Moving from options development into a public consultation period is one of the most challenging aspects for any strategic change programme.

Stand’s director, Caroline Latta, shares four key considerations to have in mind when planning your consultation timeline.

Picture the scene. You’ve worked hard with clinical teams, commissioners, stakeholders, patients and partners, and there’s strong consensus on the business case for change.

Together, you’ve developed great working ideas, developed and applied evaluation measures to include the elements that are important to staff, patients and the public.

And you’ve finally got a robust set of proposals. You are ready to move into the public consultation phase.

You may as well try and nail down jelly. 

Mapping out a public consultation strategic timeline, bringing together all the threads of planning from your options development phase, is one of the most daunting tasks for any change programme. 

The need to delicately balance the timing of multiple aspects of the change programme can be a kaleidoscope of interlinked issues. 

• Is the timing of NHS regulatory assurance, organisational governance, and consultation with health scrutiny committees lined up? 
• How long should the live public consultation period be? 
• Should it be longer to take holidays into account? 
• How much time is needed for drafting and signing off of consultation documents, accessible formats, surveys, focus groups? 
• At which points do key stakeholders need to be involved? 
• What is the best timing for the schedule of public events? 
• And are key leaders available to front them? 

With so many moving parts to align, getting back to key principles is the best way to create a clear roadmap through to the final end point of decision making. 

Map it out and write it down

Start by setting out a timeline, adding in key milestones such as those above and share it with your programme team. 

Include key meeting dates such as boards and committees, include preparation timescales, map out the public start, middle and end dates, when key public events or other research methods could take place. Add in the post consultation timeframe paying attention to when the analysis of feedback would be available and dates for consideration of feedback and decision making.

Gain feedback and contributions from colleagues so that everyone can agree and sign up to the timeline as being realistic and achievable.

Now we have deadlines to focus on and move the programme forward.

Governance trumps all

Public consultation is about making better decisions, so it stands to reason that the governance framework for decision-making is paramount. It provides the statutory legitimacy for decision-making and accountability to the public.

Be crystal clear about how the programme governance works in relation to the decision-makers and other statutory partners. For example:

→ The transformation programme board recommends the final business case to the provider trust.

↪ The provider trust wants to sign it off, before it’s submitted to NHS England and Improvement for assurance.

↪ NHSEI assures the business case and returns it to the statutory commissioners

↪ The commissioners approve the business case for public consultation. 

In simple terms, making sure the right schedule of meetings are at the right time and in the right order to pave the way for assurance and agreement.

Right now decision-makers are Clinical Commissioning Groups (CCGs). That will change on 1st July, when the Health and Care Bill gains Royal Assent when Integrated Care Boards (ICBs) will take over. That means decisions based on a consultation that starts now will be made by your ICB. 

So it’s wise to involve your ICB leaders at the earliest stage you can, because they will need to be satisfied that the duty to involve patients and the public in developing the proposals, the public sector equality duty, and all the other legal duties that come with a public consultation on a service change proposal have been met.

Remember the statutory duty to consult with Health Overview and Scrutiny

Working out the best way to discharge the statutory duty for NHS commissioners to formally consult a local authority on substantial changes is best done in partnership with health overview and scrutiny (HOSC) officers.

They can offer sage advice on how to ensure elected members are involved in the right ways. It’s worth remembering that with local authority elections in many parts of England taking place in May 2022 may mean changes to HOSC membership – so all the hard work you’ve done to develop relationships and gain understanding about the case for change might need to begin again. 

The critical dates for the HOSC are the date by which the local authority must respond to the consultation proposal and the date by which the NHS body intends to decide whether to proceed with the proposal – and it is the NHS’s responsibility to publish these dates and any changes to them.

Forward thinking change programmes will have worked with elected members during the business case development phase, making sure councillors had an opportunity to fully explore the issues in advance. Committees will be interested in communications and involvement aspects of the consultation so it’s always a good idea to ensure you share those plans and provide an opportunity to influence them. It’s likely the committee will wish to have their formal consultation meeting with the NHS on the proposals a few weeks into the live public consultation so they are able to observe the live phase underway, noting the questions and concerns from the public. 

As the HOSC will need to provide a formal response about the proposals to the commissioners, allowing their views to be taken into account at decision making, the committee will likely wish to hear the public consultation feedback to inform their thinking – all extremely important dates that should be agreed with scrutiny officers and mapped into the timeline.

Accept the timeline will keep changing

At Stand Towers, we know how hard managing a consultation timeline can be, and we want you to know that the timeframe for every single consultation we’ve worked on over the last 20 years has changed in some way, manner, shape or form after it’s been nailed down and approved.

It’s inevitable because of the multiple forces outside of the programme’s control. So let your timeline breathe a little. Build in practical contingency from the start and know what impact a change here or there will have on the whole programme. HOSC asks for an extra meeting. Your assurance team asks for amendments that will take an extra week. A key governance meeting is postponed to deal with system pressures. What impact would those have? Preparing will allow you to better manage those bumps in the road, adding flexibility and the opportunity to adjust without busting the timeline completely.