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CCG 360 o stakeholder survey 2015 Main report Version 1 Internal Use Only 1

Table of contents Slide 3 Background and objectives Slide 4 Methodology and technical details Slide 6 Interpreting the results Slide 7 Using the results Slide 9 Summary Slide 16 Overall engagement and relationships Slide 27 Domain 1 Slide 37 Domain 2 Slide 55 Domain 3 Slide 81 Domain 4 Slide 93 Domain 5 Slide 111 Domain 6 2

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 sub-regions 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. 3

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 the flexibility to determine which individual within each organisation was the most appropriate to nominate. They were also given the opportunity to add up to ten 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 local authorities, MPs, private providers, Public Health England, social care / community organisations, Voluntary Sector Council/Leader, voluntary / third sector organisations, local care homes, GP out-of-hours providers 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. Core stakeholder framework GP member practices Health and wellbeing boards Local HealthWatch Other patient groups NHS providers Acute NHS providers Mental health trusts NHS providers Community health trusts Other CCGs Upper tier or unitary local authorities One from every member practice Up to two per HWB 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 Up to five Up to five per LA 4

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 10th March 2015 and 7th April 2015. 29 of the CCG s stakeholders completed the survey. The overall response rate was 73% 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 25 19 76% Health and wellbeing boards 2 2 100% Local HealthWatch/patient groups 3 2 67% NHS providers 5 3 60% Other CCGs 2 1 50% Upper tier or unitary local authorities 3 2 67% Wider stakeholders - - N/A 5

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 cluster is presented, this refers to the overall score across the 20 CCGs that are most similar to the CCG. For more information on the cluster and how this has been defined, please see Appendix A. 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. 6

Using the results the reports This report contains a summary section, a section on overall views of relationships and a section for each of the six assurance domains which show detailed breakdowns of responses to each question. The overall summary slides show the results at CCG level for the questions asked of all stakeholders (i.e. only those in section 1 of the questionnaire). This provides CCGs with an at a glance visual summary of the results for the key questions, including direction of travel comparisons where appropriate. The remainder of the 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 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. 7

Using the results comparisons For some questions, data has been included in the reports to compare the results for the CCG with: The CCG s result in 2014 The 2015 average across all CCGs in the CCG s cluster National CCG average in 2015 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 cluster average does not always equate to better performance, and a higher score than in 2014 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. 8

Summary 9

Overall engagement and relationship summary KEY COMPARISON GROUP The CCG s 2015 result is in top third of comparison group The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group CCG in 2014 (Base: 30/*Base: 30/**Base: 29) CCG in 2015 (Base: 29/*Base: 29/**Base: 29) CCG Cluster (Base: 802/*Base: 786/**Base: 790) All CCGs (Base: 8472/*Base: 8320/**Base: 8363) Extent of engagement by CCG in last 12 months (% A great deal / A fair amount) 100% 97% Satisfaction with engagement by CCG in last 12 months* (% Very / Fairly satisfied) 97% 90% Extent that the CCG has listened to views when provided (% Strongly / ) 73% 90% Extent that the CCG has taken on board suggestions when provided (% Strongly / ) Not comparable to 2014 66% Overall rating of working relationship with CCG (% Very good / Fairly good) 97% 93% Change in working relationship with CCG in last 12 months** (% Got much better / Got a little better) 55% 41% 10

Commissioning decisions and contribution to wider discussions The CCG s 2015 result is in top third of comparison group KEY The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group CCG in 2014 (Base: 30) CCG in 2015 (Base: 29) COMPARISON GROUP CCG Cluster (Base: 802) All CCGs (Base: 8472) Extent to which the CCG engages the right individuals / organisations when making commissioning decisions (% Strongly / ) 83% 76% Confidence in the CCG to commission high quality services (% Strongly / ) 93% 86% Understanding of the reasons behind commissioning decisions (% Strongly / ) 67% 76% Effectiveness of CCG s communication about commissioning decisions (% Strongly / ) 80% 79% Confidence that the CCG s plans will deliver continuous improvement in quality (% Strongly / ) 67% 62% Extent to which the CCG has contributed to wider discussions in local health economy (% A great deal / A fair amount) Not comparable to 2014 90% 11

Monitoring the quality of services The CCG s 2015 result is in top third of comparison group KEY The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group COMPARISON GROUP CCG in 2014 (Base: 30) CCG in 2015 (Base: 29) CCG Cluster (Base: 802) All CCGs (Base: 8472) Confidence that CCG effectively monitors the quality of the services it commissions (% Strongly agree / ) 70% 79% Feel able to raise concerns about the quality of local services with the CCG (% Strongly agree / ) 97% 93% Confidence in CCG to act on feedback it receives about the quality of services (% Strongly agree / ) 83% 76% 12

Plans and priorities The CCG s 2015 result is in top third of comparison group KEY The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group CCG in 2014 (Base: 30) CCG in 2015 (Base: 29) COMPARISON GROUP CCG Cluster (Base: 802) All CCGs (Base: 8472) Knowledge of CCG s plans and priorities (% A great deal / A fair amount) 83% 90% Have had the opportunity to influence the CCG s plans and priorities (% Strongly / ) 77% 76% Comments on CCG s plans and priorities have been taken on board (% Strongly / ) 60% 59% The CCG effectively communicated its plans and priorities (% Strongly / ) Not comparable to 2014 86% The CCG s plans and priorities are the right ones (% Strongly / ) 80% 72% Improving patient outcomes is a core focus for the CCG (% Strongly / ) Not asked in 2014 97% 13

Overall leadership The CCG s 2015 result is in top third of comparison group KEY The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group CCG in 2014 (Base: 30) CCG in 2015 (Base: 29) COMPARISON GROUP CCG Cluster (Base: 802) All CCGs (Base: 8472) The leadership of the CCG has the necessary blend of skills and experience (% Strongly / ) 73% 86% There is clear and visible leadership of the CCG (% Strongly / ) 90% 93% Confidence in the leadership of the CCG to deliver its plans and priorities (% Strongly / ) 80% 83% The leadership of the CCG is delivering continued quality improvements (% Strongly / ) 70% 79% Confidence in the leadership of the CCG to deliver improved outcomes for patients (% Strongly / ) 77% 69% 14

Clinical leadership The CCG s 2015 result is in top third of comparison group KEY The CCG s 2015 result is in middle third of comparison group The CCG s 2015 result is in bottom third of comparison group CCG in 2014 (Base: 30) CCG in 2015 (Base: 29) COMPARISON GROUP CCG Cluster (Base: 802) All CCGs (Base: 8472) There is clear and visible clinical leadership of the CCG (% Strongly / ) 90% 83% Confidence in the clinical leadership of the CCG to deliver its plans and priorities (% Strongly / ) The clinical leadership of the CCG is delivering continued quality improvements (% Strongly / ) 87% 83% 70% 72% The clinical leadership of the CCG is delivering continued improvements to reduce local health inequalities (% Strongly / ) Not asked in 2014 66% 15

Overall engagement and relationships 16

Overall, to what extent, if at all, do you feel you have been engaged by the CCG over the past 12 months? All stakeholders 1 By stakeholder group 3% Stakeholder group Base Great deal / Fair amount Not very much / Not at all 41% 12 GP member practices 19 100% (19) -% (0) Health and wellbeing boards 2 100% (2) -% (0) 16 55% Local HealthWatch/patient groups 2 100% (2) -% (0) NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) A great deal A fair amount Not very much Not at all Don't know Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) 97% (28) 2015 Great deal / Fair amount 100% (30) 2014 Great deal / Fair amount Total responses : All stakeholders (2015: 29); (2014: 30) 17

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 1 2 7% 3% 12 41% By stakeholder group Stakeholder group Base Very / Fairly satisfied Very / Fairly dissatisfied GP member practices 19 89% (17) -% (0) Health and wellbeing boards 2 100% (2) -% (0) 14 48% Local HealthWatch/patient groups 2 100% (2) -% (0) NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) Very satisfied Neither satisfied nor dissatisfied Very dissatisfied Fairly satisfied Fairly dissatisfied Don't know Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) 90% (26) 2015 Very satisfied / Fairly satisfied 97% (29) 2014 Very satisfied / Fairly satisfied Total responses : All stakeholders who say they have been engaged by CCG (2015: 29); (2014: 30) 18

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 By stakeholder group 10% 24% 7 Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 89% (17) 11% (2) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 66% 19 Strongly agree Neither agree nor disagree Strongly disagree I have not given any views Tend to disagree Don't know NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) 90% (26) 2015 Strongly agree / 73% (22) 2014 Strongly agree / Total responses : All stakeholders (2015: 29); (2014: 30) 19

To what extent do you agree or disagree that the CCG has taken on board your suggestions? All stakeholders By stakeholder group 3 10% 1 3% 3 10% Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 63% (12) 11% (2) Health and wellbeing boards 2 50% (1) -% (0) 6 21% Local HealthWatch/patient groups 2 50% (1) -% (0) 55% 16 NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) 50% (1) Strongly agree Neither agree nor disagree Strongly disagree I have not given any suggestions Total responses : All stakeholders (29) Tend to disagree Don't know Wider stakeholders 0 -% (0) -% (0) 20

Overall, how would you rate your working relationship with the CCG? All stakeholders 2 By stakeholder group 7% Stakeholder group Base Very good / Fairly good Very poor / Fairly poor GP member practices 19 95% (18) -% (0) 48% 14 Health and wellbeing boards 2 100% (2) -% (0) 13 45% Local HealthWatch/patient groups 2 100% (2) -% (0) NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (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 2 50% (1) -% (0) Wider stakeholders 0 -% (0) -% (0) 93% (27) 2015 Very good / Fairly good 97% (29) 2014 Very good / Fairly good Total responses : All stakeholders (2015: 29); (2014: 30) 21

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 By stakeholder group 5 Stakeholder group Base Got much / A little better Got much / A little worse 17% GP member practices 19 37% (7) -% (0) Health and wellbeing boards 2 -% (0) -% (0) 17 59% 24% 7 Local HealthWatch/patient groups 2 50% (1) -% (0) NHS providers 3 67% (2) -% (0) Other CCGs 1 -% (0) -% (0) Got much better Stayed about the same Got much worse 41% (12) 2015 Got much / A little better Got a little better Got a little worse Don't know 55% (16) 2014 Got much / A little better Upper tier/unitary local authorities 2 100% (2) -% (0) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders who say they have a working relationship with the CCG (2015: 29); (2014: 29) 22

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 taken on board 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? 97% (28) a great deal / a fair amount 90% (26) very / fairly satisfied 90% (26) strongly / tend to agree 66% (19) strongly / tend to agree 93% (27) very / fairly good 41% (12) much better / a little better Base All stakeholders (29) All stakeholders who have been engaged (29) All stakeholders (29) All stakeholders (29) All stakeholders (29) All stakeholders who say they have a working relationship with the CCG (29) 23

Engagement and relationships: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 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 great deal / a fair amount Most stakeholders say that they have been engaged either a great deal or a fair amount. This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) 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 Most stakeholders say they are satisfied with the way the CCG has engaged with them. This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders who (29) Base CCG cluster: All stakeholders who (786) Base 2014: say they have been (30) Base national average: say they have been (8320) engaged engaged All comparisons are indicative only and do not imply statistical significance 24

Engagement and relationships: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 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 Most 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 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) Taking on board suggestions To what extent do you agree or disagree that the CCG has taken on board your suggestions? The majority of stakeholders say that the CCG has taken on board their suggestions. Percentage of stakeholders saying strongly agree / tend to agree This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base national average: All stakeholders (8472) All comparisons are indicative only and do not imply statistical significance 25

Engagement and relationships: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 Working relationship Overall, how would you rate your working relationship with the CCG? Most stakeholders say that they have a good working relationship with the CCG. Percentage of stakeholders saying very good / fairly good This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) 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 2015: All stakeholders who say (29) Base CCG cluster: All stakeholders who say (790) Base 2014: they have a working (29) Base national average: they have a working (8363) relationship with the CCG relationship with the CCG All comparisons are indicative only and do not imply statistical significance 26

Domain 1: Are patients receiving clinically commissioned, high quality services? 27

How effective, if at all, would you say the arrangements are for member participation and decision-making in your CCG? All member practices 4 4 21% 21% 79% (15) 89% (17) Very / Fairly effective 2015 Very / Fairly effective 2014 58% 11 Very effective Fairly effective Not very effective Not at all effective Don't know Total responses : All member practices (2015: 19); (2014: 19) 28

How involved, if at all, do you feel you are in your CCG s decision making process? All member practices 6 32% 26% 5 68% (13) Very / Fairly involved 2015 53% (10) Very / Fairly involved 2014 42% 8 Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All member practices (2015: 19); (2014: 19) 29

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 4 16% 21% 3 16% 68% (13) Very / Fairly confident 2015 58% (11) Very / Fairly confident 2014 47% 9 Very confident Fairly confident Not very confident Not at all confident Don't know Total responses : All member practices (2015: 19); (2014: 19) 30

Approximately how often, if at all, do you have the opportunity for direct discussions with your CCG s leaders? All member practices Weekly 16% 16% 2015 2014 2015 Number 3 2014 Number 3 Twice a month 0% 5% 1 0 Once a month 16% 21% 3 4 Quarterly 37% 53% 10 7 Twice a year 0% 16% 0 3 Once a year 0% 11% 0 2 Less than once a year 0% 0% 0 0 Don't know 0% 11% 2 0 Total responses : All member practices (2015: 19); (2014: 19) 31

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 5% 16% 42% 8 79% (15) Strongly / Tend to agree 2015 79% (15) Strongly / Tend to agree 2014 37% 7 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All member practices (2015: 19); (2014: 19) 32

To what extent do you agree or disagree that the quality of services is a key focus of your contracts with the CCG? All NHS providers 33% 1 2 67% Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All NHS providers (3) 33

How involved, if at all, would you say clinicians from the CCG are in discussions about? Quality All NHS providers 33% 1 2 67% Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All NHS providers (3) 34

How involved, if at all, would you say clinicians from the CCG are in discussions about? Service redesign All NHS providers 1 33% 67% 2 Very involved Fairly involved Not very involved Not at all involved Don't know Total responses : All NHS providers (3) 35

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 the quality of services is a key focus of your contracts with the CCG? How involved, if at all, would you say clinicians from the CCG are in discussions about? A. Quality B. Service redesign 79% (15) very / fairly effective 68% (13) very / fairly involved 68% (13) very / fairly confident 79% (15) strongly / tend to agree 100% (3) strongly / tend to agree 100% (3) very / fairly involved 67% (2) very / fairly involved Base All member practices (19) All member practices (19) All member practices (19) All member practices (19) All NHS providers (3) All NHS providers (3) 36

Domain 2: Are patients and the public actively engaged and involved? 37

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 / 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 76% 14% 7% 3% 22 4 2 1 I have confidence in the CCG to commission high quality services for the local population 86% 10% 3% 25 3 1 0 I understand the reasons for the decisions that the CCG makes when commissioning services 76% 24% 22 7 0 0 The CCG effectively communicates its commissioning decisions with me 79% 14% 7% 23 4 2 0 The CCG's plans will deliver continuous improvement in quality within the available resources 62% 34% 3% 18 10 1 0 Total responses : All stakeholders (29) 38

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 2 4 14% 1 7% 3% 7 24% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 79% (15) 5% (1) Health and wellbeing boards 2 50% (1) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 15 52% NHS providers 3 67% (2) -% (0) Other CCGs 1 100% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 76% (22) 2015 Strongly agree / Tend to disagree Don't know 83% (25) 2014 Strongly agree / Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 39

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 3 1 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree 10% 3% 10 34% GP member practices 19 89% (17) 5% (1) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 52% NHS providers 3 67% (2) -% (0) 15 Other CCGs 1 100% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 86% (25) 2015 Strongly agree / Tend to disagree Don't know 93% (28) 2014 Strongly agree / Upper tier/unitary local authorities 2 50% (1) -% (0) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 40

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 7 24% 21% 6 Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 74% (14) -% (0) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 16 55% NHS providers 3 67% (2) -% (0) Other CCGs 1 100% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 76% (22) 2015 Strongly agree / Tend to disagree Don't know 67% (20) 2014 Strongly agree / Upper tier/unitary local authorities 2 50% (1) -% (0) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 41

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 14% 2 7% 21% 6 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 84% (16) 5% (1) Health and wellbeing boards 2 50% (1) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 59% 17 Strongly agree Neither agree nor disagree Strongly disagree Tend to disagree Don't know NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 -% (0) 50% (1) 79% (23) 2015 Strongly agree / 80% (24) 2014 Strongly agree / Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 42

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 1 By stakeholder group By stakeholder group 3% 8 Stakeholder group Base Strongly / Strongly / Tend to disagree 10 34% 28% GP member practices 19 63% (12) -% (0) Health and wellbeing boards 2 50% (1) -% (0) Local HealthWatch/patient groups 2 50% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 62% (18) 2015 Strongly agree / 34% 10 Tend to disagree Don't know 67% (20) 2014 Strongly agree / NHS providers 3 67% (2) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 43

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 100% 2 Very satisfied Fairly satisfied Neither satisfied nor dissatisfied Fairly dissatisfied Very dissatisfied Don't know Total responses : All HealthWatch and patient group stakeholders (2) 44

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 50% 50% 1 A great deal A fair amount Just a little Not at all Don't know Total responses : All HealthWatch and patient group stakeholders (2) 45

To what extent do you agree or disagree with the following statements? All HealthWatch and patient group stakeholders Number Strongly 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 100% 2 0 0 0 Patients and the public have the opportunity to input into the CCG s commissioning decisions 50% 50% 1 1 0 0 Total responses : All HealthWatch and patient group stakeholders (2) 46

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 100% 2 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All HealthWatch and patient group stakeholders (2) 47

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 50% 50% 1 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All HealthWatch and patient group stakeholders (2) 48

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 100% 2 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don't know Total responses : All HealthWatch and patient group stakeholders (2) 49

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 (29) 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 76% (22) strongly / tend to agree 86% (25) strongly / tend to agree 76% (22) strongly / tend to agree 79% (23) strongly / tend to agree 62% (18) 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? 100% (2) very / fairly satisfied 50% (1) a great deal / a fair amount All HealthWatch and patient group stakeholders (2) All HealthWatch and patient group stakeholders (2) 50

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 100% (2) strongly / tend to agree 50% (1) strongly / tend to agree Base All HealthWatch and patient group stakeholders (2) 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% (2) strongly / tend to agree All HealthWatch and patient group stakeholders (2) 51

Domain 2: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 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 higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) 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 higher than the finding for CCGs overall. Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) All comparisons are indicative only and do not imply statistical significance 52

Domain 2: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 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 The majority of stakeholders say that the CCG involves and engages with the right individuals and organisations when making commissioning decisions. This is higher than the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) High quality services I have confidence in the CCG to commission high quality services for the local population Most 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 higher than the finding for CCGs overall. Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) All comparisons are indicative only and do not imply statistical significance 53

Domain 2: CCG comparisons The CCG 2015 The CCG 2014 CCG cluster average National CCG average 2015 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 The majority of stakeholders agree that the CCG s plans will deliver continuous improvement in quality within available resources. This is about the same as the finding for CCGs overall. 0 10 20 30 40 50 60 70 80 90 100 Base 2015: All stakeholders (29) Base CCG cluster: All stakeholders (802) Base 2014: All stakeholders (30) Base national average: All stakeholders (8472) All comparisons are indicative only and do not imply statistical significance 54

Domain 3: Are CCG plans delivering better outcomes for patients? 55

How much would you say you know about the CCG s plans and priorities? All stakeholders By stakeholder group 3 10% 17% 5 Stakeholder group Base Great deal / Fair amount Not very much / Nothing at all GP member practices 19 89% (17) 11% (2) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 21 72% NHS providers 3 67% (2) 33% (1) Other CCGs 1 100% (1) -% (0) A great deal A fair amount Upper tier/unitary local authorities 2 100% (2) -% (0) 90% (26) Not very much 2015 Great deal / Fair amount 83% (25) Nothing at all 2014 Great deal / Fair amount Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 56

To what extent do you agree or disagree with each of the following statements about the CCG s plans and priorities? All stakeholders Strongly agree / Neither agree nor disagree Strongly disagree / Tend to disagree Don't know Not applicable Number I have been given the opportunity to influence the CCG s plans and priorities 76% 14% 10% 22 4 3 0 When I have commented on the CCG s plans and priorities I feel that my comments have been taken on board 59% 28% 10% 3% 17 8 3 1 3% The CCG has effectively communicated its plans and priorities to me 86% 10% 25 3 1 0 3% 3% The CCG s plans and priorities are the right ones 72% 21% 21 6 1 1 Total responses : All stakeholders (29) 57

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 3 10% 8 4 28% 14% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 79% (15) 5% (1) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) 48% 14 Strongly agree Neither agree nor disagree Strongly disagree 76% (22) 2015 Strongly agree / Tend to disagree Don't know 77% (23) 2014 Strongly agree / NHS providers 3 33% (1) 33% (1) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) 50% (1) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 58

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 1 1 2 7% 3% 3% 8 28% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 63% (12) 16% (3) Health and wellbeing boards 2 50% (1) -% (0) 8 28% Local HealthWatch/patient groups 2 50% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 59% (17) 2015 Strongly agree / 31% 9 Tend to disagree Don't know 60% (18) 2014 Strongly agree / NHS providers 3 33% (1) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) -% (0) Wider stakeholders 0 -% (0) -% (0) Total responses : All stakeholders (2015: 29); (2014: 30) 59

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 1 3 10% 3% 8 28% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 89% (17) 5% (1) Health and wellbeing boards 2 100% (2) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) NHS providers 3 67% (2) -% (0) 59% Other CCGs 1 100% (1) -% (0) 17 Upper tier/unitary local authorities 2 50% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Not applicable Total responses : All stakeholders (29) Tend to disagree Don't know Wider stakeholders 0 -% (0) -% (0) 60

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 6 21% 1 1 3% 3% 7 24% By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree GP member practices 19 79% (15) 5% (1) Health and wellbeing boards 2 50% (1) -% (0) Local HealthWatch/patient groups 2 100% (2) -% (0) Strongly agree Neither agree nor disagree Strongly disagree 72% (21) 48% 14 Tend to disagree Don't know Total responses : All stakeholders (2015: 29); (2014: 30) 2015 Strongly agree / 80% (24) 2014 Strongly agree / NHS providers 3 33% (1) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) -% (0) Wider stakeholders 0 -% (0) -% (0) 61

To what extent do you agree or disagree with the following statement? Improving patient outcomes is a core focus of the CCG All stakeholders 1 By stakeholder group By stakeholder group Stakeholder group Base Strongly / Strongly / Tend to disagree 3% GP member practices 19 100% (19) -% (0) Health and wellbeing boards 2 100% (2) -% (0) 14 48% 48% 14 Local HealthWatch/patient groups 2 100% (2) -% (0) NHS providers 3 100% (3) -% (0) Other CCGs 1 100% (1) -% (0) Upper tier/unitary local authorities 2 50% (1) -% (0) Strongly agree Neither agree nor disagree Strongly disagree Total responses : All stakeholders (29) Tend to disagree Don't know Wider stakeholders 0 -% (0) -% (0) 62

How familiar are you, if at all, with the financial position of your CCG? All member practices 1 1 1 5% 5% 5% 5 26% 58% 11 Very familiar Fairly familiar Not very familiar Not at all familiar Don t know Total responses : All member practices (19) 63

To what extent do you agree or disagree with the following statement? I am regularly involved in discussions regarding the management of my CCG s finances All member practices 1 5% 3 16% 10 53% 26% 5 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don t know Total responses : All member practices (19) 64

To what extent do you agree or disagree that value for money is a key factor in decision making when formulating my CCG s plans and priorities? All member practices 3 16% 37% 7 47% 9 Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don t know Total responses : All member practices (19) 65

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 5% The financial implications of the CCG s plans 68% 26% 13 5 1 The implications of the CCG s plans for service improvement 63% 37% 12 7 0 The referral and activity implications of the CCG s plans 74% 26% 14 5 0 The CCG s plans to reduce health inequalities 68% 32% 13 6 0 The CCG s plans to improve the health of the local population 79% 21% 15 4 0 Total responses : All member practices (19) 66

How well, if at all, would you say that you understand? The financial implications of the CCG s plans All member practices 1 1 5% 5% 5 26% 68% (13) Very / Fairly well 2015 58% (11) Very / Fairly well 2014 63% 12 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2015: 19); (2014: 19) 67

How well, if at all, would you say that you understand? The implications of the CCG s plans for service improvement All member practices 2 11% 7 37% 63% (12) Very / Fairly well 2015 68% (13) Very / Fairly well 2014 53% 10 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2015: 19); (2014: 19) 68

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 5 5% 26% 74% (14) Very / Fairly well 2015 63% (12) Very / Fairly well 2014 68% 13 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2015: 19); (2014: 19) 69

How well, if at all, would you say that you understand? The CCG s plans to reduce health inequalities All member practices 2 6 11% 32% 58% 11 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (19) 70

How well, if at all, would you say that you understand? The CCG s plans to improve the health of the local population All member practices 4 21% 11% 2 68% 13 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (19) 71

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 3 4 16% 21% 84% (16) 95% (18) Very / Fairly well 2015 Very / Fairly well 2014 63% 12 Very well Fairly well Not very well Not at all well Don't know Total responses : All member practices (2015: 19); (2014: 19) 72

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 100% 3 Very well Fairly well Not very well Not at all well Don't know Total responses : All NHS providers (3) 73

How well, if at all, would you say the CCG understands the challenges facing your provider organisation? All NHS providers 1 33% 67% 2 Very well Fairly well Not very well Not at all well Don't know Total responses : All NHS providers (3) 74

To what extent do you agree or disagree that your contracts with the CCG place enough emphasis on delivering positive patient outcomes? All NHS providers 33% 1 2 67% Strongly agree Neither agree nor disagree Tend to disagree Strongly disagree Don t know Total responses : All NHS providers (3) 75

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? 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 To what extent do you agree or disagree that improving patient outcomes is a core focus for the CCG? How familiar are you, if at all, with the financial position of the CCG? 90% (26) a great deal / a fair amount Base All stakeholders (29) 76% (22) strongly / tend to agree All stakeholders (29) 59% (17) strongly / tend to agree 86% (25) strongly / tend to agree 72% (21) strongly / tend to agree 97% (28) strongly / tend to agree 63% (12) very / fairly familiar I am regularly involved in discussions regarding the management of the CCG s finances 21% (4) strongly / tend to agree To what extent do you agree or disagree that value for money is a key factor in decision making when formulating my CCG s plans and priorities? 84% (16) strongly / tend to agree All stakeholders (29) All stakeholders (29) All stakeholders (29) All stakeholders (29) All member practices (19) All member practices (19) All member practices (19) 76