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The Engagement Cycle

“There are many people who can help commissioners do this well... so a key task is nailing down who is leading on gathering data, who is looking at and interpreting the data and crucially how all that feeds into decision making.”
David Gilbert Director InHealth Associates

This resource is for commissioners of health services, it sets out what is required of you when engaging patients, carers and the public in the decisions you will make about health service provision and provides practical advice, case-study examples and links to other vital information.

This resource will support you as you develop and deliver your clinical commissioning group engagement strategy and plans. We recommend that you share this resource with colleagues and discuss it at relevant meetings.

It is easy to join the free online NHS Institute Patient Experience Network. Through the monthly email newsletter you will be kept up to date with good practice and other learning opportunities. 

Why engaging with patients and the public is important

There are many reasons for engaging with patients, users, carers, communities and the public including those which are:

  • moral - many believe that being engaged in decisions about planning, designing and delivering services is a fundamental right
  • business - engaging people in planning, monitoring and improving health services can make sound business sense. An economic case for patient and public involvement in commissioning
  • social and political - engaging people in planning, monitoring and improving health services can lead to more trusting and confident relationships between local stakeholders
  • health  - There is growing evidence that patient and public engagement (PPE) can deliver improvements, such as more responsive services, improve outcomes, patient experience, shared decision-making and self-care
  • legal - There is a statutory duty for Clinical Commissioning Groups (CCGs) to engage patients and the public and patient and public engagement (PPE) as part of the Clinical Commissioning Groups' Authorisation Process.

What The Engagement Cycle is

Engaging with patients and the public can happen at two levels:

  • Individual level – 'my say' in decisions about my own care and treatment
  • Collective level – 'my' or 'our say' in decisions about commissioning and delivery of services

This web resource focuses on the collective level.

The Engagement Cycle is a strategic tool that helps commissioning teams understand who needs to do what, in order to engage communities, patients and the public at each stage of commissioning.

It identifies five different stages when patients and the public can and should be engaged in commissioning decisions:

  • Community engagement to identify needs and aspirations.
  • Public engagement to develop priorities, strategies and plans.
  • Patient and carer engagement to improve services.
  • Patient, carer and public engagement to procure services.
  • Patient and carer engagement to monitor services.

At each of these five stages (identify, develop, improve, procure, monitor) The Engagement Cycle provides simple advice on what to do in order to undertake high quality patient and public engagement (PPE) that will enhance and support the decisions that commissioners need to make.

Each stage of the cycle provides useful intelligence for the next (like a baton being passed on from one stage to another).

The Engagement Cycle can help commissioners towards authorisation and beyond by helping to:

  • develop a shared understanding of what good engagement looks like
  • providing a strategic direction and basis for planning
  • clarifying relationships, accountabilities, roles and responsibilities. 

Who it is for

The Engagement Cycle is for all those who have a lead role in local commissioning this includes:

  • Clinical Commissioning Group Board Members (Chairs, Vice-Chairs, Clinical Leads for Patient and Public Engagement, Lay Members and other Board Members)
  • Clinical Commissioning Group managers (e.g. Chief Operating Officers) and staff
  • PPE Practitioners working with CCGs and other commissioners
  • commissioning support organisations.

It is also for local stakeholders who need to understand, input, and influence commissioning, this includes:

  • local authorities
  • health and wellbeing boards
  • health and social care providers
  • voluntary sector, patient and community organisations
  • LINks and HealthWatch. 
Image Community engagement to identify needs and aspirations Public engagement to develop priorities, strategies and plans Patient and carer engagement to improve services Patient, carer and public engagement to procure services Patient and carer engagement to monitor services Making it happen