Irene reflects on the role of public engagement in Scotland's strategic response to the pandemic.
Two recent pieces of news must have caused some pause for thought. Firstly Director General Tedros Adhanom Ghebreyesus at WHO commented that “too many countries are headed in the wrong direction. The only aim of the virus is to find people to infect”. Sit that alongside the Academy of Medical Science’s Research outlining a potential winter upsurge in coronavirus cases with a worst case scenario of 125,000 deaths in the U.K and the fact is that there is no room for complacency.
On the up side forewarned is forearmed and it must be argued that we have a better understanding of how to mobilise an attack against coronavirus than we did in February and March. In the coming couple of months… as the research paper makes clear, we must plan with military precision to win a winter war. The scientific evidence makes clear that planning is everything. The Scottish Government’s recently convened Mobilisation Recovery Group convened by the Cabinet Secretary for Health is an attempt to plan early with the right people around the virtual table.
But how do we ensure alongside staying safe, we understand and give voice to the people’s priorities? How do we put co-production with people and communities at the heart of the agenda?
Of course citizens want themselves and their loved ones to be protected but in the balance of risk knowing what is important to people and communities is vital to strategic planning.
Third Sector organisations have done much to connect into communities during these really tough times. The ALLIANCE has worked hard transferring much of our work into digital activity to keep people involved and engaged and to seek opportunities to give them a voice through continuing engagement via digital means.
In our recent experience high on the list of obvious priorities are a vaccine, improving treatments available and antibody testing.
Top of everyone’s agenda is of course containing the virus and reducing transmission to ensure that in the Director General of WHO’s words we are not “one of the countries heading in the wrong direction”.
However that being said and in terms of living their daily lives, it’s been clear that often people themselves are willing to consider balanced risk for what matters to them. A good example is the trauma of families who have had someone with dementia in care homes or care at home and who have longed to be able to visit and spend time together. Dementia is a terminal illness and in recognition of this some flexibility was felt appropriate though from what we hear it was inconsistent and variable in approach.
The recent relaxation too of hospital visiting which is very welcomed by families, carers and those in hospital is something which citizens have universally welcomed with a pragmatic named visitor approach.
“Only when patients can influence do they have power. When patients hold influence, services are designed for their experience…”
As we may head towards a winter second wave knowing and understanding what matters to citizens will be important. Given the ability to separate out COVID from Non-COVID activity alongside PPE and scrupulous application of hand hygiene, questions must be asked about whether it will be possible to sustain services which make people’s lives better. This ranges from the obvious cancer screening, to chronic pain management to simple services from primary care like ear syringing. As research points out there are risks to life and quality of life to not acting.
This is a good time to ask for people’s views and ensure that future services are genuinely co-produced by those who use them. A few years ago Scottish Government supported and assisted by the ALLIANCE and at that time the Scottish Health Council (now Healthcare Improvement Scotland (HIS) Community Engagement) set up Our Voice and undertook a National Conversation on what matter to people in relation to health and wellbeing. Much of that feedback was incorporated into the person centred care agenda and opened up things like unrestricted hospital visiting.
In this summer planning period why don’t we ask citizens themselves about their priorities for the NHS and primary care heading to the winter months? It is entirely possible to incorporate such an engagement digitally and to hear from people themselves how they have found the new ways of working and what role they see for innovation like NHS Near Me going forward.
The Integration Joint Boards (IJBs) in partnership with the Third Sector and HIS are well placed to conduct such a conversation with the people of Scotland about what matters to them. This kind of democracy in action allows politicians to weigh in public opinion in those areas where flexibility can be applied. The scientific evidence is not always clear or definitive, masks are a good example of how things can change. In these circumstances at least knowing what is important to people and communities allows planning to take place in a wider and fairer context.
The ALLIANCE looks forward to playing a key role in the next weeks and months to support that vital citizen engagement.