Welcome to…..

• Colin Smith – Patient and Public Involvement Manager • Annette Bygraves – Training & Development Manager -

Learning Outcomes

• Be able to identify the purpose, strengths and weaknesses of the focus group methodology • Understand the fundamentals of setting up and facilitating a focus group and using the information to improve services • Be able to plan your own focus group

What is Patient & Public Involvement?

The official process of ensuring that patients and the public are involved wherever decisions are taken about care in the NHS • The planning of the provision of those services • The development and consideration of proposals for changes in the way those services are provided • Decisions to be made by that body affecting the operation of those services.

Why do we do PPI?

•

It’s the law

–

Health and Social Care Act Section 11

–

Section 242 of NHS Act 2006

•

It’s PCT Policy

–

PPI Strategy May 2003

•

We are audited on it

–

Fitness for Purpose 2006

•

It improves services

–

Quality Standards 2007/8

What methods are there?

Questionnaires & Surveys Interviews Health Panels Patient / Lay Representatives Seminars Using Expert Patients Observation Patient Diaries

Focus Groups

Newsletters Patient Groups Leaflets Citizen’s Panels Patient information Using the web site Using PALS Talking to and involving local groups Displays and notice boards

Where do focus

groups

fit in?

• Communication tool • Participation tool

When are focus groups used?

As a stand alone initiative Or Before, during and at the end of consultation

Exercise 1 •

Split into pairs and discuss “What are the benefits of PPI and what are your experiences of PPI”

Purpose and Process

What are Focus Groups?

• In-depth discussion group • 6 – 12 participants • Common experience and characteristics • Specific focus to agenda • Key questions with prompts • Facilitator and scribe (audio recording)

Customer Care Objectives:

•To explore what customer care could mean for the PCT •To generate ideas on what a customer care programme would include, how it should be delivered, the sort of materials which are needed and who could be involved in delivering it

Customer Care Objective 1 on scope:

• What does the idea of ‘good’ customer care mean to you’?

• In what ways could receiving a ‘good service’ be the same as receiving good customer care? (prompt) ‘In what ways would it be different?’

Why useful?

• Generating ideas and perspectives • Creative discovery of issues • Unexpected findings • Understanding of views and reasons • Qualitative not quantitative enquiry

Pros and Cons

• Interaction for novelty: absence challenge • Generates overview : not evidence • Content emerges : comparison difficult • Transcription accuracy : time consuming • Clarification and interpretation : confidentiality • Endorsement and support : staff and patients

Pros and Cons

• Literacy skills : interpreters • Views and feelings : facilitator characteristics • Learning experience • New networks

Exercise 2 •

Freethink “In what situations do you think a Focus Group would be useful?”

Planning (1) Why and What…….

• Setting Objectives and writing questions

Part of the planning process ?

• The purpose of the focus group will determine the outcome and information you gain • The questions you use influence the kind of information you receive • Need to know who your workshop outcomes are aimed at and what information is needed

Setting Objectives

• Be clear about the purpose of the focus group and embody this in 2 or 3 objectives which need to have an action word e.g.

    To find out To explore To generate To develop

Setting Objectives

• To discover experiences of evaluating training • To generate ideas on approaches to evaluating the impact of training • To develop a 5 year strategy to firmly establish systems for evaluating of training within the organisation

Writing Questions

• Design questions relevant to objectives • Iterative process • Key questions • Prompts

Writing Questions

Obj. To generate ideas on approaches to evaluating the impact of training

• Key Qu. How can the benefit of attending training be assessed?

• Pr. Has anyone ever completed a questionnaire at the end of a training day?

• Pr. What aspects of the training were you asked to comment on?

• Pr. How were you asked to comment? (e.g. tick box)

Planning (2) Who and Where…….

Recruitment and Environment

Recruiting willing participants

• Use existing contacts • Use staff who work with patients • Use Voluntary Sector to identify people • Keep lists of willing participants

Selecting your participants

• Knowing your population • Linking objectives to population • Targeting e.g. diabetes • or Generic e.g. access to services • Or more controversially…… • Living with HIV/ AIDS versus attitudes to HIV/AIDS

Working with under-represented groups

• Faith Literacy Training • BME Mental Health Scoping Group - consultations • Race for Health initiative • Youth events • Refugee and Asylum Seekers • Older Peoples Network • Neighbourhood Forums

Equality Impact Assessments!!

Environment

        Location, location, location !

Seating plan: formal, informal Who’s facilitating ?

Audio/video equipment Flip charts & post its !!

Someone to do the writing up / audio typing !!

Refreshments Accessibility and special needs

Think before you begin!!

•

Prepare in advance

•

Make sure your preparation looks professional.

•

Do you know what the issue is about?

•

Do you know who is coming?

Make sure everything pre event has happened as it should

Running the Focus Group

• How do you do it?

Have you got the psychological environment right?

•

Create a non threatening atmosphere

•

Welcome and Introduce everyone

•

Use icebreaker or pre-discussion chat

•

Explain purpose of the session

•

Agree or share ground rules

•

Clarify how you will record discussion

•

Don’t overload the group with staff?

Has everything gone to plan?

During your focus group

• Managing the discussion and time • Ensure everyone participates • Good facilitation, – using pauses, – using a range of questions such as probing questions, – summarising and agreeing, – effective listening

Dealing with Difficult People The good news……… Most people who participate want to contribute positively Very, very occasionally you get someone who is difficult Who are they and what can you do?

Dealing with Difficult People Who are they and what can you do?

Too-talkative person – Talks all the time and monopolises the discussion

•Thank them for their contribution and ask for other peoples

comments

•Remind them that everyone is there to participate •Use your body language – Don’t look at them when you ask

for a contribution. Turn your back on them if you can!

•Ask people to talk in turn

Dealing with Difficult People Who are they and what can you do?

The silent individual – does not become involved

•Watch carefully for any signs that someone is not

participating (body language)

•Call on this person sensitively, and invite a contribution or

perhaps pose the question/point in a different way

•Ask them if they agree with the point being made •Ask people to talk in turn

Dealing with Difficult People Who are they and what can you do?

“Vicky Pollard – Yeah but, yeah but…… Agrees but then points out the opposite again and again.

•Acknowledge their concerns •Ask the rest of the group for their views •After three “yes buts”, state the need to move on and offer to talk

to them outside the group

•If the person interrupts with “yes buts” try suggesting that we are

there to get a variety of views/ideas etc and offer to talk to them outside

Dealing with Difficult People Who are they and what can you do?

Mr Angry – Hostile, negative and undermining – Disagrees with everything

•Keep your own temper in check •Talk quietly, sit down so you are on their level •Validate the person where you can but don’t use counselling jargon •Sometimes the group itself will moderate, but don’t let the group

become excited

•If the anger is directed at you, suggest a break and talk to them during

it to find out what is happening.

•If no solution is acceptable ask “what they would like to see happen”

Some useful sound bites

I don’t know, but I Know someone who will know That’s an interesting point, anyone else got a view on that?

So what should be happening/should we be doing?

Let me repeat the question I will get back to you on that issue Thank you, that’s really useful

Closing your Focus Group

• Thank people • Explaining what happens next – Writing report, timescales etc • Expenses • Make sure you have all contact details

Some final tips

Smile! Greet everyone personally and by name Remember people’s names Say thank you a lot!

Use open ended questions, not questions that will give you a Yes/no answer Make sure everyone can get home Repeat the question

Feeding back the outcomes

To the participants To the organisers To the wider staff team To the wider community Use different ways to present the outcomes depending on your target audience

Making use of the information

Change the way you and your staff team work Inform policy and decision makers about changes needed Develop new working relationships with other providers Do further information gathering to back up your findings

Closing the Circle

• Becoming a learning and reflective team • Reviewing actions as a result of the focus group outcomes • Revisiting issues to see if things have really changed • How can we learn from the experience and do even better next time !

What you will be doing – Group Exercise

• You will run and participate in a Focus Group.

• Split into pairs, agree the order you will go in, design 2 questions in each pair including prompt questions.

• Each person will have three minutes to ask their questions) • The focus group will be videoed

What you will be doing(2) Reviewing focus group

• What questions did you ask?

• How did you ask it?

• How did people respond?

• Would you do it differently next time?

The Future

Where to next with your focus group

Planning Your Focus Group

On your own consider the questions and make notes: • • • • • What would you like to find out?

Why is it important to you?

What would you do with the information you gain?

Who would participate in your group?

What questions could you ask?

Planning Your Focus Group

Discuss your plan with your neighbour and then agree: • What is the next thing you will do to take your focus group plan forwards.

Learning Outcomes

• Be able to identify the purpose, strengths and weaknesses of the focus group methodology • Understand the fundamentals of setting up and facilitating a focus group and using the information to improve services • Be able to plan your own focus group

Running a Focus Group