Test of Change in community engagement

The test is:

• Time-limited;
• Proportionate;
• Focused on learning, not decisions.

It involves:

• Community partners in Larkhall;
• Complementary patient insight work at University Hospital Wishaw A&E;
• A mix of digital engagement methods, tailored to local readiness;
• It is not a consultation on service change and does not replace statutory engagement.

A&E attendance provides a real-world lens for understanding how people behave under uncertainty.

Early engagement suggests that attendance decisions are often shaped by:

• Anxiety when symptoms persist;
• Reassurance-seeking rather than lack of knowledge;
• Social prompts from trusted people or networks.

This makes A&E attendance a useful theme for exploring communication, trust, and decision-making – without assuming people are “using services incorrectly.”

How people access information has changed.

Evidence from Ofcom shows that local, peer-to-peer digital spaces – such as community Facebook groups, WhatsApp networks, and newsletters – now shape perceptions early and quickly. Traditional channels alone no longer reach the breadth of audiences they once did.

This Test of Change explores how NHS Lanarkshire adapts its engagement methods to remain credible and resonant in that environment.

The key difference is method.

This approach:

• Engages early;
• Listens first;
• Works through trusted local connectors;
• Loops back clearly on what is heard.

It is structured through NHS Lanarkshire’s CIRCLE engagement method, aligned with national Planning with People guidance.

CIRCLE is a structured engagement approach designed for today’s engagement environment:

• Connect – meet people where they already are;
• Inquire – ask open questions and listen;
• Resonate – shape messages that land locally;
• Clarity – be honest about scope and constraints;
• Loop-back – explain what’s happening as a result of feedback;
• Execute – turn insight into action.

This Test of Change examines whether applying CIRCLE consistently at community level improves reach, trust, and insight.

The objectives are to:

• Understand local drivers of A&E attendance;
• Surface alternatives that communities recognise and trust;
• Strengthen trust and relationships with communities;
• Generate practical learning about flexible engagement models.

Success is defined by quality of insight and learning, not volume alone.

Feedback will be:

• Analysed thematically;
• Shared transparently through loop-back (“what we heard / what we can and can’t change”);
• Used to inform winter planning and longer-term engagement approaches.

The Test of Change is:

• Anchored in existing NHS Lanarkshire governance;
• Informed by learning from eTriage and Interface programmes;
• Designed to reduce risk by preventing misinformation from running ahead;
• Clear boundaries are set around scope, expectations and feedback loop-back from the outset.

No.

This work complements existing communications and engagement. It strengthens the early listening phase and improves sequencing – helping NHS Lanarkshire listen, reflect and then communicate with greater clarity and confidence.

• Digital engagement continues;
• Insight is consolidated and analysed;
• Clear loop-back is shared with communities;
• Learning informs next phases, including in-person engagement.

This Test of Change reflects a simple principle: effective, people-first engagement starts by meeting people where they actually are – not where we assume they are.

If you have questions about this Test of Change, or need support to take part, you can contact NHS Lanarkshire at: LAN.interface@lanarkshire.scot.nhs.uk