CCG 360 o stakeholder survey 2014 Main report Version 1 Internal Use Only 1
Background and objectives Clinical Commissioning Groups (CCGs) need to have strong relationships with a range of health and care partners in order to be successful commissioners within the local system. These relationships provide CCGs with on-going information, advice and knowledge to help them make the best possible commissioning decisions. The CCG 360 o stakeholder survey is a key part of ensuring these strong relationships are in place. The survey allows stakeholders to provide feedback on working relationships with CCGs. The results from the survey will serve two purposes: 1. To provide a wealth of data for CCGs to help with their ongoing organisational development, enabling them to continue to build strong and productive relationships with stakeholders. The findings can provide a valuable tool for all CCGs to be able to evaluate their progress and inform their organisational decisions. 2. To feed into assurance conversations between NHS England Area Teams and CCGs. The survey will form part of the evidence used to assess whether the stakeholder relationships, forged during the transition through authorisation, continue to be central to the effective commissioning of services by CCGs, and in doing so, improve quality and outcomes for patients. 2
Methodology and technical details It was the responsibility of each CCG to provide the list of stakeholders to invite to take part in the CCG 360 o stakeholder survey. CCGs were provided with a core list of stakeholder organisations (outlined in the table opposite) to be included in their stakeholder list. Beyond this however, CCGs had flexibility to determine which individual within each organisation was the most appropriate to nominate. Core stakeholder framework GP member practices Other CCGs Health and wellbeing boards One from every member practice Up to five Up to two per HWB They were also given the opportunity to add up to seven additional stakeholders they wanted to include locally (they are referred to in this report as Wider stakeholders ). These included: Commissioning Support Units, Health Education England, lower tier LAs, MPs, private providers, Public Health England, social care / community organisations, voluntary / third sector organisations and other stakeholders and clinicians. The survey was conducted primarily online via email invitations. Stakeholders who did not respond to the email invitation, and stakeholders for whom an email address was not provided, were telephoned by an Ipsos MORI interviewer who encouraged response and offered the opportunity to complete the survey by telephone. Upper tier or unitary local authorities Local Healthwatch Other patient groups NHS providers Acute NHS providers Mental health trusts NHS providers Community health trusts Up to five per LA One per local Healthwatch Up to three Up to two from each provider Up to two from each provider Up to two from each provider 3
Methodology and technical details Within the survey, stakeholders were asked a series of questions about their working relationship with the CCG. In addition, to reflect each core stakeholder group s different area of expertise and knowledge, they were presented with a short section of questions specific to the stakeholder group they represent. Fieldwork was conducted between 12 March 2014 and 8 April 2014. 44 of the CCG s stakeholders completed the survey. The overall response rate was 80% which varied across the stakeholder groups shown in the table opposite. Survey response rates for Stakeholder group Invited to take part in survey Completed survey Response rate GP member practices 23 18 78% Health and wellbeing boards 1 1 100% Local Healthwatch/patient groups 4 4 100% NHS providers 6 4 67% Other CCGs 8 8 100% Upper tier or unitary local authorities 5 4 80% Wider stakeholders 8 5 63% 4
Interpreting the results For each question, the responses to each answer are presented both as a percentage (%) and the number of stakeholders giving a certain answer, which are included in brackets (n). The number of stakeholders answering (the base size) is stated for each question. The total number of responses is shown at the bottom of each chart and in every table. For questions with fewer than 30 stakeholders answering, we strongly recommend that you look at the number of stakeholders giving each response rather than the percentage, as the percentage can be misleading when based on so few stakeholders. This report presents the results from 's stakeholder survey. Throughout the report, the CCG / your CCG refers to. Where a result for the Area team is presented, this refers to the overall score across East Anglia Area Team. Where results do not sum to 100%, or where individual responses (e.g. tend to agree; strongly agree) do not sum to combined responses (e.g. strongly/tend to agree) this is due to rounding. 5
Using the results the reports The results of the CCG 360 degree stakeholder survey are presented for each CCG in two separate reports a summary report and a main report. The summary report shows the results at CCG level for the questions asked of all stakeholders (i.e. only those in section 1 of the questionnaire). This report provides CCGs with an at a glance visual summary of the results for the key questions, including direction of travel comparisons where appropriate. The main report shows the results for all questions in the survey including any local questions where CCGs included them. The results for each question are provided at CCG level with a breakdown also shown for each of the core stakeholder groups where relevant. This report allows CCGs to interrogate the data in more detail. The main report has been structured by the six assurance domains. There is also an additional initial section on overall engagement and relationships which contains the general questions that are not linked to specific domains. At the end of each section of the main report, there is a table summarising the results, along with some comparative data for those questions asked of all stakeholders. 6
Using the results comparisons For some questions, data has been included in the reports to compare the results for the CCG with: The combined national CCG average in 2014 The 2014 average across all CCGs in the CCG s Area Team The CCG s result in 2012 The comparisons are included to provide a rough headline guide only and should be treated with caution due to the low numbers of respondents and differences in stakeholder lists. Any differences are not necessarily statistically significant differences; a higher score than the Area Team average does not always equate to better performance, and a higher score than in 2012 does not necessarily mean the CCG has improved. The comparisons offer a starting point to inform wider discussions about the CCG s ongoing organisational development and its relationships with stakeholders. For example, they may indicate areas in which stakeholders think the CCG is performing relatively less well, for the CCG to discuss internally and externally to identify what improvements can be made in this area, if any. 7
Overall engagement and relationships 8
Overall, to what extent, if at all, do you feel you have been engaged by the CCG over the past 12 months? All stakeholders 2 By stakeholder group 6 5% 11 Stakeholder group Base Great deal / Fair amount Not very much / Not at all 14% 25% GP member practices 18 83% (15) 17% (3) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 100% (4) -% (0) 57% 25 A great deal A fair amount Not very much Not at all Don't know Other CCGs 8 75% (6) 25% (2) Upper tier/unitary local authorities 4 75% (3) 25% (1) Wider stakeholders 5 60% (3) 40% (2) 82% (36) 2014 Great deal / Fair amount 77% (40) *2012 Great deal / Fair amount * 2012 question wording: Overall, to what extent, if at all, do you feel you have been engaged by the CCG? Total responses : All stakeholders (2014: 44); (2012: 52) 9
How satisfied or dissatisfied are you with the way in which the CCG has engaged with you over the past 12 months? All stakeholders who have been engaged by the CCG 2 1 5% 2% 6 13 14% 31% By stakeholder group Stakeholder group Base Very / Fairly satisfied Very / Fairly dissatisfied GP member practices 16 69% (11) 13% (2) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) -% (0) 48% Other CCGs 8 75% (6) 13% (1) 20 Very satisfied Neither satisfied nor dissatisfied Very dissatisfied Fairly satisfied Fairly dissatisfied Don't know Upper tier/unitary local authorities 4 100% (4) -% (0) Wider stakeholders 5 80% (4) -% (0) 79% (33) 2014 Very satisfied / Fairly satisfied 71% (36) *2012 Very satisfied / Fairly satisfied * 2012 question wording: How satisfied or dissatisfied are you with the way in which the CCG has engaged with you so far? Total responses : All stakeholders who say they have been engaged by CCG (2014: 42); (2012: 51) 10
Still thinking about the past 12 months, to what extent do you agree or disagree that the CCG has listened to your views where you have provided them? All stakeholders 3 4 2 9% 5% 1 7% 2% 11 25% By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 67% (12) 22% (4) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) 52% 23 Strongly agree Neither agree nor disagree Strongly disagree I have not given any views Tend to agree Tend to disagree Don't know NHS providers 4 50% (2) -% (0) Other CCGs 8 88% (7) 13% (1) Upper tier/unitary local authorities 4 100% (4) -% (0) Wider stakeholders 5 80% (4) -% (0) 77% (34) 2014 Strongly agree / Tend to agree 71% (37) *2012 Strongly agree / Tend to agree * 2012 question wording: To what extent do you agree or disagree that the CCG has listened to your views where you have provided them? Total responses : All stakeholders (2014: 44); (2012: 52) 11
To what extent do you agree or disagree that the CCG has acted on your suggestions? All stakeholders 3 3 7% 7% 3 7% 2 5% 16% 7 By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 56% (10) 22% (4) Health and wellbeing boards 1 -% (0) -% (0) 11 25% 34% 15 Local Healthwatch/patient groups 4 50% (2) -% (0) NHS providers 4 25% (1) -% (0) Other CCGs 8 50% (4) 13% (1) Strongly agree Neither agree nor disagree Strongly disagree I have not given any suggestions Tend to agree Tend to disagree Don't know Upper tier/unitary local authorities 4 50% (2) -% (0) Wider stakeholders 5 60% (3) -% (0) 50% (22) 2014 Strongly agree / Tend to agree 63% (33) 2012 Strongly agree / Tend to agree Total responses : All stakeholders (2014: 44); (2012: 52) 12
Overall, how would you rate your working relationship with the CCG? All stakeholders 3 1 2% 7% 7 16% By stakeholder group Stakeholder group Base Very good / Fairly good Very poor / Fairly poor GP member practices 18 61% (11) 22% (4) 45% 20 Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) 30% NHS providers 4 75% (3) -% (0) 13 Other CCGs 8 75% (6) -% (0) Very good Neither good nor poor Very poor I/we do not have a working relationship Fairly good Fairly poor Don't know Upper tier/unitary local authorities 4 100% (4) -% (0) Wider stakeholders 5 80% (4) -% (0) 75% (33) 2014 Very good / Fairly good 83% (43) 2012 Very good / Fairly good Total responses : All stakeholders (2014: 44); (2012: 52) 13
Thinking back over the past 12 months, would you say your working relationship with the CCG has got better, got worse or has it stayed about the same? All stakeholders who say they have a working relationship with the CCG 2 4 9 5% 9% 20% By stakeholder group Stakeholder group Base Got much / A little better Got much / A little worse GP member practices 18 33% (6) 22% (4) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) 17 39% 27% 12 NHS providers 4 75% (3) 25% (1) Other CCGs 8 25% (2) 13% (1) Upper tier/unitary local authorities 4 75% (3) -% (0) Got much better Stayed about the same Got much worse Got a little better Got a little worse Don't know Wider stakeholders 5 40% (2) -% (0) Total responses : All stakeholders who say they have a working relationship with the CCG (44) 14
Engagement and relationships: Summary Overall, to what extent, if at all, do you feel you have been engaged by the CCG over the past 12 months? And how satisfied or dissatisfied are you with the way in which the CCG has engaged with you over the past 12 months? Still thinking about the past 12 months, to what extent do you agree or disagree that the CCG has listened to your views where you have provided them? To what extent do you agree or disagree that the CCG has acted on your suggestions? Overall, how would you rate your working relationship with the CCG? Thinking back over the past 12 months, would you say your working relationship with the CCG has got better, got worse or has it stayed about the same? 82% (36) a great deal / a fair amount 79% (33) very / fairly satisfied 77% (34) strongly / tend to agree 50% (22) strongly / tend to agree 75% (33) very / fairly good 48% (21) much better / a little better Base All stakeholders (44) All stakeholders who have been engaged (42) All stakeholders (44) All stakeholders (44) All stakeholders (44) All stakeholders who say they have a working relationship with the CCG (44) 15
Engagement and relationships: CCG comparisons The CCG 2012 The CCG 2014 National CCG average 2014 CCG Area Team Engagement Overall, to what extent, if at all, do you feel you have been engaged by the CCG over the past 12 months? Percentage of stakeholders saying a fair amount / a great deal Most stakeholders say that they have been engaged either a great deal or a fair amount. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base 2012: All stakeholders (52) Base national average: All stakeholders (9018) Satisfaction with engagement How satisfied or dissatisfied are you with the way in which the CCG has engaged with you over the past 12 months? Percentage of stakeholders saying very / fairly satisfied The majority of stakeholders who say they have been engaged feel satisfied (fairly or very) with the way they have been engaged by the CCG. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders who (42) Base CCG Area Team: All stakeholders who (398) Base 2012: say they have been (51) Base national average: say they have been (8852) engaged engaged All comparisons are indicative only and do not imply statistical significance 16
Engagement and relationships: CCG comparisons The CCG 2012 The CCG 2014 National CCG average 2014 CCG Area Team Listening to views Still thinking about the past 12 months, to what extent, do you agree or disagree that the CCG has listened to your views where you have provided them? Percentage of stakeholders saying strongly agree / tend to agree The majority of stakeholders say that the CCG has listened to their views. This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base 2012: All stakeholders (52) Base national average: All stakeholders (9018) Acting on suggestions To what extent do you agree or disagree that the CCG has acted on your suggestions? Around half of stakeholders say that the CCG has acted on their suggestions where they have provided them. Percentage of stakeholders saying strongly agree / tend to agree This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base 2012: All stakeholders (52) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 17
Engagement and relationships: CCG comparisons The CCG 2012 The CCG 2014 National CCG average 2014 CCG Area Team Working relationship Overall, how would you rate your working relationship with the CCG? The majority of stakeholders say that they have a good working relationship with the CCG. Percentage of stakeholders saying very good / fairly good This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base 2012: All stakeholders (52) Base national average: All stakeholders (9018) Change in working relationship Thinking back over the past 12 months, would you say your working relationship with the CCG has got better, got worse or has it stayed about the same? Percentage of stakeholders saying got much better / got a little better Around half of stakeholders say that their working relationship with the CCG has got better over the past 12 months. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders who say (44) Base CCG Area Team: All stakeholders who say (399) they have a working Base national average: they have a working (8881) relationship with the CCG relationship with the CCG All comparisons are indicative only and do not imply statistical significance 18
Domain 1: Are patients receiving clinically commissioned, high quality services? 19
How effective, if at all, would you say the arrangements are for member participation and decision-making in your CCG? All member practices 3 17% 5 28% 61% (11) Very / Fairly effective 2014 4 22% 78% (18) Very / Fairly effective 2012 33% 6 Very effective Fairly effective Not very effective Not at all effective Don't know Total responses : All member practices (2014:18); (2012: 23) 20
How involved, if at all, do you feel you are in your CCG s decision making process? All member practices 4 3 22% 17% 3 17% 44% 8 Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All member practices (18) 21
How confident are you, if at all, in the systems to sustain two-way accountability between your CCG and its member practices in the CCG? All member practices 3 17% 5 28% 3 17% 67% (12) 74% (17) Very / Fairly confident 2014 Very / Fairly confident 2012 39% 7 Very confident Fairly confident Not very confident Not at all confident Don't know Total responses : All member practices (2014: 18); (2012: 23) 22
Approximately how often, if at all, do you have the opportunity for direct discussions with your CCG s leaders? All member practices Number Weekly 11% 2 Twice a month 0% 0 Once a month 33% 6 Quarterly 44% 8 Twice a year 6% 1 Once a year 0% 0 Less than once a year 6% 1 Don't know 0% 0 Total responses : All member practices (18) 23
To what extent do you agree or disagree that representatives from member practices are able to take a leadership role within the CCG if they want to? All member practices 1 3 6% 17% 44% 8 2 11% 22% 4 Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All member practices (18) 24
To what extent do you agree or disagree that quality is a key focus of your contracts with the CCG? All NHS providers 100% 4 Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All NHS providers (4) 25
How involved, if at all, would you say clinicians from the CCG are in discussions about? Quality All NHS providers 1 25% 75% 3 Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All NHS providers (4) 26
How involved, if at all, would you say clinicians from the CCG are in discussions about? Service redesign All NHS providers 1 25% 75% 3 Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All NHS providers (4) 27
Domain 1: Summary How effective, if at all, would you say the arrangements are for member participation and decision-making in your CCG? How involved, if at all, do you feel you are in your CCG s decision-making process? How confident are you, if at all, in the systems to sustain two-way accountability between your CCG and its member practices in the CCG? To what extent do you agree or disagree that representatives from member practices are able to take a leadership role within the CCG if they want to? To what extent do you agree or disagree that quality is a key focus of your contracts with your CCG? How involved, if at all, would you say clinicians from the CCG are in discussions about? A. Quality B. Service redesign 61% (11) very / fairly effective 61% (11) very / fairly involved 67% (12) very / fairly confident 67% (12) strongly / tend to agree 100% (4) strongly / tend to agree 75% (3) very / fairly involved 75% (3) very / fairly involved Base All member practices (18) All member practices (18) All member practices (18) All member practices (18) All NHS providers (4) All NHS providers (4) 28
Domain 2: Are patients and the public actively engaged and involved? 29
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? All stakeholders Number Strongly agree / Tend to agree Neither agree nor disagree Strongly disagree / Tend to disagree Don't know The CCG involves and engages with the right individuals and organisations when making commissioning decisions 55% 16% 16% 14% 24 7 7 6 I have confidence in the CCG to commission high quality services for the local population 66% 11% 16% 7% 29 5 7 3 I understand the reasons for the decisions that the CCG makes when commissioning services 61% 14% 18% 7% 27 6 8 3 The CCG effectively communicates its commissioning decisions with me 68% 20% 11% 30 9 5 0 The CCG's plans will deliver continuous improvement in quality within the available resources 45% 27% 16% 11% 20 12 7 5 Total responses : All stakeholders (44) 30
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? The CCG involves and engages with the right individuals and organisations when making commissioning decisions All stakeholders By stakeholder group By stakeholder group 3 6 14% 25% 11 Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 56% (10) 22% (4) 7% Health and wellbeing boards 1 -% (0) -% (0) 4 9% Local Healthwatch/patient groups 4 75% (3) -% (0) 16% 30% NHS providers 4 25% (1) 25% (1) 7 13 Other CCGs 8 38% (3) 13% (1) Upper tier/unitary local authorities 4 75% (3) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 80% (4) 20% (1) Total responses : All stakeholders (44) 31
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? I have confidence in the CCG to commission high quality services for the local population All stakeholders 4 9% 3 7% 3 7% 36% 16 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 61% (11) 33% (6) Health and wellbeing boards 1 100% (1) -% (0) 5 11% Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 50% (2) -% (0) 30% Other CCGs 8 50% (4) -% (0) 13 Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) 20% (1) Total responses : All stakeholders (44) 32
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? I understand the reasons for the decisions that the CCG makes when commissioning services All stakeholders By stakeholder group 5 11% 3 7% 30% 13 Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 67% (12) 28% (5) 3 7% Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) 6 14% NHS providers 4 25% (1) 50% (2) 32% Other CCGs 8 38% (3) -% (0) 14 Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 40% (2) 20% (1) Total responses : All stakeholders (44) 33
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? The CCG effectively communicates its commissioning decisions with me All stakeholders 4 1 2% 9% 11 25% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 61% (11) 17% (3) 9 20% Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) -% (0) 43% Other CCGs 8 50% (4) 13% (1) 19 Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) 20% (1) Total responses : All stakeholders (44) 34
To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? The CCG s plans will deliver continuous improvement in quality within the available resources All stakeholders 5 9 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree 3 7% 11% 20% GP member practices 18 50% (9) 33% (6) 4 9% Health and wellbeing boards 1 -% (0) -% (0) Local Healthwatch/patient groups 4 75% (3) -% (0) 27% 25% 11 NHS providers 4 50% (2) -% (0) Other CCGs 8 13% (1) -% (0) 12 Upper tier/unitary local authorities 4 50% (2) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) 20% (1) Total responses : All stakeholders (44) 35
How satisfied or dissatisfied are you with the steps taken by the CCG to engage with patients and the public? All Healthwatch and patient group stakeholders 1 1 25% 25% 50% 2 Very satisfied Fairly satisfied Neither satisfied nor dissatisfied Fairly dissatisfied Very dissatisfied Don't know Total responses : All Healthwatch and patient group stakeholders (4) 36
To what extent, if at all, do you feel that the CCG has engaged with seldom heard groups? All Healthwatch and patient group stakeholders 1 1 25% 25% 50% 2 A great deal A fair amount Just a little Not at all Don't know Total responses : All Healthwatch and patient group stakeholders (4) 37
To what extent do you agree or disagree with the following statements? All Healthwatch and patient group stakeholders Number Strongly agree / Tend to agree Strongly disagree / Tend to disagree Neither agree nor disagree Don't know The CCG s commissioning decisions are open and transparent so patients and the public are able to understand how decisions have been made if they want to 75% 25% 3 0 1 0 Patients and the public have the opportunity to input into the CCG s commissioning decisions 100% 4 0 0 0 Total responses : All Healthwatch and patient group stakeholders (4) 38
To what extent do you agree or disagree with the following statements? The CCG s commissioning decisions are open and transparent so patients and the public are able to understand how decisions have been made if they want to All Healthwatch and patient group stakeholders 1 25% 50% 2 25% 1 Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All Healthwatch and patient group stakeholders (4) 39
To what extent do you agree or disagree with the following statements? Patients and the public have the opportunity to input into the CCG s commissioning decisions All Healthwatch and patient group stakeholders 1 25% 75% 3 Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All Healthwatch and patient group stakeholders (4) 40
To what extent do you agree or disagree that the CCG listens to and acts on any concerns, complaints or issues that are raised? All Healthwatch and patient group stakeholders 1 25% 75% 3 Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All Healthwatch and patient group stakeholders (4) 41
Domain 2: Summary Base To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? All stakeholders (44) A. The CCG involves and engages with the right individuals and organisations when making commissioning decisions B. I have confidence in the CCG to commission high quality services for the local population C. I understand the reasons for the decisions that the CCG makes when commissioning services D. The CCG effectively communicates its commissioning decisions with me E. The CCG s plans will deliver continuous improvement in quality within the available resources 55% (24) strongly / tend to agree 66% (29) strongly / tend to agree 61% (27) strongly / tend to agree 68% (30) strongly / tend to agree 45% (20) strongly / tend to agree How satisfied or dissatisfied are you with the steps taken by the CCG to engage with patients and the public? To what extent, if at all, do you feel that the CCG has engaged with seldom heard groups? 75% (3) very / fairly satisfied 75% (3) a great deal / a fair amount All Healthwatch and patient group stakeholders (4) All Healthwatch and patient group stakeholders (4) 42
Domain 2: Summary To what extent do you agree or disagree with the following statements? A. The CCG s commissioning decisions are open and transparent so patients and the public are able to understand how decisions have been made if they want to B. Patients and the public have the opportunity to input into the CCG s commissioning decisions 75% (3) strongly / tend to agree 100% (4) strongly / tend to agree Base All Healthwatch and patient group stakeholders (4) To what extent do you agree or disagree that the CCG listens to and acts on any concerns, complaints or issues that are raised? 100% (4) strongly / tend to agree All Healthwatch and patient group stakeholders (4) 43
Domain 2: CCG comparisons The CCG 2014 National CCG average 2014 CCG Area Team To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? Involving and engaging the right individuals and organisations The CCG involves and engages with the right individuals and organisations when making commissioning decisions Percentage of stakeholders saying strongly agree / tend to agree Around half of stakeholders say that the CCG involves and engages with the right individuals and organisations when making commissioning decisions. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) High quality services I have confidence in the CCG to commission high quality services for the local population The majority of stakeholders say that they have confidence in the CCG to commission high quality services for the local population. Percentage of stakeholders saying strongly agree / tend to agree 0 10 20 30 40 50 60 70 80 90 100 This is about the same as the finding for CCGs overall. Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 44
Domain 2: CCG comparisons The CCG 2014 National CCG average 2014 CCG Area Team To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? Understanding of commissioning decisions I understand the reasons for the decisions that the CCG makes when commissioning services Percentage of stakeholders saying strongly agree / tend to agree The majority of stakeholders say that they understand the reasons for the decisions that the CCG makes. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) Communicating commissioning decisions The CCG effectively communicates its commissioning decisions with me The majority of stakeholders say that the CCG effectively communicates its commissioning decisions. Percentage of stakeholders saying strongly agree / tend to agree 0 10 20 30 40 50 60 70 80 90 100 This is about the same as the finding for CCGs overall. Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 45
Domain 2: CCG comparisons The CCG 2014 National CCG average 2014 CCG Area Team To what extent do you agree or disagree with the following statements about the way in which the CCG commissions services? Continuous improvement in quality The CCG s plans will deliver continuous improvement in quality within the available resources Percentage of stakeholders saying strongly agree / tend to agree Around half of stakeholders agree that the CCG s plans will deliver continuous improvement in quality within available resources. This is lower than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 46
Domain 3: Are CCG plans delivering better outcomes for patients? 47
How much would you say you know about the CCG s plans and priorities? All stakeholders By stakeholder group 1 12 27% 2% 32% 14 Stakeholder group Base Great deal/ Fair amount Not very much/ Nothing at all GP member practices 18 67% (12) 33% (6) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) 25% (1) 39% Other CCGs 8 38% (3) 63% (5) 17 Upper tier/unitary local authorities 4 100% (4) -% (0) Wider stakeholders 5 80% (4) 20% (1) A great deal A fair amount Not very much Nothing at all Total responses : All stakeholders (44) 48
To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? All stakeholders / All stakeholders except member practices Strongly agree / Tend to agree Neither agree nor disagree Strongly disagree / Tend to disagree Don't know Number I have been given the opportunity to influence the CCG s plans and priorities 66% 18% 14% 2% 29 8 6 1 When I have commented on the CCG s plans and priorities I feel that my comments have been taken on board 50% 30% 11% 9% 22 13 5 4 *The CCG has effectively communicated its plans and priorities to me 65% 27% 8% 17 7 2 0 The CCG s plans and priorities are the right ones 55% 30% 9% 7% 24 13 4 3 Total responses : All stakeholders (44); *All stakeholders except member practices (26) 49
To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? I have been given the opportunity to influence the CCG s plans and priorities All stakeholders By stakeholder group 4 9% 2 1 5% 2% 30% 13 By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 72% (13) 17% (3) Health and wellbeing boards 1 100% (1) -% (0) 8 18% Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) 25% (1) 36% Other CCGs 8 13% (1) 13% (1) 16 Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) 20% (1) Total responses : All stakeholders (44) 50
To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? When I have commented on the CCG s plans and priorities I feel that my comments have been taken on board All stakeholders 2 3 5% 7% 4 9% 13 30% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 61% (11) 22% (4) Health and wellbeing boards 1 -% (0) -% (0) Local Healthwatch/patient groups 4 75% (3) -% (0) 13 30% 20% NHS providers 4 50% (2) -% (0) Other CCGs 8 13% (1) -% (0) 9 Upper tier/unitary local authorities 4 50% (2) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) 20% (1) Total responses : All stakeholders (44) 51
To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? The CCG has effectively communicated its plans and priorities to me All stakeholders except member practices 2 5 8% 19% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree Health and wellbeing boards 1 100% (1) -% (0) 7 27% Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) 25% (1) Other CCGs 8 25% (2) -% (0) 46% Upper tier/unitary local authorities 4 100% (4) -% (0) 12 Wider stakeholders 5 60% (3) 20% (1) Strongly agree Neither agree nor disagree Strongly disagree Tend to agree Tend to disagree Don't know Total responses : All stakeholders except member practices (26) 52
To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? The CCG s plans and priorities are the right ones All stakeholders 3 3 1 7% 7% 11 25% 2% By stakeholder group By stakeholder group Stakeholder group Base Strongly/Tend to agree Strongly/Tend to disagree GP member practices 18 61% (11) 22% (4) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 75% (3) -% (0) 13 30% 30% NHS providers 4 50% (2) -% (0) Other CCGs 8 13% (1) -% (0) 13 Upper tier/unitary local authorities 4 75% (3) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Total responses : All stakeholders (44) Tend to agree Tend to disagree Don't know Wider stakeholders 5 60% (3) -% (0) 53
How well, if at all, would you say you understand? All member practices Number Very well / Fairly well Not very well / Not at all well Don't know The financial implications of the CCG s plans 72% 22% 6% 13 4 1 The implications of the CCG s plans for service improvement 61% 33% 6% 11 6 1 The referral and activity implications of the CCG s plans 61% 33% 6% 11 6 1 Total responses : All member practices (18) 54
How well, if at all, would you say that you understand? The financial implications of the CCG s plans All member practices 1 2 2 11% 11% 6% 5 28% 72% (13) 57% (13) Very / Fairly well 2014 Very / Fairly well 2012 44% 8 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2014: 18); (2012: 23) 55
How well, if at all, would you say that you understand? The implications of the CCG s plans for service improvement All member practices 1 6% 4 22% 33% 6 61% (11) Very / Fairly well 2014 61% (14) Very / Fairly well 2012 2 11% 28% 5 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2014: 18); (2012: 23) 56
How well, if at all, would you say that you understand? The referral and activity implications of the CCG s plans All member practices 1 6% 4 22% 33% 6 61% (11) Very / Fairly well 2014 70% (16) Very / Fairly well 2012 2 11% 28% 5 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2014: 18); (2012: 23) 57
How well, if at all, do you understand what is required of your practice in order to implement the CCG s plans? All member practices 1 6% 6 5 28% 33% 67% (12) Very well / Fairly well 2014 70% (16) Very well / Fairly well 2012 33% 6 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2014: 18); (2012: 23) 58
How well, if at all, would you say the CCG and your organisation are working together to develop long-term strategies and plans? All NHS providers 25% 1 3 75% Very well Fairly well Not very well Not at all well Don't know Total responses : All NHS providers (4) 59
How well, if at all, would you say the CCG understands the challenges facing your provider organisation? All NHS providers 1 1 25% 25% 50% 2 Very well Fairly well Not very well Not at all well Don't know Total responses : All NHS providers (4) 60
Domain 3: Summary How much would you say you know about the CCG s plans and priorities? To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? 70% (31) a great deal / a fair amount Base All stakeholders (44) A. I have been given the opportunity to influence the CCG s plans and priorities B. When I have commented on the CCG s plans and priorities I feel that my comments have been taken on board C. The CCG has effectively communicated its plans and priorities to me D. The CCG s plans and priorities are the right ones How well, if at all, would you say that you understand? A. The financial implications of the CCG s plans B. The implications of the CCG s plans for service improvement C. The referral and activity implications of the CCG s plans 66% (29) strongly / tend to agree All stakeholders (44) 50% (22) strongly / tend to agree 65% (17) strongly / tend to agree 55% (24) strongly / tend to agree 72% (13) very well / fairly well 61% (11) very well / fairly well 61% (11) very well / fairly well All stakeholders (44) All stakeholders except member practices (26) All stakeholders (44) All member practices (18) How well, if at all, do you understand what is required of your practice in order to implement the CCG s plans? How well, if at all, would you say the CCG and your organisation are working together to develop long-term strategies and plans? How well, if at all, would you say the CCG understands the challenges facing your provider organisation? 67% (12) very well / fairly well 100% (4) very well / fairly well 75% (3) very well / fairly well All member practices (18) All NHS providers (4) All NHS providers (4) 61
Domain 3: CCG comparisons The CCG 2014 National CCG average 2014 CCG Area Team Knowledge of plans and priorities How much would you say you know about the CCG s plans and priorities? Percentage of stakeholders saying a great deal / a fair amount The majority of stakeholders say that they know a great deal or a fair amount about the CCG s plans and priorities. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? Influence over the CCG s plans and priorities I have been given the opportunity to influence the CCG s plans and priorities Percentage of stakeholders saying strongly agree / tend to agree The majority of stakeholders say that they have been given the opportunity to influence the CCG s plans and priorities. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 62
Domain 3: CCG comparisons The CCG 2014 National CCG average 2014 CCG Area Team To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? Taking comments on board When I have commented on the CCG s plans and priorities I feel that my comments have been taken on board Percentage of stakeholders saying strongly agree / tend to agree Around half of stakeholders say that they feel the CCG takes on board their comments on the plans and priorities. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) The right plans and priorities The CCG s plans and priorities are the right ones Around half of stakeholders agree that the CCG s plans and priorities are the right ones. Percentage of stakeholders saying strongly agree / tend to agree This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2014: All stakeholders (44) Base CCG Area Team: All stakeholders (406) Base national average: All stakeholders (9018) All comparisons are indicative only and do not imply statistical significance 63
Domain 4: Does the CCG have robust governance arrangements? 64
To what extent do you agree or disagree with the following statements about the way in which the CCG monitors and reviews the quality of commissioned services? All stakeholders Number Strongly agree / Tend to agree Neither agree nor disagree Strongly disagree / Tend to disagree Don't know I have confidence that the CCG effectively monitors the quality of the services it commissions 68% 11% 7% 14% 30 5 3 6 If I had concerns about the quality of local services I would feel able to raise my concerns with the CCG 84% 5% 7% 5% 37 2 3 2 I have confidence in the CCG to act on feedback it receives about the quality of services 77% 7% 9% 7% 34 3 4 3 Total responses : All stakeholders (44) 65
To what extent do you agree or disagree with the following statements about the way in which the CCG monitors and reviews the quality of commissioned services? I have confidence that the CCG effectively monitors the quality of the services it commissions All stakeholders 6 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree 2 14% GP member practices 18 61% (11) 17% (3) 5 1 5% 2% 11% 41% 18 Health and wellbeing boards 1 -% (0) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 100% (4) -% (0) 27% Other CCGs 8 75% (6) -% (0) 12 Upper tier/unitary local authorities 4 75% (3) -% (0) Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All stakeholders (44) Wider stakeholders 5 40% (2) -% (0) 66
To what extent do you agree or disagree with the following statements about the way in which the CCG monitors and reviews the quality of commissioned services? If I had concerns about the quality of local services I would feel able to raise my concerns with the CCG All stakeholders 2 2 1 2 5% 2% 5% 5% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 78% (14) 17% (3) Health and wellbeing boards 1 100% (1) -% (0) 13 30% 55% 24 Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 100% (4) -% (0) Other CCGs 8 75% (6) -% (0) Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Total responses : All stakeholders (44) Tend to agree Tend to disagree Don't know Wider stakeholders 5 80% (4) -% (0) 67
To what extent do you agree or disagree with the following statements about the way in which the CCG monitors and reviews the quality of commissioned services? I have confidence in the CCG to act on feedback it receives about the quality of services All stakeholders By stakeholder group 3 1 3 7% 2% 7% 3 7% 41% 18 By stakeholder group Stakeholder group Base Strongly / Tend to agree Strongly / Tend to disagree GP member practices 18 67% (12) 22% (4) Health and wellbeing boards 1 100% (1) -% (0) Local Healthwatch/patient groups 4 100% (4) -% (0) NHS providers 4 75% (3) -% (0) 36% Other CCGs 8 75% (6) -% (0) 16 Upper tier/unitary local authorities 4 100% (4) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Total responses : All stakeholders (44) Tend to agree Tend to disagree Don't know Wider stakeholders 5 80% (4) -% (0) 68
Would you say that the amount of monitoring the CCG carries out on the quality of your services is too much, too little or about right? All NHS providers 1 25% 75% 3 Too much About right Too little Don't know Total responses : All NHS providers (4) 69
To what extent do you agree or disagree with the following statement? When there is an issue with the quality of services, the response of the CCG is proportionate and fair All NHS providers 1 25% 50% 2 25% 1 Strongly agree Neither agree nor disagree Strongly disagree There has never been an issue with the quality of services Tend to agree Tend to disagree Don't know Total responses : All NHS providers (4) 70
Domain 4: Summary Base To what extent do you agree or disagree with the following statements about the way in which the CCG monitors and reviews the quality of commissioned services? All stakeholders (44) A. I have confidence that the CCG effectively monitors the quality of the services it commissions B. If I had concerns about the quality of local services I would feel able to raise my concerns with the CCG C. I have confidence in the CCG to act on feedback it receives about the quality of services 68% (30) strongly / tend to agree 84% (37) strongly / tend to agree 77% (34) strongly / tend to agree Would you say that the amount of monitoring the CCG carries out on the quality of your services is too much, too little or about right? To what extent do you agree or disagree with the following statement? When there is an issue with the quality of services, the response of the CCG is proportionate and fair 25% (1) about right All NHS providers (4) 50% (2) strongly / tend to agree All NHS providers (4) 71