What People are Telling Us 

Understanding the needs of the population and the performance of the services they use is useful but it is only part of the picture; a vital part of any Needs Assessment and Commissioning Process is hearing the voice of the people who live in the area. What people say about their needs and the services they use gives a much better idea how to improve the services being commissioned in a way that responds to the needs of the population. This is a two-way process – not only do commissioners need to listen to what people are saying but they also need to let people know about local needs and the services they are commissioning on their behalf


This section looks at the main ways in which local health services and councils hear the voice of local people. It describes the key engagement activities that took place in the financial year 2009/10 and where possible we have included what is happening in response. It includes activity carried out by the the London Boroughs of Sutton and Merton in relation to social care services for children, young people and adults. It also covers the ways in which local health services involved patients and the public


Links are included to the engagement strategies for local councils and the PCT, and to other reports for further information


Why do we need to involve service users and communities?

National evidence suggests that good engagement can:

  • lead to improved clinical and economic outcomes in health care
  • improve experience of and satisfaction with health and social care services
  • make services more responsive to individual needs
  • help develop services that support people’s dignity and independence
  • challenge established methods and ideas and encourage innovation and creativity
  • encourage a better understanding of decision-making, prioritisation and use of resources in health and social care services
  • enable individuals to manage their health and social care more effectively, particularly in relation to long-term conditions

Engagement and Involvement Strategies

Community Engagement is the action taken to consult, involve, listen and respond to communities through ongoing relationships and dialogue. Communities participate to develop solutions, shape and design policies and services. Engagement enables citizens and organisations to influence decisions as well as make decisions themselves. Engagement activities include the provision of information, consultation, survey, interview and focus groups. These activities can be conducted face-to-face, via telephone, by the provision of hardcopy written information or online.


The engagement strategies for the PCT and Boroughs can viewed at:

NHS Sutton and Merton




Duty to Involve Report

Health commissioners have a legal duty to consult patients and the public before making commissioning decisions that affect how health services are planned and provided. In 2010, a new legal duty came into force requiring PCTs to produce an annual report on consultation


NHS Sutton and Merton’s first Annual Report on the Duty to Involve in Consultation 2009-2010 includes full details on consultations carried out during the year, including commissioning decisions made, what consultation took place prior to the decision being made, what views were expressed, and how they were taken into account


These consultations are summarised here


More details are available in the report itself which can be accessed here


How do we hear the views of patients and communities?


Local Involvement Networks (LINks)

Local Involvement Networks (LINks) are networks set up all over England to help people and groups have more of a say in how local health and adult social care services are delivered. This may involve talking directly to health and social care staff about gaps in services, or suggesting ways that an existing service could be made better. Below are examples of some of the activities that Sutton and Merton LINk members have been involved in during 2009/10:

  • A wide range of projects with St Helier hospital aimed at improving patient experience including food, cleanliness, privacy and dignity, patient information and supporting during hospital discharge
  • Input into the design and delivery of Older People’s services including reducing the number of falls within community settings and footcare services
  • Exploring access to early intervention and prevention mental health services and working with the local Trust to improve early take up of day care services
  • Involvement in a range of programmes relating to transforming healthcare, e.g. Better Healthcare Closer to Home, procurement of community services and changes to paediatric surgical services at St Helier
  • Enabling the community, through regular meetings and special events, to understand and influence the personalisation of social care (Self-Directed Support)

Community Engagement Networks

INVOLVE is Merton's Community Engagement Network. It is a network of the community and voluntary sector and aims to make sure that the needs and preferences of service users, carers and the wider community are identified and kept central to the planning and delivery of future services in Merton


In Sutton the existing Community Engagement Network has been combined with the Sutton LINk, enabling both individuals and community groups to have their say about all the services provided by the Council and the Local Health Service. In March 2010 Sutton LINk Mental Health Working Group carried out a survey of local people with severe and enduring mental health problems and of the people who care for them. This raised issues around housing, diagnosis, care plans, sources of support and links with primary care. These will be taken to the Sutton Mental Health Partnership Board and its constituent organisations to act on

Community Forums and Area Committees

Community Forums (known as Area Committees in Sutton) help people make sure that the Borough and other agencies know about their concerns and aspirations for their community. Each Forum meeting is attended by a Borough representative whose role is to follow up on issues raised and ensure that they are resolved. Health and social care topics discussed in 2009/10 include:

  • Plans for the development and future use of Nelson Hospital
  • Personalisation of social care, moving towards people creating their own care packages and receiving direct payments to pay for them
  • Proposed relocation of GP surgeries in Merton
  • A community engagement project in Hackbridge supporting local people to achieve a healthy life

As well as the area-based groups described above there are a wide range of other forums, networks, groups and partnerships that enable different sections of the population to express their views on local services and issues. Some examples include youth parliaments, Black and Asian Minority Ethnic (BAME) networks, learning and physical disability partnerships, faith-based forums, patient groups, and carers forums and partnerships



When commissioners are considering significant changes to local services, formal public consultations are carried out to seek the views of local people. The details of consultations carried out by the PCT and boroughs are given here


Other engagement activities

As well as consultation there are also a variety of other ways to empower, involve, listen and respond to patients and communities. Examples of some of these activities are in Local Engagement


Patient Advice and Liaison Service (PALs) and Complaints

PALS provides a point of contact to resolve concerns or any difficulties experienced with health services. The PCT also regularly monitors and reviews complaints concerning PCT and Community Services issues. More information on these areas is can be found in the attached Complaints and PALs


National Surveys

There are several surveys carried out on a national basis by both the PCT and the Boroughs. The key results of these surveys and actions arising from them are in National Surveys


Key Commissioning Implications for improving services based on what people are telling us

Commissioners have a legal duty to seek views of service users and patients when commissioning services. This includes looking at the experience of existing services, and seeking views about planned changes to services before they are made

A better understanding of patient or service user experience can help drive improvement by showing where efforts need to be targeted. Commissioners can draw on a wide range of data sources, both national and local, qualitative and quantitative, to support this process


Commissioners also need to consider what is the appropriate involvement approach for different projects. For a major service change, a formal public consultation will be required. When seeking to improve health outcomes and access to services for specific groups, engagement may include social marketing insight work to help understand the beliefs and attitudes that influence health behaviours and use of services


It is important that commissioners are proactive in seeking views from marginalised groups who often experience poorer health outcomes, often referred to as ‘seldom-heard voices’