Stakeholder Engagement – It really is all about People and Relationships.


Capture.PNGHello, my name is Dan Harley. I am Corporate Head of Stakeholder Engagement with NHS 24. NHS 24 is responsible for the delivery of clinical assessment and triage, health advice and information by telephone and online services to the population of Scotland 24 hours a day, 365 days a year.

In this blog I’m going to briefly cover what stakeholder engagement is and some thoughts on what social networks can offer.

My job title might sound peculiar to some readers. You may be visualising Dr Van Helsing standing over Dracula clutching a wooden stake!


Thankfully, however, a search on the internet will reveal much less chilling definitions of stakeholder and stakeholder engagement.

Defining Stakeholder Engagement

Two definitions I find quite useful right now are:

Stakeholder- A person, group or organisation that has interest or concern in an organisation. Stakeholders can affect or be affected by the organisation’s actions, objectives and policies (Tustian, 2014)


Stakeholder engagement- Active and committed decision-making about a meaningful problem through respectful interactions and dialogue where everyone’s voice is considered (Norris et al, 2017)

My role

In essence, my job is to lead the development, implementation and ongoing management of stakeholder engagement across NHS 24, working with a number of internal teams that carry out engagement.

Our stakeholders are wide-ranging and diverse including the public, the third sector, professional bodies, other public bodies and the Scottish Government. You could say my job is generally about helping my colleagues work more effectively with our stakeholders to make good decisions about how NHS 24 plans and delivers services. This is an important priority for NHS 24. In our corporate strategy for 2017-22 we have set a key priority to significantly improve stakeholder engagement and use stakeholder insights to improve decision-making processes at all levels of the organisation. We also have a strategic improvement programme aiming to deliver improvements in, digital, urgent care, outpatients, and mental health, therefore engaging with our stakeholders will be critical to helping shape our contribution to health and social care.

At a basic level, stakeholder engagement is about helping people attend to the social relationships and connections that bind them together or drive them apart. It’s also about strengthening and building connections or social networks between people by creating the conditions for respectful interactions and dialogue.

b8Organisational role

I believe stakeholder engagement in NHS 24 is fundamentally about:

  • understanding who are stakeholders are
  • understanding what matters to our stakeholders
  • safe and trusting relationships of cooperation and collaboration
  • applying best practice engagement methods and tools
  • using what we learn from our stakeholders to inform the decisions we make
  • working together as a team, and
  • being clear about who we are, what we offer and how we fit with our partners

b1How to do it?

To go about this I have begun to use a quality improvement approach in my work to improve the system and processes associated with NHS 24’s stakeholder engagement. This includes developing a theory to improve our system (popularly know as a driver diagram an early version of which I attach here).



Since taking up post, I have begun a process to explore and understand how NHS 24 teams and individuals network across our internal boundaries and with our external stakeholders. This includes the formal and informal relationships or – social networks – that we have with each other.


What do we mean by networks? “Networks are defined as cooperative structures where an interconnected group or system coalesce around shared purpose and where members act as peers on the basis of reciprocity and exchange based on trust respect and mutuality.” …

There is now good evidence to support the use of networks in healthcare especially in managing complexity. Social networks have many benefits including:

  • acting as coordinating mechanisms for sharing knowledge
  • supporting dialogue for making better use of resources
  • enabling quality improvement
  • enhancing ability to be innovative and creative
  • distribution of power and leadership across members
  • reciprocity and exchange based on shared interest around a common purpose

Before joining NHS 24 I worked as an improvement advisor on national improvement programmes including maternity and mental health, and I experienced first hand how when people come together with a common purpose to share and learn, their collective intelligence can facilitate discussion and experimentation in lots of different ways. I am increasingly interested in how value can be created for NHS 24 and, ultimately for service users, from developing a sense of community, through networks. I am also interested in how we can create the conditions for networks to grow – it’s very easy to talk about cooperation and collaboration towards mutual benefit but this requires safety and trust between people and this can take time to build.

If you are interested in stakeholder engagement or social networks in health and care and have any examples in practice I would be delighted to hear from you – I use Twitter (@danharley3) to share my work and interests so please do follow me if you find this blog of interest and want to continue the conversation




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