anonymous sensitive on their turf on their turf depends on event Younger people less likely to answer on their turf on their turf depends on event Older people Women Men less likely to attend less likely to attend Staff time constraints time constraint s time 21 constraints

22 Method: Online Surveys Potential Costs: free Potential Timeframe: 1-8 weeks Audiences: Particularly useful for getting views of a large number of people, especially younger people, people with limited time to take part in events, men, people with hearing disabilities. GUIDANCE Online Surveys are a quick and cheap method of undertaking both qualitative and quantitative research into the views and preferences of a wide range of groups. Tips: Keep questions to a minimum Use plain English and avoid jargon / acronyms Ensure you allow at least one open question at the end for people to give views not covered in your questions out to as many contacts as possible and ensure that the survey is prominent on website to attract traffic. As well as addressed, can be sent to mobile phones: mobilenumber@sms.nhs.net Drawbacks: No interaction with people so you will miss out on a lot of qualitative feedback /ideas. Unless you have it translated, it limits participation from foreign language groups. Older people and some disabled groups are less likely to take part. 22

23 Method: Paper Surveys Potential Costs: printing & postage Potential Timeframe: 1-8 weeks Audiences: Particularly useful for getting views of a large number of people, older people, those with limited time to take part in events, men, deaf people. GUIDANCE Paper Surveys are a quick method of undertaking both qualitative and quantitative research into the views and preferences of a wide range of groups. Tips: Keep questions to a minimum Use plain English and avoid jargon / acronyms Ensure you allow at least one open question at the end for people to give views not covered in your questions Consider where is the best place to leave surveys (e.g. in a clinic or library / at events) Will require pre-paid envelopes for people to send back their views Factor in staff time for inputting results Drawbacks: No interaction with people so you will miss out on a lot of qualitative feedback /ideas. Unless you have surveys translated, it limits participation from foreign language groups. Difficult for people with visual disabilities. 23

24 Method: Surveys in Person Potential Costs: staff time Potential Timeframe: 1-2 days Audiences: Particularly useful for getting views of patients or groups attending an event, older people, women, blind people. GUIDANCE Undertaking Surveys in person allows you to take a quick snap shot of views and preferences on a specific topic. Tips: Keep questions to a minimum Use plain English and avoid jargon / acronyms Ensure you allow at least one open question at the end for people to give views not covered in your questions Consider where is the best place to undertake surveys (e.g. in a clinic waiting room, out in the town centre or at events your target audience are likely to attend) Factor in staff time for inputting results Drawbacks: Limits participation from foreign language groups and deaf people. Commercial / Charity over-use of street canvassers puts any people off. Limited to people there on the day. 24

25 Method: Phone Surveys / Interviews Potential Costs: cost of phone calls Potential Timeframe: 1-2 weeks Audiences: Particularly useful for getting qualitative views from older people, carers, people who are home bound. GUIDANCE Relatively quick method for undertaking both qualitative and quantitative research into the views and preferences of a specific group usually service users. Tips: Keep questions to a minimum Use plain English and avoid jargon / acronyms Consider where is the best place to leave surveys (e.g. in a clinic or library / at events) Will require pre-paid envelopes for people to send back their views Factor in staff time for inputting results Drawbacks: Limits participation from foreign language groups and people with hearing problems. Commercial use of cold-calling makes people reluctant to take part. Staff time in calling and then writing up responses. 25

26 Method: Focus Groups Potential Costs: venue, invites, catering Potential Timeframe: 4 weeks Audiences: Particularly useful for getting qualitative views from a specific group. Older people, younger people, men, women, BME groups, disabled groups GUIDANCE Particularly useful for getting specific in-depth data from a target group. Tips: Choose an accessible venue that will suit the people you want to talk to Where possible, go to them you will get a better turnout and more positive feedback Identify and invite target audience in advance, considering dates that will suit them Be clear what you want to know and what the group need to know to give their views Structure the event (presentation, Q&A, group discussions) Consider access, interpreting and catering needs (e.g ramps, hearing loops, signers, vegetarian or Halal meals, copies of information in correct format / language ) Factor in staff time post-event for inputting results Remember to feed back to the group Drawbacks: Limited number of views Time and cost implications 26

27 Method: Workshops Potential Costs: venue, invites, catering Audiences: GUIDANCE Potential Timeframe: 4 weeks Particularly useful for getting qualitative views from a specific group. Older people, younger people, men, women, BME groups, disabled groups Good for getting specific in-depth data from a target group. Tips: Choose an accessible venue that will suit the people you want to talk to Where possible, go to them you will get a better turnout and more positive feedback Identify and invite target audience in advance, considering dates that will suit them If the event is open, advertise in advance The engagement team has a database of over 350 local groups to circulate invites to Be clear what you want to know and what the group need to know to give their views Structure the event to suit the target audience (group discussions, presentations, reports back) Consider access, interpreting and catering needs (e.g ramps, hearing loops, signers, vegetarian or Halal meals, copies of information in correct format / language ) Factor in staff time post-event for writing up results Remember to feed back to the group the write up and what happened as a consequence Drawbacks: Limited number of views Time and cost implications 27

28 Method: Town Hall Meetings Potential Costs: venue, invites, catering Audiences: GUIDANCE Potential Timeframe: 4-12 weeks Wider range of local views. Best for older people, carers, women, disabled groups Good for communicating with a wide audience. Tips: Choose an accessible venue that will suit the people you want to talk to Where possible, go to them you will get a better turnout and more positive feedback Identify and invite target audience in advance, considering dates that will suit them Advertise the event in advance using local media and posters in venues where the target audience are likely to see them The engagement team has a database of over 350 local groups to circulate invites to Be clear what you want to say and get out of the event Structure the event to suit the target audience (presentation / Q&A) Consider access, interpreting and catering needs (e.g ramps, hearing loops, signers, vegetarian or Halal meals, copies of information in correct format / language ) Factor in staff time post-event for writing up results Remember to feed back to the group the write up and what happened as a consequence Drawbacks: Less interactive due to the size of the event Some people will find it difficult to give their views in such a setting Less likely to get views from younger people, families, BME groups Time and cost implications 28

29 Method: Info Stalls at Events Potential Costs: leaflets, freebies, staff time Audiences: GUIDANCE Potential Timeframe: 4-12 weeks Wider range of local views. Best for older people, carers, women, disabled groups Good for communicating with a wide audience. Tips: Choose events that are relevant to the people you want to talk to and the topic you want to discuss Make the venue as central as possible and think of parking Advertise the event in advance using local media and posters in venues where the target audience are likely to see them The engagement team has a database of over 350 local groups to circulate invites Be clear what message you want to get across and choose appropriate leaflets, posters, banners Think of key, quick questions to put up on engagement boards Use a sliding scale to get views using sticky dots on the engagement boards Take more detailed paper surveys with pre-paid envelopes for people to send them back Factor in staff time post-event for writing up results Remember to feed back online what happened as a consequence Drawbacks: Confidentiality is a big issue in these settings Less likely to get views from younger people, families, BME groups Time and cost implications 29

30 Engagement Tools The Engagement Team has a range of tools you can use for involving local groups. To borrow any of the following, contact reception on x 5000 Table-top Display Boards (x4) Adhesive Engagement Boards (x2) Pull-up Banners [Barracudas] (x5) [NHS Stockport / Choose Well / Support your local NHS / Patient Engagement] Health Event Banner Trolley boxes [for carrying leaflets etc] (x2) Digital Camera Flip HD Video Camera Dongles (x2) Projector & Screen Survey Submission Box 30

31 Engagement Tools Pull-up Banners [Barracudas] 31

32 Engagement Tools Table-top Display Board Adhesive Engagement Board Health Event Banner 32

33 Engagement Templates The Engagement Team has a range of templates you can adapt for consultations. These are saved on the Shared drive at: S:\Corporate Documents\Community Engagement\Templates Posters Fliers Survey Cards Paper Surveys Agendas Engagement Feedback Reports 33

34 Engagement Templates 34

35 Engagement Templates 35

36 Engagement Templates 36

37 Engagement Templates Tell us what you think! Q1 How would you rate your health? Very good Good OK Bad Very bad Q2 When did you last see your GP? This week This month Past 6 months Past year More than a year ago Never Q3 How would you rate the Practice? Very good Good OK Bad Very bad Name of Consultation Tel: xxxx contact@nhs.net 37

38 Engagement Templates Men s Health Survey How would you rate your health? Very Good Good OK Bad Very bad Are you registered with a GP? Yes No How would you rate your GP Practice? Very Good Good OK Bad Very bad When did you last go to the Doctors? this week this month in the last 6 months in the last year never When did you last go to A&E? this week this month in the last 6 months in the last year never Do you eat 5+ portions of fruit or vegetables a day? Yes Sometimes No How often do you exercise? Daily Weekly Monthly Sometimes Never Which of these activities have you done in the past seven days? Walking Jogging / running Swimming Sports Other Exercises Work out at a gym Cycling Dancing None Do you smoke? Yes, I smoke No, I Quit Never smoked Do you drink alcohol? Yes No Sometimes How often do you usually drink alcohol? Every Day 3-4 times a week Once a week Once a month Most Days 2 times a week Once a fortnight Less Never What types of alcohol do you drink? Cider Beer / lager Wine Spirits In the last week, how much alcohol did you drink? (1 pint = 2-3 units ; spirits = 1 unit) None 1-14 units units units 29+ units Do you check for testicular lumps? Yes Sometimes Never What worries you most about your health? BACKGROUND DETAILS We would like to know more about you so that we can compare experiences of different groups. About you Gender: Male Female Year of birth: Disability... Do you have a long-standing illness, health Yes No problem or disability? Do not wish to declare If yes, please specify: Physical Sight Hearing Deaf-blind Learning Disability Mental Health Problems Long-term illness Other What is your ethnic background? White Black / Black British Other ethnic backgrounds British Caribbean Chinese Irish African Gypsy / Traveller Other white background Other Black background Any other background Mixed Asian/Asian British... White & Black Caribbean Indian Do not wish to declare White & Black African White & Asian Pakistani Bangladeshi Other mixed background Other Asian background What is your religion? Buddhist Christian Hindu Jewish Muslim Sikh Other (please specify) None Do not wish to declare... What is your sexual orientation? Heterosexual (straight) Lesbian (woman) Gay (man) Bisexual Do not wish to declare Gender Identity Would you describe yourself as transgender? Yes No Do not wish to declare Location What part of Stockport do you live in? Contact details:.. Please tick this box if you do not wish to be contacted for future surveys / health events Thank you for taking the time to feed back your views. For further information, please contact: Engagement Team, Regent House, Heaton Lane, Stockport SK4 1BS Tel: sto-pct.haveyoursay@nhs.net 38

39 Online Consultation Hub To help fulfil our statutory duty to consult, NHS Stockport has established an online consultation hub: 39

40 Online Consultation Hub You can get a username and password for the hub from the Engagement Team: Angela.Beagrie@nhs.net x 5610 / Shirley.Hamlett@nhs.net x 5895 To create your own survey, you need to log in to the site at: Once logged in, you will see an additional line under the three main tabs which allows you to access the database behind the website. 40

41 Online Consultation Hub To add a consultation: Select Consultations Add Consultation You will need to give your consultation a title and select a url address, appropriate to the consultation. 41

42 Online Consultation Hub There are four types of consultation you can create: 1. Quick Consult Online is for online surveys 2. Downloadable Document is for formal consultations where you upload a paper for a 4-12 week period and ask for comments 3. External Link can be used to send people to a DH or partner s survey or consultation 4. Explanatory Text allows you to advertise an event / workshop and then upload results of the meeting afterwards. 42

43 Online Consultation Hub With all consultation types, you will be asked to give an overview of the consultation and why you are doing it. 43

44 Online Consultation Hub To add an image into your explanation or write up, click on the photo icon: 44

45 Online Consultation Hub For all consultations, you will be asked for a start and end date. After the consultation closed, you will be sent a reminder asking you to publish results of the consultation. A few weeks later, you will be asked to complete the We Asked, You Said, We Did section to let the public know what changes we have made in response to their views. A full manual for using the Consultation Hub is available on the shared drive at: S:\Corporate Documents\Community Engagement\Guidance Training courses will also be available through the Engagement Team. 45

46 You don t know until you ask! Make sure everyone who has an interest in REVIEW the decision has a real opportunity to give their opinions. FEED Engage in a way that suits MAP BACK the people whose views you want. Make sure the range and number of events is proportional to the scale of the decision. People can t take decisions on things they don t know about so present the facts in an accessible manner and then ask for feed back. Make sure someone RATIFYis assigned to take notes in meetings and write up PLAN the comments. PUBLIC CONSULT ENGAGE DECIDE DRAFT 46

47 Write up feedback from engagement: The full range of views expressed during consultation should be acknowledged and REVIEW attention will be drawn to areas of agreement and disagreement. Put the write-up of your engagement onto the results section of the Consultation FEED Database. MAP BACK Use views and ideas to draft your plan: Nobody knows better than service users what works for them and what doesn t. Where a number of options are presented, make it clear which options were supported by which local groups. RATIFY PLAN PUBLIC CONSULT ENGAGE DECIDE DRAFT 47

48 All decisions on changes that affect service users must be taken in light of local views. REVIEW It is the role of the Commissioning Manager to ensure that the Board / Executive has all the available data health FEED needs; service access; service costs; patient & public views to take an informed decision. MAP BACK Where a decision is taken against locally expressed opinions, the reasons behind this decision must be made clear and documented. RATIFY PLAN PUBLIC CONSULT ENGAGE DECIDE DRAFT 48

49 Once the Board / Executive has taken its view on the proposal, the final paper will be put out to formal consultation for a period of 2-12 weeks, depending on the scale of the decision. REVIEW Full consultation documents FEED should include: MAP BACK a cover note explaining the decision a brief explanation of what engagement was undertaken and how this influenced the proposal a form including specific questions about the decision (e.g. do you think this reflects local views?) and a section for additional comments a copy of or link RATIFY to the paper from the Board / Executive PLAN This should be uploaded onto the Consultation PUBLIC Hub for consideration and publicized to those individuals or groups who took part in the engagement. CONSULT ENGAGE DECIDE DRAFT 49

50 Consultation Document Consultation Policy Description of the Paper: We recognise that our decisions, policies, and services have a major impact on the lives and wellbeing of the local people, so we will actively seek to engage with all sectors of the community to ensure that everyone has an equal chance to have their say before we make major decisions. Consultation on the organisation s policy for involving local people in decision making and service changes September 2011 This Policy provides the framework for all consultation undertaken by the organisation. Key Questions for Consideration: Do you agree with our consultation principles? Do you think this policy puts local views at the heart of decision making? Are any key stakeholders missing from the list of who to consult? Are you happy with the process outlined in this policy? Do you think the EIA takes into consideration all potential impacts on protected groups? Does this policy adequately reflect local views? Any other comments / suggestions? Issued: 30 th September2011 Respond by: 7 th November 2011 Enquiries / Consultation & Engagement Team submissions to: NHS Stockport, Floor 7 Regent House Heaton Lane, Stockport, SK4 1BS sto-pct.haveyoursay@nhs.net 50

51 Consultation Period Strategy Service Change Policy Must involve users developing & considering proposals Must involve users in planning services Must involve users in making decisions affecting the operation of services 11 week formal consultation 3-11 week formal consultation 3-7 week formal consultation 51

52 Consultation Period No. of people affected Size of contract Under 5,000 People 5, ,000 People Over 100,000 People Under 200,000 3 weeks 3 weeks 7 weeks 200,000-1m 3 weeks 7 weeks 11 weeks Over 1million 7 weeks 11 weeks 11 weeks 52

53 REVIEW FEED BACK MAP RATIFY PLAN PUBLIC After the consultation has closed, a report of submissions will be taken to the Board / Executive for discussion. CONSULT ENGAGE If the submissions are generally supportive, the policy / paper / decision will be ratified and adopted. Where there is a clash of opinions, DECIDE Board / the Executive DRAFT will take a final decision, reflecting on all the available evidence and explain their reasoning. 53

54 REVIEW FEED BACK MAP RATIFY PLAN PUBLIC The final decision and how local views influenced it goes onto the website. CONSULT ENGAGE Managers should complete the We Asked, You Said, We Did section of the consultation hub. Commissioning Managers should then continue to monitor service progress and performance; patient experience; DECIDE complaints received; DRAFT and any views submitted to ensure that the intended results are achieved. 54

55 REVIEW FEED BACK MAP RATIFY PLAN PUBLIC The final decision and how local views influenced it goes onto the website. CONSULT ENGAGE Managers should complete the We Asked, You Said, We Did section of the consultation hub. Commissioning Managers should then continue to monitor service progress and performance; patient experience; DECIDE complaints received; DRAFT and any views submitted to ensure that the intended results are achieved. 55