Engaging health and care staff about the future of the NHS

The challenge

The Department of Health and Social Care commissioned Kaleidoscope Health and Care as part of a partnership led by Thinks Insights, to engage the public and health staff on the future of the NHS.

This engagement would inform the 10 Year Health Plan, which was announced by the Secretary of State for Health and Social Care as part of his policy to make the NHS fit for the future. It would be based on three major shifts: from hospital to community; from analogue to digital; and from sickness to prevention.

To ensure long-term success, the Prime Minister and Secretary of State wanted to involve patients and staff through the biggest national conversation on the NHS’s future.

Kaleidoscope led the direct staff engagement workstream of the programme, called Change NHS.

It was important that Change NHS felt different from other engagement, so it was designed to be wide-reaching and inclusive of those who do not typically participate in engagement. The staff engagement covered all roles working in the NHS, social care and public health across seven NHS regions to ensure we captured a diverse range of views.

Our approach

We designed and delivered an ambitious programme of staff engagement to ensure health and care professionals had a meaningful voice in shaping the 10 Year Health Plan. We tailored our approach to support both large-scale participation and in-depth deliberation, creating opportunities for staff to engage in ways that suited them best.

We engaged staff in three ways.

Large-scale online events

We facilitated 18 online shift-specific sessions at different times of the day, enabling busy staff to take part when it suited them. They were open to all staff and attracted up to 250 participants per event, enabling staff to share their thoughts on opportunities and concerns for the shifts, and on the barriers preventing their delivery. Later events explored emerging themes and tensions from the engagement.

We provided psychologically safe methods for participants to share views honestly, and live panel discussions featured frontline staff reflecting on emerging insights.

Regional face-to-face deliberative workshops

We facilitated seven all-day events in each NHS region. These enabled us to hear in-depth from a representative sample of NHS, social care and public health staff to understand their experiences and ideas relevant to the three shifts. Staff were put in mixed professional groups for facilitated discussions on their preferred shift, plus cross-cutting issues on recruitment, retention, and structural and cultural change. We used purposive recruitment through regional structures to ensure broad representation across staff types, care settings and communities.

Targeted engagement with under-represented groups

We identified and ran dedicated sessions with groups under-represented in other activities – including porters, cleaners, security staff, healthcare assistants, primary care support staff, nursing and AHP trainees, and staff from ethnic minority backgrounds. We used tailored recruitment approaches, working directly with NHS trusts for some groups and through professional networks for others.

Impact

The engagement programme has set a new bar for participation in national policy making. Our staff engagement workstream was at the heart of Change NHS, capturing diverse perspectives from more than 3,700 staff across all NHS regions in the full range of roles and settings – many of whom are never usually asked for their views. It was part of the largest conversation about the NHS, generating more than 270,000 contributions overall.

The engagement directly influenced development of the Plan. Staff insights on what success would look like and their views on the shifts continuously fed into policy development throughout the six-month process. Emerging insights and developing policy were continuously tested with participants, ensuring they were actively engaged as the Plan evolved.

We successfully engaged a large and diverse sample of health and care staff. This included those rarely engaged in such exercises, such as porters and healthcare assistants. We ensured good representation across regions, communities, sectors, roles and paybands.

Staff gave overwhelmingly positive feedback on the events. In surveys after the events, more than 90% said they would recommend a similar event to colleagues, and participants felt their input was genuinely heard and valued. They valued sharing experiences with other professionals who they did not routinely work with, realising shared challenges and gaining better understanding of other services. Many felt empowered and hopeful by influencing change, anticipating positive changes in the future.

Kaleidoscope brought expertise, energy and insight to design and deliver a range of activities and meaningful conversations ensuring staff perspectives are genuinely shaping the Plan. Their approach resulted in a process where staff felt valued and heard.

Sally Warren, Director General of the 10 Year Health Plan, Department of Health and Social Care