Revealing insights from Action Based Co-creation (ABC) workshops in Tower Hamlets are informing a strategy to transform local primary care.
Pressure on GP services is rarely out of the news and is a big issue for NHS commissioners. It is a particular concern in the east London borough of Tower Hamlets, where population growth is putting a strain on primary care services and on practitioners.
NHS Tower Hamlets Clinical Commissioning Group (CCG) is developing a strategy to cope with demand and contracted Partners in Creation to design a co-creation process that would inform that planning.
Ellie Hobart, the CCG’s Deputy Director of Corporate Affairs explained: “Since taking on co-commissioning of primary care we have been rethinking how we do it and working with stakeholders to develop a new strategy for how we can improve services and tackle the issues facing primary care. it.
“We felt we had done a lot of engagement with people who are already using services regularly but we were conscious that there was a whole raft of people who we weren’t capturing in our wider engagement plans.”
Together the CCG and Partners agreed an approach that included two ABC workshops, each with more than 20 residents and nine health professionals. Included in the groups, which ran in July 2016, were Dr Sam Everington, Chair of the CCG, and Jenny Cooke, Deputy Director of Primary Care.
The workshop revealed a local population with well-formed and constructive opinions. According to John Isitt, one of Partners' Founding Directors: “Local residents are active collaborators in waiting – a resource which Tower Hamlets could tap into for further help to design a new service offer.”
People were found to have strong ideas about how they would like services to work; often informed by the sort of customer experience they received from other sectors.
“For instance, the perception is that people feel they need to see a clinician; a GP [in the first instance],” says Ellie Hobart. “What people were saying to us in the workshops was that they didn’t actually feel that need for minor ailments. They trusted the practice nurses or other roles equally, if this would give them speedier access.”
For Ellie Hobart and the Tower Hamlets team, the ABC workshop set up worked well. “The feedback we got was that everyone who participated found them really valuable, and very different.
“It was the process itself, and the investment [Partners] put into developing it and recruiting the right people that paid off, because people felt really engaged. That was the professionals as well as what we call the ‘naive participants’.
“One person who came along does a lot of community work. She said ‘we never hear these people’s voices’. She gets so used to working in the community and hearing the same people. She was hearing other stories and experiences and it brought into sharp contrast for her what the difference was. “
A key benefit of the approach for the CCG was having professionals, including senior staff, present and participating without hierarchy coming into play. “It was good for them to hear the conversations people were having,” says Ellie. “They contributed when it was appropriate but didn’t throw the conversation one way. That first person experience was a massive benefit.”
For her the project drew people out. “We reached a level of information I don’t think we would have got to with other methods. There was a whole section of the community that isn’t usually listened to or reached. It was extremely valuable and the process itself was very well received.
“It is influencing our strategy; we’re still working that through with our membership and other stakeholders but it has fundamentally influenced and given support to a new model of care.”