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Nhs citizen research workshop

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Nhs citizen research workshop

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Slides from NHS Citizen Research Workshop convened on the 7th of April 2015 at the University of Westminster to discuss the Research Hub, a brand new element of the NHS Citizen design intended to support wider research and knowledge sharing.

The aim of the workshop was to explore possible research questions and projects and this presentation introduces what NHS Citizen research might look like in its different forms.

Slides from NHS Citizen Research Workshop convened on the 7th of April 2015 at the University of Westminster to discuss the Research Hub, a brand new element of the NHS Citizen design intended to support wider research and knowledge sharing.

The aim of the workshop was to explore possible research questions and projects and this presentation introduces what NHS Citizen research might look like in its different forms.

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Nhs citizen research workshop

  1. 1. Dr Dione Hills Tavistock Institute of Human Relations d.hills@tavinstitute.org What is NHS Citizen Research? Research workshop 7/4/15
  2. 2. Action research, evaluation and research • The NHS citizen design process is an action research project. • It is also being evaluated. • It also potentially provides research opportunities, over and above the action research and evaluation activities.
  3. 3. Research Evaluation Action research
  4. 4. Use of terms: • Action research: continuous cycles of planning, implementation, data collection and reflection leading to revision and further planning • Evaluation: A more ‘removed’ activity (i.e. the evaluators and the actors are not the same people), and is generally constructed around a clear set of evaluation questions (What works? For whom? Under what circumstances?). • Pure’ research: Has a primary aim of enhancing knowledge, with a particular programme or policy providing a ‘test bed’ in which theories and hypotheses can be explored.
  5. 5. Action research activities: data collection Website – Sign ups for newsletter – Utilisation data – Hits – issues and comments posted Other activities – Evidence/research reviews (citizenship) – Participant interviews (citizenship) Team activities – Team meetings and planning documents – Individual discussions/interviews – Team reflections – Learning log Events – Participant ‘sign in’ – Feedback sheets (online) – Gather test at expo and for first assembly – Discussions taking place
  6. 6. Evaluation aims • To ensure that learning is surfaced and developed across the system by gathering relevant information, reflection on the process as it occurs, and any findings that are fed back into NHS citizen during reflection events. • To feedback learning into the system of developing NHS citizen • For accountability (for funding received for this development process) • To generate data to support its ongoing work • To develop thoughts for longer term evaluation of NHS citizen itself.
  7. 7. Evaluation activities • Theory of change mapping (provides evaluation framework) • Survey of participants (on line) • Interviews with team members • Case studies of ‘issues’ • Collation of data and report writing (during April) • Evaluation of citizen jury events (external researcher)
  8. 8. Citizens: self selecting, act as combatants, lack trust and confidence Locations mapping themselves People signed up with NHS citizen Planning for assemblies and citizens panel Individual (board, staff, directors) gain understand of their role as NHS citizens NHS citizen enters mainstream thinking Citizen centred technical architecture in place Review process tested New networks developing New patient groups reached Technical design of website Board not connected with citizens Planning for ‘front door’ and space for conversations Identify and talk with individual (directors, their PAs and champions NHS staff: not engaging citizens as co- producers Connections/ Communicatio ns: fragmented, poor quality, not visible, Lack results Networks: fragmented, poorly informed, Change in board behaviour Prioritising of meetings by board PI orgs understand how NHS citizen can help Assembly meeting process designed and implemented Citizen’s panel process and role designed Growing audience of NHS citizens Leading PI orgs brought together Technical advisory group set up Actions Outputs Outcomes Impacts Clear route for people and ideas established Network mapping Issues Kings fund symposium Assemblies take place Citizen panel tests Processes for taking ideas to action developed and tested 3 design events take place NHS citizen prototype in place Connections built to networks and organisations Demonstrations of ideas leading to action Website launched More NHS staff use social media New expectations of behaviour inside system Local events
  9. 9. Process evaluation questions to date • Are the actions to date ‘on target’ to deliver a prototype of NHS citizen by March 2015? • What is being learned about democratic engagement, and how is this being translated into changes within the programme as it evolves? • Is the notion of ‘NHS citizen’ emerging as a useful concept? • Is NHS citizen successfully engaging groups whose voices often go unheard? • Is a process emerging through which ‘issues’ to be identified, researched, and presented in a way that can be addressed? • Is a structure, culture and environment (on and off line) being created in which all participants feel included, and able to take part in deliberation and decision making processes? • What are some of the key elements of this structure, culture and environment? • To what extent are the different ‘streams’ of the project working effectively together ?
  10. 10. Outcome and impact questions to date • To what extent has an NHS citizen prototype been developed that is responsive, trusted, inclusive and transparent • Is there evidence that NHS citizen is on course to meet the aims set out on the website: i.e. creating: –a direct transparent route for citizens and organisations to the heart of the NHS England decision making process – a new source of evidence and opinion for the NHS England board –a mechanism providing accountability for the work of NHS England –a mechanism/system that leads to action, quickly • Has NHS citizen begun to introduce changes in the culture of the NHS • Has NHS citizen contributed to more active engagement and networking between individuals, groups and organisations • Is there evidence than any of the above is sustainable in the future and likely to lead to further change?
  11. 11. Process questions going forward…… • Does the NHS Citizen model of citizenship work within the different spaces in the system? • What are the best ways of moving beyond the barriers that are preventing the development of a more collaborative, open and participative culture within NHS England? • Is there internal coherence between our different methods of filtering and prioritising issues? • Does the NHS Citizen model of democratic participation work in practice? Is it being delivered in such a way that decisions are measurably more participative and effective? • Do these methods address unconscious bias within the system and offer something new in terms of decision-making? • What measures need to be taken to support sustainable change?
  12. 12. Outcome and impact questions going forward... • Does NHS Citizen contribute to an effective culture of collaboration and accountability? • To what extent does the NHS Citizen model of collaboration and accountability help to unlock this culture change? • How well does NHS Citizen enable people inside and outside the system to reach out to hidden and excluded communities and facilitate the discussion of issues critical to them within the system? • What is the appropriate rate at which to scale different activities to ensure that the current momentum is maintained while not over-reaching NHS England’s capacity to respond to the issues that arise? • How well do the prototypes being developed deliver against specification and intended outcomes? There will be a particular focus on Gather over the first nine months.
  13. 13. Broader research questions raised What is the role of deliberation, citizen engagement and democratic innovation in the area of health policy development (Linked to wider theoretical development and research in this area) What is the link between democratic reform and existing structures of governance and accountability (e.g. looking at whether this is different in relation to health policy compared with local authority policy making?) What does NHS citizen tell us about other ‘big’ issues facing the NHS in England: –The challenge of translating core ‘values’ (like citizen involvement) into practical structures and activities –How does citizen involvement interface with the challenge of managing scarce resources –How to introduce ‘culture change’ in an old (67 years) organisation already subject to numerous reorganisations and culture change interventions. Plus many more…..
  14. 14. Research Evaluation Action research Learning exchange via research hub (and further research workshops) External research utilising opportunities provided by NHS citizen Supporting internal action research and evaluation capacity
  15. 15. What kinds of research could be undertaken? Compatible with NHS Citizen values, i.e. •Responsive, trusted, inclusive and transparent •Participative research methods •Respectful of ethical and legal (data protection) issues •Seen as ‘valid’ in health service settings ? ? ?

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