Step 4: Stakeholder Engagement
Tool 1: Engaging Stakeholders
This tool is for use in conjunction with Step 4 of the Commissioning Toolkit document

Five stage engagement plan
1)		Identifying your stakeholders	
	•	Draw up a list of all the stakeholders you and your colleagues think should be involved in and/or informed of your commissioning project.  
•	For the groups and organisations you list, identify named individuals to engage with directly.  They need to be in the position to sufficiently represent their organisation.
•	Create an initial stakeholder list.  You might like to use the stakeholder analysis template as a starting point.	
2)		Carrying out a stakeholder assessment	
	•	Analyse your stakeholders, thinking through issues such as: 
o	What do they currently think about the pathology service they receive? Is local or national performance benchmarking available?
o	Are they likely to support or oppose your commissioning project?
o	What motivates them?
o	Who might they be influenced by?
o	If they are likely to remain in opposition to your work, how will you manage that?
•	When analysing your stakeholders, use existing sources of data which might be useful, such as patient surveys, average test turnaround times, etc
•	Using a stakeholder map like the one in this toolkit, translate your analyses into a stakeholder map, so you can determine those which are:
o	High importance, high influence 
o	High importance, low influence 
o	Low importance, high influence
o	Low importance, low influence 
•	Once your stakeholders are mapped, you can more easily identify who your key stakeholders are for the project and will need particular attention.	
3)	Being clear about what engagement means	
	•	Ensure that the leads of your commissioning project have a real commitment to engagement in the project.  For example, check that there are adequate resources such as the right people, time and money, and add engagement issues to the project’s risk log.
•	Be clear from the outset, what aspects of your commissioning project stakeholders can realistically influence.  
•	Have a shared,  understanding of what your commissioning project’s objectives, and the purpose of the engagement 
•	When engaging stakeholders, establish their roles, responsibilities and provide a terms of reference for the activities you’re asking them to take part in.  
•	Ensure confidentiality and conflict of interest forms are signed, as appropriate, and signatories understand their responsibilities and breach implications	
4)	Drawing up engagement activities	
	•	Before you start, be sure that everyone in your commissioning team is clear about your key messages.  Consider composing:
o	A list of key facts
o	Answers to some frequently asked questions
o	Some ‘lines to take’ for representatives of your organisation so they can give a consistent message to stakeholders
•	Establish how you will inform and/or engage with your stakeholders – this may change as the project progresses.  Routes may include: 
o	Bespoke focus groups
o	Face to face meetings
o	Representation on project team
o	Presenting at established network meetings
o	Designated project web pages
o	Bespoke news updates (it may not have to be printed material, an email update may suffice)
o	Digital marketing routes such as online surveys or your organisation’s facebook page
•	Draw up a detailed engagement plan for each stakeholder group.  You may like to use the sample individual stakeholder activity summary in this toolkit.
•	Remember to make effort to include traditionally ‘hard to reach’ groups
•	Plot activities against the commissioning project timeline 	
5)	Feeding back on progress	
	•	Ensure that stakeholders know how their involvement will shape your project, then feed back on how their input has influenced the decision making process.  For example they might be able to:
o	Help develop key performance indicators
o	Input into specifications documents
o	Play a part in shortlisting bidders 
•	Keep a log of engagement activities to demonstrate how stakeholders have been involved and informed
•	Include stakeholder activities and feedback in update reports to the project board
•	Keep stakeholders regularly informed.  A ‘little and often’ approach helps to maintain stakeholder commitment – e-newsletters are quick and cost effective ways of doing this
•	Anticipate and manage potential media interest in your commissioning project.  Issue press releases, as appropriate, and be ready with your ‘lines to take’
•	Say “thank you” and celebrate milestones and outcomes.	

Stakeholder analysis template
This stakeholder analysis template appears in NHS Central Lancashire’s Public Engagement Toolkit.  An editable excel version is available from www.centrallancashire.nhs.uk/Library/PEToolkit/03_Stakeholderanalysistemplate.xls

Sample stakeholder map
You may have identified quite a list of people and organisations that you need to engage with as part of your commissioning project.  It may help to prioritise them, identifying which you need to focus your energies on, which could block or spur on your project, which will be interested and which not.   Creating a stakeholder map could help with this process. 

The example below is compiled by the Strategic Projects Team at NHS Midlands and East as part of its communications and engagement plan for phase three of the Transforming Pathology Services project.  You may need to revisit your map at key stages of your project as key stakeholders may change.  

Sample individual stakeholder activity summary
Once you have identified your key stakeholders and prioritised them, you need to establish how you will involve, engage and inform them.  The sample below was compiled by the Strategic Projects Team at NHS Midlands and East as part of its communications and engagement plan for phase three of the Transforming Pathology Services project.  It focuses specifically on patients and patient representative groups.  Similar tables were created for other stakeholder groups.
Remember to revisit your engagement activities at key stages of your project as approaches may need to change.  

Target audiences:
	Patient and patient representative groups

Sub audiences:
Specific patient groups (eg: LINks/Healthwatch)
Carers 
Other patient participation  groups (eg: those with long term conditions, surgery groups)
GPs
	
Why?
Why are we engaging with them?	•	They’re the users of pathology services (over 70% of consultations require diagnostic testing)
•	We need to understand patients’ preferences to how, where and who delivers their pathology services.  
	
What are our objectives?
What do we want the audience to do? 	•	Advise on their access needs to phlebotomy services, to inform specifications for future provision
•	Advise on how they want to access their test results
•	Give us anecdotal evidence of their current experiences 
•	Give us anecdotal evidence of their ideal pathology experience (how they would solve the problems they currently experience) 	
What are our key messages?
What do we want to convey to achieve our objectives and mobilise the audience?	•	This is your chance to shape the future of pathology service provision, improving quality (your suggestions feed into specifications)
	
How?
What combinations of communications channels will be most effective in doing this?	•	Contact all LINk patient groups in region, but aim to focus on four to six (from different PCT regions)
•	Presentations to LINk group meetings
•	Face to face focus group meetings (if we can’t link into established meeting agendas)
•	Link in with GP patient participation groups
•	SPT website 
•	Online surveys via Surveymonkey
•	Social media (eg: LinkedIn and Twitter)
•	Patient specific information leaflet	
When?
What’s the critical timing? Any windows of opportunity? Key dates in which things have to happen by?	•	The schedule of meetings of the various LINk groups and patient participation groups
•	Project plan (specifications developed by May/June)
•	Set a deadline for survey responses
•	Overall, results of exercises need to feed into specifications, with first stages completed by Friday 8 April.
	
KPIs
How will we measure success? 
	•	Clear considerations to include in service specification
•	No of meetings presented at / focus group sessions held (target for 4-6)
•	10 ‘how it is now’ anecdotal stories collected
•	10 ‘how I would organise things’ anecdotal stories collected
•	No of people completing survey
	
What’s happening?
Is the communication working? What feedback are we getting? 	(to be developed as engagement progresses)	

Engagement checklist
The checklist below, which is illustrative rather than exhaustive, stems from the one that appears in NHS South East Essex’s Consultation and Engagement Toolkit (July 2010)
•	Sought appropriate expert advice
•	Agreed a dedicated budget for communications and engagement activities
•	Agreed who is going to make the decisions and what the decision making process will be at each stage 
•	Identified sufficient staff and other resources to do the work
•	Identified a communications and engagement lead 
•	Undertaken equality impact screening and , if applicable, equality impact assessment (see www.idea.gov.uk/idk/core/page.do?pageId=8017247 for more information) 
•	Agreed principles for how the commissioning team and partners will work together (protocols for drafting, editing, approvals, presenting etc) 
•	Identified a senior clinical lead who can confidently and knowledgably articulate your pathology requirements
•	Informed the Chair and Board
•	Involved the local overview and scrutiny officials and local LINk/Healthwatch
•	Involved appropriate GP consortia 
•	Identified and articulated project’s key messages, eg: prepared ‘10 key facts’ and ‘lines to take’
•	Drafted a communications and engagement strategy that is integral to the pathology commissioning process and appropriate to the scale of the proposed change 
•	Achieved clarity about how stakeholders’ feedback will inform and influence project outcomes (if perceived as token or shallow ‘tick box’ exercise, then likely to have a negative impact on engagement)
•	Established effective communications processes to respond to (and where necessary, correct) any misleading information that enters the public domain and to publicise the involvement process 
•	Mapped out a range of innovative and creative ways to involve patients 
•	Established systems for capturing and analysing feedback 
•	Established routes through which to feed back to stakeholders, demonstrating impact of their engagement.