The Engagement Cycle

Engagement strategy, culture and systems

This is the hub of the Engagement Cycle – This area of work is about developing the wider vision for engagement, making sure it is part of everyday practice and driving the work operationally. It will also help ensure that data and outcomes from each stage of the Cycle are fed into the next stage and that the ‘baton’ is not dropped – to ensure that it is really a ‘cycle’. There are ten key elements of the hub.

Be clear on the vision and build shared understanding

  • The model can contribute towards a shared understanding of what engagement means, its different purposes and benefits. It helps develop the principles underpinning a vision, strategy and plans for local engagement. Senior commitment and clinical ownership comes as people get clear on the business, health and social benefits of good engagement.

Develop an engagement strategy that links to other work

  • The Engagement Cycle can be used as the basis for developing a strategy on engagement and should be linked to other organisational plans. You need to hard-wire The Engagement Cycle by developing key systems and processes that will ensure engagement runs throughout the organisation.

Be clear about who needs to do what

  • Roles and responsibilities for engagement at strategic and operational level need to be clear (includes Chief Operating Officer, clinical lead for PPE, lay members, programme leads for different conditions and pathways, engagement practitioners and those providing commissioning support). Partnership roles should also be thought through (e.g. Health and Wellbeing Board, HealthWatch, etc.).

Embed engagement in government arrangements

  • The Board requires processes to ensure that data and outcomes from engagement are used to provide insight (into current services) and foresight (for strategic planning). The lay member is crucial, but the board has a collective engagement duty. Plans and business cases for change and service improvement require assurance of high quality (and resourced) engagement before signing off

Use data and insight to inform decision-making

  • An assessment of engagement activities (outcomes, processes, mechanisms) should be undertaken for each stage of the cycle. Be clear on what data needs to go the Board, but make sure that data capture is not just about meeting performance management requirement, but is useful and relevant for improvement. Involve patients, carers and the public in gathering data, analysing it, and in decisions about what happens next

Develop meaningful engagement structures

  • Think ‘function before form’ and build on what already exists. Any structure (e.g. supra-patient participation group) should have clear purposes. Don’t automatically set up formal mechanisms unless convinced that existing mechanisms need revamping. There needs to be clear links between what these structures do and decision-making processes. See The Eight-Eight Model

Build trusting relationships

  • At each stage of The Engagement Cycle, it is crucial that commissioners develop dialogue with local patient and community organisations and patient leaders. Take every opportunity to build links with local people and groups – be ready to ‘walk the talk’ and be able to explain clearly what you are doing. Make sure you get support from communication colleagues. See

Provide adequate resources

  • To move engagement from a ‘nice to have’ to a ‘must do’ means providing sufficient resources for engagement within operational programmes and team budgets. This includes payment and incentives for patients and the public, as well as investment in training and support

Provide learning and support to staff

  • Different people require learning and support in order to implement The Engagement Cycle. It is important to think through who needs learning and support in order to develop confidence, and skills in this area, for example Board members at strategic level, programme leads (alongside engagement practitioners), health professionals and other staff.

Provide learning and support to patients, carers and the public

  • Providing learning and support for patients and the public is crucial. There are many sorts of patient leaders who also need opportunities to build their capacity to engage in dialogue, be effective and build trusting relationships. See Centre for Patient Leadership for more information.

The Engagement Cycle