Start With People: South Yorkshire 2024 - 2028

What hasn’t changed in this refresh, is that at the heart of our role as an Integrated Care Board (ICB) is the commitment to listen consistently to, and collectively act on, the experiences, needs and aspirations of local citizens and communities.

This strategy is our commitment to you about what we will do to make sure we hear from you, actively listen, and most importantly - act on what we hear.

We know that citizen involvement is crucial in improving health outcomes and reducing health inequalities. When communities actively participate in discussions about healthcare it helps health and care providers and commissioners to better understand your needs.

This understanding allows for the development of more effective and inclusive services that address specific challenges faced by different communities.

Citizen involvement fosters trust between communities and health and care services, which is essential for us to be able to effectively promote healthy behaviours to our population and support our communities to make the best use of services.

We know that when you feel involved in decision-making processes regarding your health you are more likely to adhere to treatment plans and seek help when needed. This in turn leads to earlier detection and management of health conditions and then improves health outcomes.

We know that for citizen involvement to be effective it must be appropriately resourced.

Read more about the work we have already done since we launched our first strategy back in 2022, the approaches we've taken to citizen involvement, what people told us and how we're prioritising citizen involvement as a partnership.

Download the executive summary. 

Ten principles for working with people and communities

NHS England’s Working in Partnership with people and communities statutory guidance provides 10 principles to follow to build effective partnerships with people and communities. NHS South Yorkshire ICB is committed to following these principles

These principles feature in both our Start with People involvement strategy and also the NHS South Yorkshire ICB constitution. Each year the involvement team works through these principles to identify what actions we need to take to ensure we are meeting the principles.

Action plans can be found in the Get Involved section of our website.

We looked at developing a South Yorkshire version of the principles however feedback from our
citizens and partners when we put together our first Start with People strategy back in 2022 was that we should adopt the national ones.

Ten principles:

1. Put the voices of people and communities (including children and young people) at the centre of decision-making and governance, at every level of the integrated care system.
2. Start engagement early when developing plans and feed back to people and communities how their engagement has influenced activities and decisions.
3. Understand your community’s needs, experience and aspirations for health and care, using engagement to find out if change is having the desired effect.

4. Build relationships with excluded groups, especially those affected by inequalities.

5. Work with Healthwatch and the voluntary, community and social enterprise (VCSE) sector as key partners.
6. Provide clear and accessible public information about vision, plans and progress, to build understanding and trust.
7. Use community development approaches that empower people and communities, making connections to social action.
8. Use co-production, insight and engagement to achieve accountable health and care services.
9. Co-produce and redesign services and tackle system priorities in partnership with people and communities.
10. Learn from what works and build on the assets of all ICS partners – networks, relationships, activity in local places.

Download this information. 

Our involvement priorities

• Put the voices of people and communities at the centre of decision-making

This includes: Working with system partners on a coordinated and where possible standardised
approach to citizen involvement; developing a ‘start with people’ minded workforce; ensuring
governance, assurance processes and systems all support this aim and improving communication and feedback to our communities to build understanding and trust.

• Embed mechanisms to enable citizen involvement to play a key role in the system focus on tackling health inequalities

This includes: Working with the VCSE, Healthwatch and partners on an approach for ongoing
insight capturing, particularly from our underserved communities, to ensure we understand our
communities’ needs and empowering our people and communities; ensuring systems and processes are in place for a continuous involvement cycle where citizens can talk to us at any point, in any way, and we will listen and gather their insights and use them to inform our work and developing opportunities for coproduction and working hand in hand with our communities to tackle system priorities.

• Work with people and communities on the priorities identified within the Joint Forward Plan and on transformational change programmes

This includes: Ensuring our future plans involve our citizens, using appropriate involvement levels and approaches, including coproduction and working in partnership with our communities, and consultation where needed.

Download this information. 

How our goals and priorities work together

Goals

• To listen consistently to, and collectively act on, the experience and aspiration of local people and communities, as articulated within our Start with People: South Yorkshire strategy.
• Involved communities - to work with our communities so their strengths, experiences, and needs are at the heart of all decision making, one of the three goals of NHS South Yorkshire.
• To listen and coproduce with people and communities a South Yorkshire Integrated Care Partnership Strategy joint commitment.

Priorities

• Priority 1

  • Put the voices of people and communities at the centre of decision making. This links to principles 1, 2 and 3.

• Priority 2
  • Embed mechanisms to enable citizen involvement to play a key role in the system focus on tackling health inequalities. This links to principles 4, 5, 6 and 7.
• Priority 3
  • Work with people and communities on the priorities identified in the Joint Forward Plan. This links to principles 8, 9 and 10.

This is an explanation of some of the names and terms we use in the strategy. 

Insights and the South Yorkshire insights bank

We have an ambition to put our citizens firmly at the heart of all we do, and in order to fulfil that ambition, we need to become more insight led - with a particular focus on citizen insights.

To be an intelligence led system using the collection, analysis, and interpretation of data to inform our decisions it is essential we have the full picture of the health and care needs of our population.

While we have access to a wide range of data about outcomes and performance measures that can tell us about ‘what’ is the problem and ‘how much’ of an issue we have, such data can rarely can tell us ‘why’ we have the problem or to what extent it matters to our population or how we can address it in a way that will meet our citizens’ needs.

We need all three of these things to be an insight led organisation:

Insights provide a deeper understanding of people’s experiences, opinions, beliefs, views, experiences and attitudes. They are typically collected through methods such as interviews, focus groups, and observations, and are analysed using a variety of involvement techniques.

Insights can provide rich and detailed information about people’s experiences and perspectives that may not be captured through data alone. For example, they can help us to better understand the underlying reasons for certain behaviours or attitudes, or provide insight into the emotional impact of a particular experience. Insights are often used in health and care to explore patient experiences, perceptions, and preferences.

They can also be used to inform the development of health and care interventions, policies, and programmes that better meet patient needs and preferences. They are not often gathered as systematically as they could be, or managed in the best way to ensure they inform health and care decisions in the way they could.

Historically within NHS organisations insights are gathered by engagement / involvement teams, typically as part of a service re-design or specific project, rather than routinely as part of ongoing dialogue with our citizens. Similarly experience data has been collected and dealt with on a service-based/ individual issue identification type way, rather than as part of an integrated systematic, connected approach that would enable the data to help influence strategy.

Insights bank

An insights bank is a place to keep insights that organisations collect and to store it for future use.

The purpose of an insights bank is to provide a single location for storing and organising data and insights, making it easier for organisations to access and use the information to inform decision-making. An insights bank can also help ensure that knowledge and insights are not lost or forgotten over time, and can be used to identify trends and patterns over time.

By collecting and storing data and insights in an insights bank, we can more easily track trends, identify areas for improvement, and evaluate the impact of interventions over time.

Our Insights Bank in South Yorkshire will:

• Be co-designed and co-branded so that all organisations in South Yorkshire, including all the NHS organsations, local authorities and VCSE organisations feel ownership of the Insights Bank, use it and contribute to its growth
• Be open access so that anyone can upload insights and anyone can search for insights that would help them
• Protect citizens who have provided insights with anonymisation where needed
• Address the shift that universally citizens and partners tell us they want - ‘don’t come and talk to us when you want to hear something, listen when we’re ready to tell you’.
• Encourage South Yorkshire organisations to work together to gather and share insight, particularly where individuals/organisations are working on the same area or are wanting the answers to the same questions
• Increase the accessibility and value of insight from across the system, through proactively gathering and organising insight
• Maximise our limited resources
• Minimise the burden on communities by supporting an ‘ask once’ approach
• Enable more targeted engagement where gaps or deeper understanding is warranted and ensure we are reaching those we don’t normally hear from
• Support the use of a variety of methods for gathering insight • Help us answer the question “What do we know already?”
• Support an improved approach to the annual refresh of documents such as the NHS South Yorkshire Joint Forward Plan

Insight led system

We have developed this section of our strategy alongside our colleagues who have developed the South Yorkshire Data and Insights Strategy.

The Data and Insights Strategy is pivotal for the journey to build an insight led system in South Yorkshire, which strives to use data to improve the health, wellbeing, outcomes and experiences of our citizens.

The Strategy sets out the commitment to developing a collaborative approach to insight generation across the system, by co-ordinating a system-wide Data and Insight Alliance to make better use of skills, knowledge and capacity across the community; developing a data platform to allow co-creation of insights, which will be derived from both the health and care journeys of our citizens, and the voice of our citizens; and ensuring those insights are easily understandable, and accessible on demand. The ambition is to also go further and use advanced analytical techniques to generate improved insight for decision making.

Within the Data and Insights Strategy, one of the initiatives is to support the development of a data-literate, insight-led health and care system that uses integrated data to unlock insights to understand health inequalities and improve population health. The development of the insights bank sits within this initiative.

Overall the initiative is designed to help the system to greater understand the needs and complexities of the population to better inform design of health and care services. As well as the insights bank this initiative will provide a platform for sharing reports and dashboards across the system; provide improved analytical insights alongside reports and dashboards to draw the user to key points of interest; incorporate more qualitative insights into our analysis including patient voice and experience, the evidence base of ‘what works’ and triangulation with quantitative data; and continually promote an intelligence-led approach to decision making, ensuring data and insights are accessible, understandable and timely.

This wholescale system wide approach will help ensure parity of qualitative insights with data and that the system becomes truly insight led.

Download this information. 

Why get involved?

Who better to tell you why you should get involved than people who already volunteer their time with us.

Watch the video on this page to see how one group of people who used their experiences when pregnant to help support others who are going through similar things. 

"I joined the Cancer Alliance Advisory Board after my own journey with cancer, and as a carer of a friend who died of cancer, as I wanted to use my experiences to help make a difference to services and more importantly, improve the experiences of the patient's and their families and carers. Attending and contributing to the Advisory Board helps to give me a voice in making changes for other patient s and their families."

"The patient voice can be very powerful. Some of my feedback has surprised people because it was something only a person with lived experience knows and they just hadn't thought of it. I've met some fabulous people through being a patient representative, people who otherwise I would not have had the opportunity to meet. Listening to other people talk about their experiences makes you realise that you are not alone and that we all want the same thing."

"During the face-to-face Sheffield event, I had an amazing day working as a Young Person’s Health Equity Champion and meeting other likeminded people. I felt proud of all the effort that I have put in as a volunteer, it gave a sense of purpose and empowerment to my role."

"I feel like myself and other champions have gained insight and perspective into what health inequalities look like and how young people’s experiences of this are reflected across the country, irrespective of where we are in the country. This is such a unique role and I’ve loved being a part of shaping the view on health inequalities and how to positively change it."

"I had a stroke and had no idea what the future held. During one of my visits from the community nurses they told me about a panel of people who'd had a stroke or cared for someone who had that the NHS wanted to put together. I applied to join as I knew that what I could contribute would hopefully help the NHS and myself understand what my experience, opinions, ideas & fears could hopefully give them an idea of how I felt. My experience would hopefully be something they could use to promote and help with stroke prevent ion. I was accepted and have been on the panel from the start. This has gone far wider than I ever expected, the panel have been involved in Stroke Association video's, leaflets, helping other areas in the country, school projects, peer support and lots more.

The NHS use the experiences we have talked about and listen to the ideas we have and act on the one's that are viable. We need to carry on with new project s and help people understand more about strokes without us and the NHS this would not happen."

"I felt proud to be part a project where I could use my experience to improve the journey for others. It was great to be listened to and respected and to feel involved. It wasn’t just an exercise, the project has already been implemented to help others. It shows the NHS want s to improve and will ask for help to do this. Services should be available to everyone and I feel that my part in this will help to make this possible."

"It has been great to be able to put some of my skills and knowledge to good use, in a way that feels like it is going to make a difference to the lives of people in Barnsley. I’m glad I’ve been able to take part in a process that has given people who usually don’t have a voice the chance to be able to be involved. It’s been really good to be part of such a wide group of people who all do different things to come together and work on a project.

I have also got a lot out of the networking side and feel like personally I have been able to make links with organisations and people who potentially I have the opportunity to work with in the future. I am excited to see this project through to the end and to continue working with you all to make Barnsley even better for people with Autism, their families and the wider community."

Download this information. 

We want you - patients, public, citizens of South Yorkshire to get involved in our work. We therefore provide a range of ways you can do this. This section of our Start With People: South Yorkshire Strategy tells you about how you can get involved.

We are always reviewing opportunities for people to be involved in our work so this section of the strategy is a snapshot of our opportunities at the time we have written the strategy. For the latest information please visit the Get Involved section of our website. 

You might also be interested to read some other sections of our strategy:

• The section called ‘Involving specific communities and working with partners’ will tell you more about how we work with partners to widen our involvement opportunities - so things like how we can hear from you if you get involved with your local GP practice, or if you have connections with a charity or local community group or voluntary organisation
• The section called ‘How we use what you tell us’ will tell you what we do with the information we gather from our involvement activity
• The section called ‘Involvement in decision making meetings’ will tell you more about how what we hear as part of our involvement activity is used by decision makers.

Each section has links to web pages for more information or to sign up, however if you do not have access to digital tools please call us on 0114 305 1713.

South Yorkshire Membership Network

We have a South Yorkshire Membership network, which has approx. 1400 members (aged 16+) who have been recruited to be representative of the population. Members of the network sign up to allow us to proactively approach them (digitally) to ask if they would like to participate in our engagement activity.

Members are not accountable to the population; they are actively interested populations who have signed up to be further involved in our work. We send our membership bulletins every 3 months. You can sign up to our membership. In our membership bulletin we also try to keep you updated about opportunities to get involved offered by NHS England and our South Yorkshire partners too.

South Yorkshire patient panels and patient networks

There are currently a number of patient panels operating across South Yorkshire, some of the details of which can be found below. We are committed to growing our partnerships with patients, patient voice partners / Experts by Experience and anticipate that more work in this space will be an imminent development to the involvement mechanisms of the ICB post-publication of this strategy. 

• Cancer Alliance - People Affected by Cancer Advisory Board (PABCAB)

The People Affected by Cancer Advisory Board (PABCAB) is a panel of people who have been affected by cancer in South Yorkshire, Bassetlaw or North Derbyshire either as a patient or as someone who has cared for, or supported, someone with cancer.

It is designed to ensure that the needs of patients and carers are given priority, and to challenge the thinking of those making decisions where necessary. PABCAB meet every two months along with programme leads from the Cancer Alliance, partners from Trusts and partner organisations or charities, for approximately two hours (either online or in-person).

The meetings are a great opportunity to share feedback and updates and to discover opportunities for further involvement. The work of the Advisory Board is then fed back to senior leaders and key decision-making forums of the Cancer Alliance.

Find out how you can get involved.

The Cancer Alliance also has a People Affected by Cancer Membership List which does not involve a requirement to attend meetings and allows you to be involved with less commitment.

Find out more information about being on the membership list. 

• Stroke Survivor and Carer Panel

In July 2021, we developed our South Yorkshire Integrated Stroke Delivery Network (ISDN) Stroke Survivor and Carer Panel. We were overwhelmed by the support that we received and have 12 panel members from across the region.

Our members represent a diverse mix of stroke survivors and carers, all with lived experience of stroke. Members come from each place across our region and their work makes a real difference.

During the panel’s first meeting, members developed their mission statement, which is now the centre of everything they do: “We want a voice and we want to be heard. We want to be able to communicate our experience, both good and bad. So that everyone at all levels understand what problems we hit and how services might be improved. We want equal care and support for everyone across South Yorkshire.”

Work of the panel has included:

• Reviewing the ISDN work programme and priorities
• Co-designing the Thrombolysis patient and carer leaflet
• Reviewing and approving two SY ISDN funding proposals
• Volunteering to take part in a national project on Patient Reported Experience Measures (PREMs)

If you would be interested in being part of this panel, please make contact with the SY ISDN team on: sth.sybisdn@nhs.net 

• Local Maternity Voice Partnerships

Each place in South Yorkshire has a Maternity Voice Partnership. Find out more by visiting their Facebook pages or emailing them:

• Barnsley
  • Facebook https://www.facebook.com/mvpbarnsley/
  • Email barnsley.mvp@nhs.net
• Doncaster
  • Facebook https://www.facebook.com/DBMVP
  • Email fimvpchair@gmail.com
• Rotherham
  • Facebook https://www.facebook.com/profile.php?id=100057350774149
• Sheffield
  • Facebook https://www.facebook.com/SheffMaternity/
  • Email sheffieldmvpchair@gmail.com

What matters to you - Ongoing campaign

When we started our involvement campaign for the Integrated Care Partnership (ICP) Strategy we launched our ‘What matters to you’ involvement campaign, which we then re-launched to help inform the Joint Forward Plan (JFP). We are now launching our ‘What matters to you’ campaign as an ongoing tool for our citizens to use to feedback to us on an ongoing basis.

All year-around people will be able to complete an online survey and the findings will be analysed each quarter and added to the insights bank. This is in response to feedback that people don’t know where to raise issues that are not personal to their experience of care (the route for this would be via complaints/ experience) that they feel the NHS needs to be addressing / prioritising. Periodically we will take action to remind people that they can tell us what matters to them at any time of year, and this will be reflected on our website all year around.

This ‘What matters to you’ approach is designed to complement the work of our Healthwatch partners, who remain the first port of call in the system for this feedback, and who are able to offer alternatives to online feedback mechanisms. Visit the Get Involved to fill out a What Matters to You form.

Come and see us or invite us to attend your meeting

We are increasingly looking at how we can work with our communities to co-produce and co-design services and ensure we are community led in terms of what we prioritise. To give your views on this or our wider work you can attend one of our regular Involvement drop in events, attended by one or more of the Executive Board Non-Executive and Executive Members.

The Get Involved section of our website will list upcoming events: https://southyorkshire.icb.nhs.uk/get-involved

We also offer ‘Invite us to your meeting’ with the aim of strengthening our relationships with our communities.

Please email syicb.involve@nhs.net if you would like to invite us to come and visit you. We also have examples within our system where existing citizen led and administered meetings are given the opportunity to feed in to our systems.

Please contact us if you would like to discuss this further: syicb.involve@nhs.net

Download all this information, together with how we use complaints and experience data, work alongside Healthwatch. You can also read all the ways to get involved in your local area. 

Involving specific communities

For some of the communities we serve, children and young people for example, our traditional involvement approaches wouldn’t work and so we take a tailored approach to working with these communities.

This section of our strategy explains more about the way we work to ensure we hear the voices of these communities.

It also explains how we are supporting parts of the system for which we are not directly responsible for citizen involvement, but for whom we know we can make a difference if we offer our partners our support - such as helping GP Practices to better involve their patients.

This involving children and young people; Involving people from the learning disability and autism communities; Involving people from our underserved communities (including minority communities, people of protected characteristics and our most vulnerable citizens); Involving patients through primary care (GP, dentist, pharmacies and opticians); Involving people who work and volunteer in a health and care role).

Read more about how we work alongside different communities. 

Working with our partners on citizen involvement

Working as an involvement network Over the course of refreshing the Start with People Strategy, involvement professionals from across South Yorkshire’s statutory and voluntary organisations have started working together in an involvement network. 

We are committed to continuing to develop the network of involvement professionals from across South Yorkshire. This approach will allow us to grow best practice across South Yorkshire’s organisations, reduce duplication, improve systems for feeding back citizen voice and experience to the different parts of the system, and help us to develop a system wide involvement commitment to our citizens.

Working with Voluntary, Community and Social Enterprise (VCSE) sector partners, particularly to involve members of our underserved communities

We recognise and work in partnership with the sector to harness the crucial role that the VCSE plays in citizen involvement, particularly for underserved and disadvantaged communities.

We recognise that the VCSE sector has connections with our communities that we would never be able to recreate, thanks to:

• Established trust - Through years of dedicated independent service and grassroots initiatives, VCSE organisations develop deep-rooted relationships based on empathy, understanding, and mutual respect. This trust becomes invaluable when engaging with disadvantaged communities, as individuals are more likely to open up and seek support from familiar faces within their community.
• Cultural competence - VCSE organisations often operate at the grassroots level, where they are intricately attuned to the cultural nuances and sensitivities of the communities they serve. This deep understanding allows them to tailor their approaches and interventions to suit the specific needs and preferences of different demographic groups.
• Accessibility - VCSE organisations are often deeply embedded within the communities they serve. This makes them highly accessible to individuals who may face barriers to accessing mainstream services or resources. VCSE organisations provide a familiar and welcoming environment where individuals feel comfortable.
• Empowerment and ownership - The VCSE sector empowers individuals within disadvantaged communities to take ownership of their circumstances and become agents of change. Through capacity-building initiatives, skill development programmes, and participatory decision-making processes, VCSE organisations equip community members with the tools and confidence to advocate for their rights, access opportunities, and effect positive transformations within their neighbourhoods. South Yorkshire what this partnership approach to citizen involvement looks like and ensure that we resource it.

In South Yorkshire we have a VCSE Alliance. The VCSE Alliance is a South Yorkshire wide network of VCSE organisations and health and care system leaders collaborating to tackle health inequalities across South Yorkshire. The Alliance aims to develop equitable partnership working within the health and care system and maximise the potential of the VCSE across strategy, delivery, engagement and insight. It is one of the three key enabling priorities of the VCSE Alliance to strengthen the VCSE participation role in engagement, qualitative insights and co-design.

We are committed to working in partnership with the VCSE sector to ensure we benefit from the unique position they have to hear from our most underserved communities. We will codesign with the sector in South Yorkshire what this partnership approach to citizen involvement looks like and ensure that we resource it.

Working with Healthwatch

Healthwatch is your health and social care champion. Across the UK there are over 150, in South Yorkshire there are four:

• https://www.healthwatchbarnsley.org.uk/
• https://www.healthwatchdoncaster.org.uk/
• https://www.healthwatchrotherham.org.uk/
• https://www.healthwatchsheffield.co.uk/

If you use health services or need care, they want to hear about your experiences. They have legal powers to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. They can also help you to find reliable and trustworthy advice and information. They are entirely independent and impartial, and any information you share with them is confidential.

Healthwatch was established under the Health and Social Care Act 2012. Each one is funded by and accountable to their local authority. Their main statutory functions are to:

• Obtain the views of people about their needs and experience of local health and social care services. Local Healthwatch make these views known to those involved in the commissioning and scrutiny of care services
• Make reports and make recommendations about how those services could or should be improved
• Promote and support the involvement of people in the monitoring, commissioning and provision of local health and social care services
• Provide information and advice to the public about accessing health and social care services and the options available to them
• Make the views and experiences of people known to Healthwatch England, helping them to carry out their role as national champion
• Make recommendations to Healthwatch England to advise the CQC to carry out special reviews or investigations into areas of concern

The work Healthwatch does is shaped by the issues that are important to local people. They are somewhere independent that people can take feedback and (based on what they hear) they bring challenge to local services, and advocate for improvement.

In South Yorkshire Healthwatch representatives attend many of our NHS South Yorkshire ICB Boards and key meetings to help assure that patient voice is always at the heart of our work.

They also work closely with our involvement team helping bring independent support and challenge to our day to day involvement work.

They can be commissioned by health services, and other partners, to deliver additional services on top of their core responsibilities. In South Yorkshire they are often commissioned to work with the voluntary sector, community organisations and patient and citizen groups to help NHS organisations to hear more voices, particularly of those who are least likely to come directly to us with their experiences, insights and views.

We have a strong relationship with our South Yorkshire Healthwatch organisations and recognise the important role they play in citizen involvement work and offering us support and challenge. We are committed to continuing to maintain and grow our work with Healthwatch.

Download this information. 

How we use what you tell us

In whichever way you are involved in our work we use your insights to help better inform decision making about health and care services.

This might not always be obvious to you because sometimes we take what you tell us and use it to better inform ourselves, but historically we haven’t been very good at getting back to you about the fact that we have used what you’ve told us and the difference it has made.

In publishing this strategy we make this commitment to you: “We will get better at informing our citizens about how their insight has helped inform our work.”

Examples of ways we will do that include:

• Publicising more about this on our website more regularly
• Sharing this on our social media channels and with the local newspapers
• Where possible providing this information back to you in the same way you provided it to us
• Regular reports to our public meetings about what we’re hearing Regular returns to our public meetings about what we’ve done with what we heard

It’s important that you know when you are providing insight to us most of the time this will be gathered together with common views shared from more of our population. We then use that to see what the big issues are that lots of our citizens are facing. We can then put plans in place to address these issues. Often they are not overnight problems that we can solve, but we must get better at coming back to you to let you know about the progress we are making towards addressing them.

We also make sure what we hear from our citizens is heard in our decision making meetings so that our citizens can see how you have directly influenced the decisions that are made, you can read more about this in the section of the strategy called ‘Involvement in decision making meetings’.

If you have a general complaint or comment about a service that you have received care from and you want a personalised response about the care you received, it’s a good idea for you to feed that back to the service, either directly or through Healthwatch. In the NHS we call this experience or complaints, rather than involvement, and these are the parts of our structures that provide direct feedback to you about the care you have received. Your feedback in that way will still help services improve the care they provide too.

If you are interested in finding our more about personalised feedback you might find the section of our strategy called ‘How you can get involved’ and particularly the section within that on ‘Complaints and Experience Data’ is helpful.

Download this information. 

Involvement in the decision making process

There are a number of ways that we make sure what we hear from our citizens is heard in our decision making meetings (this can be called governance).

As well as the mechanisms highlighted below, each paper that is brought to the meetings should spell out how citizens have been involved in forming the content of the paper too.

We are committed to growing our partnerships with Patient Voice Partners / Experts by Experience and will review their future role in our governance accordingly.

If you are interested in knowing more about our governance you can find it on our website.

Download this information. 

Measuring how citizen involvement is making a difference

There are a number of mechanisms by which the involvement work of the ICB is measured through assessment and accountability processes, including:

• NHS England has an assurance process to check we are following the correct processes for consultations
• Local Overview and Scrutiny Committees and Joint Health Overview and Scrutiny Committee
• Involvement Annual Report assurance processes
• Assurance at the Quality, Patient and Public Involvement and Experience (QPPIE) Committee and other governance meetings such as ICB Board and ICP (see ‘Involvement in decision making meetings’ section for more details)

In addition, we’ve looked at our three priorities and the 10 principles and identified what we think outcomes for our population would look like if we were meeting them.

This approach will help determine how we are doing against our aims but also whether our achievements are meaningful to our populations, not just achieving improved involvement approaches, but the improvement in approach following through and leading to improved outcomes for citizens, which is ultimately what drives us.

As with all we do, we recognise that our citizens will be able to provide insight into how we should measure our achievements therefore we are testing these outcome assumptions with our population and we will then work with our citizens to co-design a meaningful measurement framework.

We anticipate that the framework will help us to develop a system that allows us to work with others to measure our work to ensure check and challenge and accountability.

Download this information. 

The NHS has legal duties with regards involving citizens in their work. The main duties on NHS bodies to make arrangements to involve the public are all set out in the National Health Services Act 2006, as amended by the Health and Care Act 2022.

For our partners this includes:

https://www.legislation.gov.uk/ukpga/2006/41/section/13Q  https://www.legislation.gov.uk/ukpga/2006/41/section/242

In this section we will focus on the duties for Integrated Care Boards, including the main involvement duties and other duties where citizen involvement is also referenced:

Section 14Z45 - Public involvement and consultation by integrated care boards

(1) This section applies in relation to any health services which are, or are to be, provided pursuant to arrangements made by an integrated care board in the exercise of its functions (“commissioning arrangements”).

(2) The integrated care board must make arrangements to secure that individuals to whom the services are being or may be provided, and their carers and representatives (if any), are involved (whether by being consulted or provided with information or in other ways)— (a) in the planning of the commissioning arrangements by the integrated care board, (b) in the development and consideration of proposals by the integrated care board for changes in the commissioning arrangements where the implementation of the proposals would have an impact on— (i) the manner in which the services are delivered to the individuals (at the point when the service is received by them), or (ii) the range of health services available to them, and (c) in decisions of the integrated care board affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact.

(3) This section does not require an integrated care board to make arrangements in relation to matters to which a trust special administrator’s draft or final report under section 65F or 65I relates before— (a) in a case where the administrator’s report relates to an NHS trust, NHS England and the Secretary of State have made their decisions under section 65K(1) and (2), or (b) in a case where the administrator’s report relates to an NHS foundation trust, the Secretary of State is satisfied as mentioned in section 65KB(1) or 65KD(1) or makes a decision under section 65KD(9).

Section 14Z36 - Duty to promote involvement of each patient

Each integrated care board must, in the exercise of its functions, promote the involvement of patients, and their carers and representatives (if any), in decisions which relate to— (a) the prevention or diagnosis of illness in the patients, or (b)their care or treatment.

Section 14Z52 - Joint forward plans for integrated care board and its partners

(1) Before the start of each financial year, an integrated care board and its partner NHS trusts and NHS foundation trusts must prepare a plan setting out how they propose to exercise their functions in the next five years.

(2) The plan must, in particular— (a)describe the health services for which the integrated care board proposes to make arrangements in the exercise of its functions by virtue of this Act; (b)explain how the integrated care board proposes to discharge its duties under— (i)sections 14Z34 to 14Z45 (see above 14Z45 is the ICB involvement duty)

Section 14Z54 - Consultation about forward plans

(1) This section applies where an integrated care board and its partner NHS trusts and NHS foundation trusts are— (a)preparing a plan under section 14Z52, or (b)revising a plan under section 14Z53 in a way that they consider to be significant.

(2)The integrated care board and its partner NHS trusts and NHS foundation trusts must consult— (a)the group of people for whom the integrated care board has core responsibility, and (b)any other persons they consider it appropriate to consult.

Section 14Z58 - Annual report

(1)An integrated care board must, in each financial year, prepare a report (an “annual report”) on how it has discharged its functions in the previous financial year.

(2)An annual report must, in particular— (a)explain how the integrated care board has discharged its duties under sections 14Z34 to 14Z45 (see above 14Z45 is the ICB involvement duty

Section 14Z59 - Performance assessment of integrated care boards

(1)NHS England must conduct a performance assessment of each integrated care board in respect of each financial year.

(3)The assessment must, in particular, include an assessment of how well the integrated care board has discharged its duties under— (f)section 14Z45 (public involvement and consultation)

Section 116ZB Integrated care strategies

1)An integrated care partnership must prepare a strategy (an “integrated care strategy”) setting out how the assessed needs in relation to its area are to be met by the exercise of functions of— (a)the integrated care board for its area, (b)NHS England, or (c)the responsible local authorities whose areas coincide with or fall wholly or partly within its area.

(4)In preparing a strategy under this section, an integrated care partnership must— (a)involve the local Healthwatch organisations whose areas coincide with or fall wholly or partly within its area, and (b)involve the people who live or work in that area.

National Health Service Act 2006 (c. 41) SCHEDULE 1B– Integrated Care Boards

PART 1 CONSTITUTION OF INTEGRATED CARE BOARDS Introduction 1 An integrated care board must have a constitution. Arrangements for public involvement:

14 The constitution must include— (a) provision about the arrangements to be made by the integrated care board for discharging its functions under section 14Z45(2), and (b) a statement of the principles to be followed by the board in implementing those arrangements

New ministerial intervention powers for NHS service configurations

A new process for ministerial intervention in reconfiguration of NHS services came into force on 31 January 2024.

Under the updated process:

• A new call-in power allows the Secretary of State to intervene in NHS service reconfigurations at any stage where a proposal exists and take or re-take any decision that previously could have been taken by the NHS commissioning body
• Call-in requests can be submitted to the Secretary of State - the Department of Health and Social Care (DHSC) expects these only to be used in exceptional situations where local resolution has not been reached
• NHS commissioning bodies have a duty to notify the Secretary of State of notifiable reconfigurations - this duty does not apply to reconfiguration proposals where before 31 January 2024 a consultation has commenced with the local authority in accordance with regulation 23(1)(a) of ‘The Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013’
• Local authorities are no longer be able to make new referrals to the Secretary of State under the 2013 regulations

Legal duties in relation to equality

The Equality Act 2010 unifies and extends previous equality legislation. Nine characteristics are protected by the Act, age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex, and sexual orientation. Section 149 of the Equality Act 2010 states that all public authorities must have due regard to the need to a) eliminate discrimination, harassment and victimisation, b) advance ‘Equality of Opportunity’, and c) foster good relations.

To help support organisations to meet these duties a set of principles have been detailed in case law. These are called the Brown Principles.

• The organisation must be aware of their duty
• Due regards are fulfilled before and at the time any change is considered as well as at the time a decision is taken. Due regards involve a conscious approach and state of mind
• The duty cannot be satisfied by justifying a decision after it has been taken
• The duty must be exercised in substance, with rigour and with an open mind in such a way that it influences the final decision
• The duty is a non-delegable one
• The duty is a continuing one

An Equality and Health Inequalities Impact Assessment (EHIA) will need to be undertaken on any proposals for changes to services that are developed through the programme, to understand any potential impact on protected groups and ensure equality of opportunity. Involvement must span all protected groups and other groups, and care should be taken to ensure that seldom-heard interests are engaged with and supported to participate, where necessary.

Involvement must span all protected groups and other groups, and care should be taken to ensure that seldom heard interests are engaged with and supported to participate, where necessary.

NHS Constitution (Refreshed August 2023)

The NHS Constitution produced by the Department of Health establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. The Secretary of State for Health, all NHS bodies, private and voluntary sector providers supplying NHS services, and local authorities in the exercise of their public health functions are required by law to take account of this Constitution in their decisions and actions. Seven key principles guide the NHS in all it does. They are underpinned by core NHS values which have been derived from extensive discussions with staff, patients, and the public. Principle four focuses around patient engagement and involvement and is emphasised through the patient’s rights Section.

Principle four “The patient will be at the heart of everything the NHS does."

It should support individuals to promote and manage their own health. NHS services must reflect, and should be coordinated around and tailored to, the needs and preferences of patients, their families, and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment. The NHS will actively encourage feedback from the public, patients, and staff, welcome it and use it to improve its services.

Section 14Z51 - Guidance by NHS England

(1) NHS England must publish guidance for integrated care boards on the discharge of their functions.

(2) Each integrated care board must have regard to guidance under this section.

Guidance

Both NHS England, and the Department of Health and Social Care, have produced Guidance documents on how to Implement the Act that relate to the duties of NHS England, ICBs and ICPs.

Some of the guidance relates to sections of the Act and have statutory, or legal status, others are more general describing how ICBs and ICPs should carry out their ‘functions’ (responsibilities).

Working in partnership with people and communities: statutory guidance is the key guidance that we follow in discharging our ICB involvement duties. It can be found here: https://www.england.nhs.uk/publication/working-in-partnership-with-people-and-communitiesstatutory-guidance/

This guidance focuses on the involvement duty under section 14Z45 - duty to involve people in commissioning plans and decisions, rather than the other ICB public involvement duties previously listed.

The Statutory Guidance outlines the ten principles of involvement that all ICBs and all Trusts are expected to demonstrate in their approach to involving people and communities in their work, and details how the performance of each ICB be assessed in achieving these expectations.

The guidance is clear the ICB Strategies for Working with people and communities should include:

• Principles and approaches to working with people and communities
• Approach to working with partners so people and communities are involved in priority-setting and decision-making forums across the ICS
• Arrangements for gathering intelligence about the experience and aspirations of people who use care and support, and its approach to using these insights to inform decision-making and quality governance

The Guidance provides links to other relevant guidance and the NHS Constitution:

a) The NHS Constitution – part of Principle 7 is quoted in the Statutory Guidance: “The system of responsibility and accountability for taking decisions in the NHS should be transparent and clear to the public, patients and staff.”

And it adds a further statement: “Transparent decision making, with people and communities involved in governance, helps make the NHS accountable to communities.” b) Integrated Care Strategies – Statutory Guidance on their preparation published by the Department of Health & Social Care on 29th July 2022.

It confirms the legal duty for Integrated Care Partnerships ((116ZB (4)(b)) to: involve “the people who live and work in the area covered by the integrated care partnership” in the preparation of the Integrated Care Strategy.

c) System Quality Groups – National Quality Board Guidance (non-statutory) This was published in January 2022 by NHS England’s National Quality Board.

It recommends that ICB System Quality Group:

• Membership must include at least two patient safety partners (see below) and two members with lived experience
• Act as an important source of insight into what matters to patients and a forum which works with people to make quality improvements
• Act as a partnership to collate intelligence about service quality and influence the ICB to be sure that the system demonstrates good practice in quality of services across the ICS
• That people with lived experience are on any task and finish groups reporting to SQGs
• ICS Places should also have two lived experience on their Quality Groups

• d) NHS Patient Safety – NHS Patient Safety Strategy updated 2021
  • At least 2 Patient Safety Partners as equal partners on ICB Patient Safety clinical governance committees by April 2023

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Future plans

A number of the areas included in this strategy are fairly new ambitions, and there are also areas where we have made reference to our ongoing developing plans.

These are some of our commitments for the future development of citizen involvement for NHS South Yorkshire ICB, and how they align to many of the key themes from what people told us we should do differently to involve them:

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How did we involve citizens in this strategy?

Background: On 1 July 2022 NHS South Yorkshire launched our people and communities strategy. 

The strategy set out how ‘at the heart of our role as a new integrated care board is the commitment to listen consistently to, and collectively act on, the experience and aspirations of local people and communities’.

When we wrote the strategy we undertook to work with our communities and stakeholders as widely as possible to help them to shape our document, but always accepted there were limitations. We also knew that as we were launching the strategy at the start of our new organisation that things would likely change as the organisation more clearly found its way, we therefore acknowledged that this would be our starting position and we would change and adapt, looking specifically at a one-year review of the strategy.

In late February 2023 we let people know that we would be planning our refresh and should there be any feedback that people would like to submit they could do so via email. Other than that statement on our website, we delayed the work to refresh the strategy to allow South Yorkshire’s NHS Joint Forward Plan and running cost allowances programme to be further developed so that the refreshed Strategy is informed by a position that better reflects the future of the organisation, and to address capacity limitations within the team during this time.

Work on the ambitions within the initial strategy did not stop during this time.

Approach to the refresh 2024/25

We started with what we already heard from our citizens in various citizen involvement pieces of work (including from our initial involvement activity when we launched the original strategy). This included our own involvement work and information that our partners shared with us.

The ambition was to ensure a much more joined up approach with our partners than when the initial strategy was written. Therefore the refresh has been led by a task and finish group of involvement professionals from across South Yorkshire and citizens/ citizen representatives. Virtually this group includes over 40 attendees and has met a number of times since an initial workshop.

An initial workshop with the task and finish group took place on 29th November with 20 participants from a range of sectors and places within South Yorkshire (as follows):

Healthwatch Doncaster • Healthwatch Sheffield • Voluntary, Community, Social Enterprise (VCSE) Alliance representative • Citizen – Member of the Cancer Alliance Patient Advisory Board • Rotherham Council • Cancer Alliance • Citizen – Andy’s Man Club representative • Rotherham FT • Voluntary Action Rotherham • Sheffield Council • NRS Healthcare • Rotherham United Community Sport • NHS South Yorkshire Integrated Care Board • Chair: Lesley Dabell, Non-Executive Director from NHS South Yorkshire Integrated Care Board and Chair of the Quality, Performance, Patient Involvement and Experience Committee • Independent Facilitator: Paul Parsons, The Consultation Institute Associate

The workshop covered:

• Background and where are we now
• Where are you now
• Where do we want to be
• Features of a good involvement strategy
• How do we involve citizens in refreshing our strategy

The themes from the workshop were used to shape our six-page citizen involvement plan. We set out in the plan how we’ve got to where we’ve got, what we think might change and stay the same in our refresh, the timescales for the work and how people could get involved. We endeavoured to provide a number of ways that people could get involved so that they could pick their preferred method, this included: 

• An email address for people who prefer inputting via open text
• A survey for people who prefer to be more guided in their responses
• An online meeting
• Four drop in sessions, one in each of South Yorkshire’s places
• An invite for community groups to invite us to their existing meetings
• An opportunity to be involved in a Readers Panel

We invited citizens who are signed up to our 1400 strong membership network if they wanted to be on a Readers Panel for this piece of work. Thirteen people joined the panel and gave their input to the citizen involvement plan before it was launched. The invite to be part of the Readers Panel was included in the citizen involvement plan for people who would like to read and contribute their views to the draft strategy.

Emails promoting the opportunity to get involved and signposting to the citizen involvement plan were sent to:

• All system comms leads with ask of them to circulate in their networks and share on social media
• JHOSC Officers with ask of them to send to JHOSC members and Council Membership colleagues for circulating to all elected members so that they could chose whether they would like to contribute and also invite their constituents to contribute
• The 1400 strong NHS SY ICB Membership
• All system involvement leads with ask of them to circulate
• Healthwatch leads

The opportunity to get involved was also shared on social media from this date and every couple of days there-after and a press release was issued to the local media.

Alongside the opportunities for our actively engaged citizens to input into the refresh, we also commissioned the South Yorkshire Healthwatches to work with our underserved communities to ensure the refreshed strategy reflects their voices.

The timescale for citizen involvement was as follows:

2022 - Approach to developing the original 'Start with People' strategy

This describes how our People and Communities Strategy ‘Start With People’ was originally developed in 2022, building on the existing engagement and involvement strategies of partners and using insight from communities about what works and what doesn’t for NHS engagement. Colleagues from NHS organisations, Healthwatch, VCSE and other partner organisations fed in their views and experiences, as did members of the public.

March 2022

Plan for developing the People and Communities Strategy for the South Yorkshire Integrated Care Board

Overview

• Where something is a national directive/ reference to national policy/ reflection of wider policy/ elements that can’t be influenced etc this will be written reflecting the strategy template provided by NHSE/I (see below)
• We will develop the People and Communities Strategy as a high-level document to work alongside an Annual Communications & Engagement Plan, which will involve more details about the priority topics for each year
• Where something can be influenced, we will work with stakeholders to develop these elements. We have identified the following opportunities:
  • Principles
  • How we will involve
• When we have drafted the Strategy ,we will give stakeholders the opportunity to comment on our draft

Principles

• We will analyse the existing principles that have been provided nationally and have already been developed locally in Place and we will develop a set of our own principles based on these
• We will then approach our stakeholders to ask:
  • Are these principles right?
  • Is there anything missing? 

How we will involve

• We will develop narrative and questions designed to encourage people to tell us: ‘What would good patient and public involvement from an NHS organisation look like from your point of view?’
• We will work with partners and using existing mechanisms to gather as many responses as possible
• We will have these responses independently analysed to help shape the approach to involving people and communities in the ICB that we will then explain in the People and Communities Strategy

Stakeholders

•Patients / Citizens / Service Users (including patient groups) / Carers • Public - Citizen’s Panels - Memberships - PPG networks - Wider public via social media / networks / discussions at meetings / Media coverage - Campaign groups - Community groups - Seldom heard communities • Staff • Leaders • VCSE partners • Healthwatch partners • Local Authority partners • Wider public sector partners and place partners • Health and Wellbeing Boards / Councillors / MPs • Trust Governors • Children/ Young people • Carers / Families / Relatives Groups

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