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Good practice for working with people and communities during the COVID-19 outbreak

(Published 18 March 2020)


This short document has been produced by the NHS England and NHS Improvement Public Participation team. It is intended to offer some practical advice and suggestions for Engagement Practitioners and others working with people and communities during the COVID-19 outbreak (also known as corona virus). It is good practice advice and not formal or statutory guidance – existing statutory guidance still stands. It does not provide public health or clinical advice around COVID-19, which should be accessed via the Public Health England or NHS websites.


There are some specific suggestions about particular scenarios in the next section, but there are also some general principles to follow when thinking about public participation over the next few weeks and months.

Essentially, for all engagement activity which is underway or planned, there will be four options (not all mutually exclusive):

  • Continue as planned
  • Postpone the activity
  • Move to online / virtual methods instead of face-to-face
  • Cancel.

There is no obligation for patient and public participation to be face-to-face and any such engagement activity should only be undertaken where not prohibited or discouraged by the latest government advice.

Some questions to think about when deciding on the best approach for your particular activity / proposal:

1. Are any of the participants known or likely to be in one of the ‘at risk’ groups, or particularly impacted by COVID-19? This includes older people and those with underlying health conditions (check the latest guidance), and people with caring responsibilities.

2. Do participants / your target audience have access to online communication and engagement methods? If not, could they be supported to access online methods, or contacted by telephone?

3. Do relevant staff members, especially clinical staff, have the capacity to be involved in engagement activity at the moment?

4. What would be the impact of postponing the activity? Could any of the negative impacts be mitigated against?

Your responses to these questions can guide your decision making and risk assessments / mitigation around the different engagement activities you have underway / planned, including most appropriate next steps.

Communication and community response

Whatever the outcome of your review of existing / planned engagement activity, it is really important to maintain communication with your local partners, including local Healthwatch, patient groups and Voluntary, Community and Social Enterprise Social organisations, as well as Patient and Public Voice (PPV) Partners. It is likely that your Communications team will already be implementing a response plan, but consider whether this includes links to volunteering and community action to support people whilst self-isolating.

The COVID-19 outbreak poses fundamental challenges to public authorities in how they go about meeting their usual duties and it is necessary to adapt. Patient and public participation is no exception and we must prioritise the health, safety and welfare of patients, staff and wider society.

Advice about common scenarios

? We are about to launch a consultation on a major service change / reconfiguration, what should we do?

The coming weeks and months are likely to see very high demand on frontline services, so it makes sense to delay any significant activity which can be postponed to free up capacity. Members of the public are also likely to be limited in their ability to get involved due to illness, self-isolation and caring responsibilities. Many groups and networks who would usually form a staple part of your consultation plan are unlikely to be meeting. On the basis of government advice at 18.03.20, social distancing means that face-to-face events should not go ahead.

These factors may mean the consultation is not the best use of public resources, or make it more difficult for some consultees to be reached and/or to provide meaningful response. We recommend that you consider these factors when deciding whether to postpone or make changes to your consultation plans.

? What if we need to take an urgent decision during the outbreak?

At the time of writing, the NHS duty to involve the public is unaffected by the outbreak or any emergency legislation. However, where there is a genuine and pressing need to make a decision about, or a change to, services to protect the health, safety of welfare of patients or staff, then the NHS duty to involve the public may be met by very limited public involvement – but at the very least changes to services should be announced to the public at the earliest reasonable opportunity.

In such circumstances, you are not required to consult your local overview and scrutiny committee prior to taking the decision (but you should still promptly notify the committee of the decision taken and why no consultation has taken place).

However, this approach should be used only when necessary and it is likely that regular engagement with patients, staff and other stakeholders will be essential for practical reasons in any event (for example so that patients understand how to access services). It remains important to liaise with your overview and scrutiny committee, local Healthwatch and other key stakeholders, ideally before taking the decision, where possible. Remember too that you may need to carry out further engagement in future if it is intended that temporary changes will become permanent.

? We are about to start engagement / consultation in response to a provider giving notice / a need to retender a service, what should we do?

Many of the considerations relevant to major service change / reconfiguration apply – as outlined above. In addition, it would be appropriate to consider interim approaches which could help to ‘buy time’ and enable the engagement / consultation to be postponed to a later date – for example, extending the current contract or arrangement, or enacting a temporary change to service provision. If you must go ahead at this point, consider virtual / online engagement approaches, and working with local Healthwatch / a relevant patient group to ensure some meaningful patient / public participation, even if this is from a smaller group.

? We are recruiting Patient and Public Voice (PPV) Partners, do we need to stop?

As with all potentially ‘non-essential’ activity, consider the impact on staff capacity at this time of high demand. However, there is not necessarily any need to pause this recruitment, assuming your existing communications routes are still operating. It would be appropriate to consider interviewing shortlisted candidates virtually rather than face-to-face, for example using video conferencing or webinar technology. As many meetings are likely to be moved to online methods during the coming weeks, this is also a chance for potential PPV Partners to showcase or build their technical skills. The exception is likely to be if you are targeting recruitment at groups known to be digitally excluded, for example inclusion health groups, in which case postponement may be the most sensible approach.

? We have a number of established forums / groups for hearing from members of the public, with meetings scheduled over the coming weeks and months, should we cancel them?

Many people are likely to have concerns about travelling and attending meetings / events over the coming weeks and months, and others will be self-isolating or have responsibilities. Therefore, it would be appropriate to consider changing

face-to-face meetings to teleconferences, video conferences or webinars. If this is unlikely to work for group members, then it may be necessary to cancel meetings for the time being.

Further information

For advice about COVID-19 visit the Public Health England or NHS websites.

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