360 Degree Stakeholder Survey 2015 Summary of Findings Lincolnshire East Clinical Commissioning Group
Purpose This briefing provides summary information on the findings of the 2015 360 Degree Stakeholder Survey, delivered by Ipsos Mori on behalf of NHS England. The briefing includes the headline results for South Lincolnshire Clinical Commissioning Group (CCG). Headline results from each section of the survey are provided as well as a comparison to the 2014 results, where available. Benchmarking tables for key questions are also provided. The full results can be accessed through the report compiled by Ipsos Mori. Background The 2015 CCG 360 Degree Stakeholder Survey was delivered by Ipsos Mori on behalf of NHS England. This survey was also delivered in 2012 and 2014. It aims to provide information that the CCG can use to inform organisational development and to feed into the assurance process between NHS England Area Teams and the CCG. Fieldwork for the survey was undertaken between 10 th March 2015 and 7 th April 2015. Preparation for the survey was undertaken by the CCG, with support from Arden and GEM CSU, in drawing together the stakeholder list and contacts in line with NHS England guidelines. The survey included a series of questions for all stakeholder groups with additional targeted questions for specific groups. The overall response rate to the survey for Lincolnshire East CCG was 56%. A breakdown of responses by stakeholder group is included overleaf in table 1. 2
Table 1 Breakdown of responses by stakeholder group Stakeholder group Invited to take part in survey Completed survey Response rate GP member practices 31 15 48% Health and wellbeing boards 2 1 50% Local Healthwatch/patient groups 4 4 100% NHS providers 7 4 57% Other CCGs 3 2 67% Upper tier or unitary local authorities 6 4 67% Wider stakeholders 4 2 50% 3
Findings Ipsos Mori provides comparisons of the 2015 survey results to: The 2014 survey results (where comparison is available); The national average; The cluster average*. *Each CCG is compared to a cluster of 20 other CCGs to which they are most similar Due to the low number of responses and differences in stakeholder lists comparisons should be treated with caution. Differences in results are not necessarily statistically significant. Sample The overall response rate to the survey was 56%. This is slightly lower than the 72% response rate achieved in 2014. The largest stakeholder group within the survey is member practices, with the fifteen responses from this group accounting for nearly half of all responses. The low number of respondents from all groups should be noted when considering the results, particularly in any breakdown of responses by stakeholder group. Comparisons should be treated with caution and it is more useful to consider changes in the numbers of responses rather than the percentages, which may be misleading. Summary The overall trend is downward with less positive responses from stakeholders for most questions. Responses from GP member practices are, broadly, less positive and more negative compared to the 2014 survey results. There are a number of areas where this downward trend is more pronounced, particularly understanding of and confidence in the CCG s plans and priorities. 4
Benchmarking The CCG benchmarks in either the middle or the bottom third against the cluster group and/or nationally for most questions in the survey. As with comparisons to the 2014 survey results the low number of responses should be taken into account before drawing any conclusions from benchmarking. The CCG benchmarks in the bottom third both nationally and against the cluster group for most questions on plans and priorities; clinical leadership and monitoring of service quality. Overall engagement and relationships Most stakeholders (26, 81%) rate their working relationship as very good or fairly good. This is about the same as in 2014. About half feel that their working relationship with the CCG has got better in the last 12 months. Again, this is about the same as in 2014. There is a downward trend in responses from member practices, with less stating that they feel engaged with the CCG and less satisfaction with the way in which they have been engaged. Most member practices (11, 73%) rate their working relationship with the CCG as good, about the same as in 2014. Benchmarking The benchmarking position of the CCG is mixed for questions on overall engagement and relationships. Most results are within the middle third of results nationally and against the cluster group. 5
Domain 1: Are patients receiving clinically commissioned, high quality services?* *Questions in this section are targeted for either member practices or NHS providers. Results are not benchmarked. Member practices are less positive about the CCG s arrangements for member involvement than in 2014. The exception to this is in the proportion of member practices who feel that they are able to take a leadership role, which has increased. NHS providers are either positive or neutral about the way the CCG works with them. Domain 2: Are patients and the public actively engaged and involved? *Questions in this section do not necessarily relate to patient and public involvement There has been a downward trend in positive responses to these questions. Responses from healthwatch and patient group stakeholders appear more negative than in 2014, although the very low number of responses from this stakeholder group should be noted. Benchmarking Only one benchmarked question in this section relates to patient and public involvement the extent to which stakeholders agree that the CCG involves the right individuals and organisations. The CCG benchmarks in the bottom third against both the cluster group and nationally for this question. The CCG benchmarks against the middle or bottom third nationally and against the cluster group for all other questions for which comparison is provided. 6
Domain 3: Are CCG plans delivering better outcomes for patients? There is a downward trend in confidence in the CCG s plans and priorities and in the extent to which stakeholders feel that they can influence them. This is driven by member practice responses. Eight member practices (53%) state that they know a great deal or a fair amount about the CCG s plans and priorities compared to sixteen (76%) in 2014. Five member practices (33%) agree that the organisation s plans and priorities are the right ones compared to thirteen (62%) in 2014. However, most member practices agree that improving patient outcomes is a core focus of the CCG. More member practices indicated that they do not understand the implications of the CCG s plans and priorities than in 2014. Benchmarking The CCG s results for almost all questions in this section are within the bottom third nationally and among the cluster group. Domain 4: Does the CCG have robust governance arrangements? Responses in this section are mostly similar to those in 2014 for stakeholders overall. There is a small downward trend in positive responses from member practices. There is a marked decrease in the number of member practices who have confidence that the CCG acts on the feedback it receives about the quality of services from seventeen (81%) in 2014 to seven (47%) in 2015. Benchmarking Only the three questions on monitoring service quality are benchmarked. The CCG benchmarks in the bottom or middle third for each of these against the cluster group and/or nationally. 7
Two new questions for member practices were included in the 2015 survey around co-commissioning. These were not benchmarked. In terms of member practices involvement in discussions around co-commissioning nine feel that they have been involved and six feel that have not. Nine practices are fairly or very confident that the CCG is taking the right steps to prepare for co-commissioning. Domain 5: Are CCGs working in partnership with others? Responses within this section targeted at specific stakeholders are difficult to analyse meaningfully due to the low numbers of responses. Health and Wellbeing Board stakeholders responded positively against all questions they were asked in this section, as they did in 2014. Upper tier local authority stakeholders were mostly positive or neutral, apart from the question on the effectiveness of the CCG s involvement with the Safeguarding Adults Board. Benchmarking There is one benchmarked question in this section on the extent to which the CCG has contributed to wider discussion in the health economy. Results are within the middle third nationally and against the cluster group. Domain 6: Does the CCG have strong and robust leadership? There are more negative responses from member practices on the overall leadership of the CCG compared to the 2014 results. There is not a significant degree of difference in the proportion of stakeholders responding positively to questions on the overall leadership of the CCG, compared to the 2014 survey results. Responses relating to the clinical leadership of the CCG are broadly the same as in 2014. 8
Benchmarking Results for the CCG on overall leadership are mostly within the middle third nationally and against the cluster group. Results for the clinical leadership of the organisation are mostly within the bottom third nationally and against the cluster group. Conclusion While the results suggest a downward trend and poor performance against the national average and the cluster group they should be treated with caution. The sample is not statistically reliable and changes in results or comparisons to other CCG s results should be treated with caution. The results can however, provide an indication of areas in which stakeholders view the CCG as strong and areas they view the CCG as not strong where they are backed up by other sources of intelligence. The views of member practices are better represented than those of other groups as they make up nearly half of all responses. The results point to potential developments in member practice engagement for the CCG, particularly around understanding of and confidence in the CCG s plans and priorities. There are potentially concerns among some member practices about the monitoring of service quality. If these concerns are being expressed through other channels then this is also a clear area for focus for member engagement. Similarly, the results indicate some member practices have concerns around the organisation s plans and priorities and a lack of confidence in the clinical leadership of the organisation. Most stakeholders (81%, 26) rate their relationship with the CCG as good or very good. A much lower proportion of stakeholders (47%, 15) however, feel that their relationship with the CCG has got better in the last twelve months. This is a similar picture to the results in 9
the 2014 survey. Four stakeholders respond that their relationship has got worse this includes three member practices. While analysis of responses from other stakeholder groups is problematic due to the small numbers of responses it should be noted that there are consistently negative responses from healthwatch/patient group stakeholders. This indicates another potential area for focused stakeholder engagement. 10