STPs: Top tips for community engagement

Jason Helgerson in front of whiteboard

24 / 10 / 2016

Jason Helgerson, the man at the helm of New York State’s Medicaid programme, has spent his professional life driving health and social care transformation in the United States.

With the sustainability and transformation plan (STP) process now moving from development to engagement, we picked his brains for top tips on how to successfully engage communities in local transformation efforts.

Here's what he told us.

1. State the problem – don’t sugar coat it: outcomes are not what you or anyone would want and the fiscal situation is dire. Communicate this with data and visuals and use the facts to frame the discussion. Clearly stating the problem isn’t about assigning blame; rather, it’s about being honest and explaining the situation to the community in a way that will allow them to formulate their feedback in ways that will address the real issues.

2. Present your STP in a fair and balanced way – your job isn’t to defend every comma. The last thing you want is to come across as defensive. Make clear that the STP isn’t final, that you really want feedback and that community views will be reflected in the final plan.

3. Be transparent – post all materials to the web. Make all ideas public. Host public meetings and invite everyone. No person should be prevented from participating. 

4. Catalogue all new ideas – in New York, we created a standard form and tracked all ideas that were presented, regardless of origin. We gathered over 4,000 ideas in a little over two months. Lots of great ideas came out of this process.

5. Identify a strong project manager to support this effort – stakeholder engagements fail because they are poorly managed. Treat this engagement like a project and manage it with rigour. Look like you know what you are doing by having well-organised meetings and a professional approach to gathering feedback.

6. No sacred cows – nothing should be ‘off the table’. It’s a very slippery slope when you start saying certain programmes/providers/services are so preferred that they can’t be examined. Once you take one off the table, others will call for similar treatment. Even the most cost-effective programmes can be improved. 

7. Publish multiple versions of the STP for public consideration – demonstrate that you are taking feedback. Demonstrate that this is an iterative process. This will give the community multiple chances to provide feedback and lowers the stakes, especially at the beginning, so that the community is less defensive. 

8. Make community engagement a central part of how you operate – in New York, we see community engagement as part of our organisational culture. We use it for both plan development and implementation. I sometimes say that we are most vulnerable when we aren’t actively engaging our community in some sort of project. This will build credibility and will allow for thoughtful implementation.

9. Be open to even small ideas – health and social care is big and complex and some will want to focus on big, bold ideas. While you should as well, don’t shy away from smaller ideas. Many small ideas can be done quickly and can both demonstrate your willingness to listen and help you generate some quick wins that will help your transformation effort build momentum.

10. Celebrate your successes – this may sound a little premature, but be prepared to tell your story and celebrate your successes. No one else will. This isn’t about PR. This is about helping to demonstrate to the community – particularly your frontline health and social care providers – that transformation is possible. Success trumps pessimism. You must fight pessimism with every ounce of strength you have.

“It’s not easy, but it can be done and it can be extremely rewarding,” Jason told us. 

“I have found that our greatest successes in transformation in New York are all tied to meaningful community engagement. 

“For those interested, my colleagues and I would be happy to assist any ‘footprint’ in your challenging efforts. Good luck!” 

Follow Jason on Twitter @policywonk1 and read his latest NHS Voices post.

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