Payment and reimbursement of trust involvement

1 Introduction

Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) are committed to involving the people it serves at all levels of the organisation. This policy includes a range of people including, patients, their families and carers, members of the public and our community partners all of whom have their own lived experience and skills to offer. We will seek to actively encourage involvement wherever and whenever we can by working with anyone who is willing to share their perspective and experience in a range of different ways. Those sharing their experiences may also be referred to as participating in “patient and public involvement”.

The trust has a legal duty to involve people in all aspects of its service provision and is committed to developing creative ways to involve people in decision-making, policy creation and service development. The trust will ensure that a culturally diverse range of people, including those with lived experience are also included to reflect the communities that we serve. Involvement should be part of our governance, decision-making forums, and quality assurance although we acknowledge there may be differences between our services in the implementation of this policy.

The trust’s involvement work is part of a wider approach to patient and public involvement. It complements other approaches currently undertaken by the trust, for instance, the review and analysis of patient insight and feedback data. This involvement brings to the trust a range of different perspectives and unique experiences. Individuals sharing their lived experience as a patient or carer, a member of a community with specific health care needs or those involved in peer support groups can help challenge and inform our way of thinking. These invaluable experiences will aid in making our services more responsive to people’s needs, help improve access and in turn lead to improving health outcomes.

2 Purpose

The purpose of this policy is to set out how the trust supports people to be involved in its work through reimbursing expenses and in certain circumstances how we provide involvement payments. Peer support workers, staff and other people with lived experience have been involved in the development of this policy. Anyone wishing to participate in involvement opportunities are not employees, workers, or agents of the trust.

3 Scope

This policy applies to all services provided by the trust. It sets out the principles and practice of reimbursing expenses and circumstances when paid involvement is appropriate.

The trust encourages co-production and co-design to strengthen relationships between people with lived experiences, stakeholders, professionals, and community organisations.

Where people are working in partnership with us, we will recognise their valuable contributions. There are numerous ways to do this:

being thanked, receiving an acknowledgement in writing
support to develop their skills through offering necessary training where appropriate
ensuring that the person sharing their experience is supported, physically and emotionally throughout their engagement
providing feedback to people on how sharing their experience has promoted change or influenced service provision

People should not be out of pocket because of their involvement, therefore reasonable expenses will be reimbursed where appropriate. This should be done at the earliest opportunity, travel pre-arranged wherever possible and details for involvement payments for significant support to be taken on the day of the activity.

Reimbursing expenses and, in certain circumstances, offering involvement payments is intended to support inclusion and create an incentive for active participation and engagement. It also supports people whose financial circumstances mean that they might otherwise be unable to contribute. The trust will also support those engaging in activities to donate their payment to a third party if the participant would prefer to do this for whatever reason.

It is possible for people to undertake a range of different roles at any one time. However, the number of roles involving membership of groups/committees that an individual can hold simultaneously may be limited. This helps ensure that there are opportunities for a greater range of people to participate.

4 Responsibilities, accountabilities and duties

The chief executive has overall responsibility for the maintenance and implementation of trust policies.

The executive director of nursing and allied health professionals (AHPs) is accountable for the implementation and maintenance of this policy.

The Patient Experience and Involvement team are responsible for the approval of this policy.

All trust staff, particularly service managers and team managers, should be aware of the policy and familiar with the details of how to implement in their areas.

5 Procedure or implementation

5.1 Principles and application

Principles in relation to reimbursing expenses and offering involvement payments.

Reimbursement payments should be used to remove financial barriers, which may otherwise restrict or stop those who are on lower incomes or are from less privileged groups in our communities. The named person leading the participation activity should be open and transparent about any payments when advertising for people to be involved.
Reimbursement of travelling expenses incurred travelling to and from the involvement activity. This may either be the cost of public transport by producing bus tickets or if a private vehicle is used including the cost of parking, the public transport mileage rate currently applicable to the trust employees. Travel wherever reasonable should be pre-arranged and pre-booked to ensure no financial burden regardless of how short for is placed on the persons taking part in the involvement. Financial support for this should be sorted by completing the form in appendix B and providing receipts for auditing to the cash office.
Where appropriate food or drink vouchers should be issued by the person leading the engagement activity (these vouchers apply to levels B, C, and D). These vouchers are available from the patient experience team and should be sought before any involvement activity takes place. The drinks voucher entitles the holder to a hot drink regardless of time frame and the food voucher entitles the holder to one hot meal and one hot drink where engagements last over 2 hours.
Where the involvement activity involves physical activity, consideration should be made regarding a person’s clothing. The person leading the engagement activity should ensure that everyone as the right personal protective equipment (PPE) for instance overalls for horticulture or gloves for food handling.
Before any involvement activity takes place, a named person must be named and lead the liaising about expenses and involvement payments with the person taking part in the involvement.
Anyone experiencing barriers to becoming involved should contact the Patient Experience and Involvement (PEI) team on rdash.patient-experience@nhs.net.
The named person must advise the person taking part in the involvement activity to consult with their local Citizens Advice Bureau (CAB), about any impact on the benefits that person maybe in receipt of. Details can be found in appendix C for each locality.
Recognise and show our appreciation for the contribution that people make, through treating respectfully and listening to their views, saying “thank you” and feeding back on the impact of their participation and inclusion.
Support people to develop new skills and enhance their knowledge, including access to resources, training and learning opportunities as part of networks.
Trust staff and individuals undertaking involvement activities have a responsibility to identify and use the most cost-effective options, to minimise financial expenses.
Personal identifiable information is required to support participation in involvement and to process any reimbursement and, or payment. Paperwork relating to involvement activities will be kept in line with the Data Protection Act (DPA) (2018). All paperwork will clearly identify the purpose for which it is collected, how it will be shared, for how long it will be kept and for what purpose.

Levels of reimbursement for people undertaking involvement opportunities

There will be four levels of involvement with the trust. These are as follows:

Level A: People choose to respond or comment on open access engagement opportunities, for example responding to online surveys. Level A, no expenses can be claimed.
Level B: People who choose to volunteer with the trust on a regular basis to help improve staff and patient experience. Level B, out-of-pocket expenses are covered and reimbursed. Vouchers for food and drink also offered.
Level C: People are invited to attend workshops, events, focus groups on a “one off” basis, is a member of regular working group meetings. Level C, vouchers will be offered, and out-of-pocket expenses are reimbursed.
Level D: Expert advisors are senior roles that demonstrate strategic and decision-making activities, for example, committee membership, strategy development, some aspects of transformation work. Taking part in the trust’s interview process of the hiring or promotion of staff will also be regarded as a level D activity.

5.2 Level D, Considerable contribution

It is important that individuals involved any activity that falls under the guise of level D are well and truly involved. Adequate measures must be put in place to enable this to happen ensuring that every individual is supported to have their voice heard in a way they comfortable by the person leading the activity.

5.3 Removing the financial implication for the ward or team

There will be a centralised budget for engagement to cover costs of out-of-pocket expenses, involvement fees and food and drink vouchers. This will allow all wards and teams to involve people with lived experience regardless of their budget.

The trust will aim to reimburse all out-of-pocket expenses at the point of contact for those taking part in an engagement event, the person leading the involvement activity should therefore complete the form in appendix B for this to occur.

For level D involvement, RDaSH are making a conscious decision to pay more than the minimum wage to anyone who participants in involvement with the trust. NHS England recommend that all trusts should in best practice not exceed the maximum of £150 for one day’s involvement. Therefore, the patient experience team will be paying the following set rates from the centralised budget for involvement:

Calculation £150 (maximum fee) divided by total hours of involvement
Hours	Fee
One hour	£18.75
Two hours	£37.50
Three hours	£56.25
Four hours	£75
Five hours	£93.75
Six hours	£112.50
Seven hours	£131.25
Eight hours	£150

Wherever appropriate the person leading the activity should consider using multiple people with lived experience if their activity takes more than one day, to have less of an impact and any benefits a person maybe in receipt of. If the same persons are being involved with the trust on more than an ad hoc basis, then consideration must be given on whether this is still classed as involvement or whether a more structured contractual agreement needs to be implemented between both parties. The patient experience team will consider each case on its own merit.

5.4 Potential risks and financial implications to involvement for the individual

The responsibility for declaring potential reimbursement from involvement lies with the individual undertaking an involvement activity as outlined in the subsequent sections. Staff must make people aware of the need to seek advice prior to agreeing to accept any reimbursement. This information will also be documented on all paperwork relating to all involvement activities.

The involvement lead for the activity should operate best practice and refer the individual to their local Citizens Advice Bureau for expert advice if there are any doubts. Information on local Citizens Advice Bureaus can be found in appendix C.

5.5 Supporting people in receipt of state benefits

The trust actively seeks a diverse and inclusive approach to involvement. We recognise that some people have ongoing health conditions and, or disabilities and may be in receipt of state benefits. Although the trust seeks to ensure that being in receipt of state benefits should not constitute a barrier to involvement, the person with lived experience should be encouraged to seek their own benefit advice before partaking in the activity, such as that from the local Citizens Advice Bureau.

In general, people who are claiming out-of-pocket expenses can do so without an adverse impact on their benefit entitlements. However, people who receive anything that may be deemed to be earnings or income by Her Majesty’s Revenue and Customs Service (HMRC) or the Department of Work and Pensions (DWP) including an involvement payment, may put their benefit entitlement at risk. In addition, participation in any involvement activity can be seen by Jobcentre Plus as evidence of readiness to work.

Breach of benefit conditions can result in an individual’s benefit being stopped or sanctions applied, sometimes for long periods, this can have huge consequences for individuals, potentially causing them significant financial hardship and personal distress.

It is important that staff ensure people are aware that it is their responsibility to comply with the conditions of their benefits, and not the trust. However, the trust has a responsibility to provide information which enables individuals to make informed decisions about whether to apply for or accept an involvement activity, especially where this is a level D role. The named person leading the activity should be able to signpost the person with lived experience to employment specialists in their locality such as the Job Centre Plus or Citizens Advice Bureau.

Paperwork relating to involvement opportunities will always include information about reimbursement of expenses and the offer of an involvement payment. Documentation relating to an involvement activity will refer to the possible impact to those in receipt of state benefits and suggest seeking advice from the relevant agency, for example Jobcentre Plus, particularly one which attracts an involvement payment, even if they intend to decline the payment.

5.6 Involvement payments and income tax

Individuals are responsible for their own tax affairs, including ensuring that any income tax due on involvement payments is declared. If in any doubt about their income tax arrangements, individuals are advised to contact their local tax office for guidance.

Individuals can choose to decline payments or to request a lesser amount of payment if they so wish to do so. However, any involvement payment for level D involvement payment must be at least equal to the national minimum wage. If a person decides to donate their involvement payment to a charity, this is entirely at their discretion.

5.7 People in receipt of health insurance premiums

Individuals who are in receipt of an income from medical insurance either as an individual or through their employment, for example because they are currently on sick leave from work, should be aware that involvement activity, and especially acceptance of an involvement payment, may be a breach in their policy’s terms and conditions, and could therefore put future payments at risk. If in any doubt about the potential impact of involvement activity on medical insurance arrangements, people should be advised to contact their employer and (or) insurance provider, as appropriate.

5.8 Reimbursements of out-of-pocket expenses, travel

Reimbursement of travel and any other out-of-pocket expenses should be agreed prior to taking part in any involvement activity.

Out-of-pocket travel reimbursement will be paid to the exact amount and will be paid from declared home address directly to involvement activity and back to the home address. The person leading the activity should take pro-active measures to pre-book and pay for any travel expenses before the involvement, this includes the pre-booking of taxis and payment for bus or train tickets. Following the form in appendix B should allow for this to happen and payment be made from the centralised budget for involvement.

If an individual is taking part in more than one involvement activity in the same day, they cannot claim travel expenses twice; for example, if both involvement activities are at the same building location. Where they have had to travel between venues, this should be calculated according to total distance travelled.

Reimbursement of private mileage will be paid in line with HM Revenue and Customs Rates and allowances. Fuel costs must be ready for the person to collect on the day to avoid any financial hardship. Following the process on the form in appendix B should allow for this to happen and payment to be made from the centralised budget for involvement.

Travel mileage, fuel rates and allowances (opens in new window) (receipts for all expenses should be returned to finance for auditing).

5.9 Foundation trust governors and volunteers

The role of the foundation trust governor is separate to that of a people undertaking involvement activities. Foundation trust governors may also be registered with the PEI team and can act as a service user, patient, carer, or public representative with prior agreement from the PEI team. It must be explicit and agreed which role an individual is undertaking within any activity.

The role of a volunteer is separate to that of people undertaking involvement activities. Volunteers may also be registered with the PEI team and can act as a service user, patient, carer, or public representative with prior agreement from the PEI team. It must be explicit and agreed which role an individual is undertaking within any activity.

5.10 Working in partnership with other organisations

Individuals may be involved in working with a number of organisations, for example, with the trust, a local authority, or a university. If an individual is claiming expenses and, or an involvement payment from one organisation for involvement in a specific piece of work, they may not claim expenses and, or an involvement payment from any other organisation for the same piece of work.

5.11 Co-hosted meetings and events

When the trust is working jointly with another organisation, for example, another trust or local ICB, it should be made clear to individuals in advance which organisation is responsible for their expenses. The policy implemented in these circumstances will be the policy of the lead organisation, and this should be communicated to people in advance of the activity.

5.12 Working with children and young people

This policy applies equally to children and young people as to adults and older people. The same categories or roles outlined should be identified whether expenses should be reimbursed and, or an involvement payment should be offered.

Care should be taken to proactively cover children and young people’s travel and subsistence costs, rather than expecting them to pay out of their own funds and await reimbursement, as this may not be possible for some children and young people.

Where young people do not have a bank account, arrangements should be made with parents or guardians. For those children too young to travel alone, out-of-pocket expenses for private mileage should be reimbursed to the parent or guardian.

Where children or young people need to use public transport, they should have trust approved taxis arranged by staff to ensure safety is maintained.

5.13 Involving ‘seldom heard’ groups

This policy should be used to support the involvement of ‘seldom heard’ groups in the trust’s work, including through removing and minimizing financial and other barriers to participation.

Seldom heard groups can include people from protected characteristic groups (as defined by the Equality Act (2010)), for example people who identify as lesbian, gay, bisexual, trans or queer (LGBTQ+) or people with a learning disability, and people from inclusion health groups, for example people from Gypsy and Traveller communities, children and young people, older people, BAME communities, religious or faith and non-faith-based communities, homeless people and sex workers.

Vouchers may be issued to patients, service users and, or carers who are known to be in rehabilitation and where giving cash could have a detrimental effect on that rehabilitation. It should be noted that gift vouchers have the same impact on benefits as a cash payment.

5.14 Involving people who may lack or have fluctuating capacity

A person’s lack of or fluctuating capacity should not be a barrier to involvement. Wherever possible the person leading the activity should ensure adequate provisions are put in place to both support and empower the individual to portray their thoughts views and feelings whilst been enabled to have a meaningful input to the activity.

Where the individuals taking part in the activity lack the capacity to manage their own finances the involvement fee (if applicable) should be paid to a responsible person or charity on their behalf.

5.15 Professional behaviours and performance issues

Individuals working with RDaSH are expected to behave in a professional manner and in line with our trust values.

We will always attempt to resolve any performance and behavioural issues or conflict fairly and respectfully. In such cases, the relevant manager and, or patient experience lead will discuss their concerns with the individual and seek to resolve the matter in a quick and professional manner.

If there are performance issues related to an individual, we will work with the person to identify any training or support that may improve performance, or else re-deploy them to a more appropriate role. Ongoing or persistent issues may result in the termination of an individual’s relationship with the trust. Anyone who exhibits poor behaviours not in line with the trust values may be asked to leave their role.

6 Training implications

6.1 Patient Experience and Involvement team

How often should this be undertaken: Once then update of any policy changes.
Length of training: As required.
Delivery method: As part of local induction.
Training delivered by whom: Line manager.
Where are the records of attendance held: Electronic staff record system (ESR) personal file.

6.2 Service and team managers

How often should this be undertaken: Once then update of any policy changes.
Length of training: As required.
Delivery method: As part of local induction.
Training delivered by whom: Line manager.
Where are the records of attendance held: Electronic staff record system (ESR) personal file.

As a trust policy, all staff need to be aware of the key points that the policy covers. Staff can be made aware through:

continuous professional development sessions
1 to 1 meetings and supervisions
daily email (sent Monday to Friday)
posters
group supervision
practice development days
intranet
special meetings
local induction
team meetings

7 Monitoring arrangements

7.1 Expenditure

How: Monthly finance meetings.
Who by: Budget manager PCCT
Reported to: Finance meeting
Frequency: Quarterly.

8 Equality impact assessment screening

To access the equality impact assessment for this policy, please email rdash.equalityanddiversity@nhs.net to request the document.

8.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, “not just clinically but in terms of dignity and respect”.

As a consequence the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).

8.1.1 How this will be met

No issues have been identified in relation to this policy.

8.2 Mental Capacity Act (2005)

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individuals’ capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all staff working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the rights of individual are protected and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

8.2.1 How this will be met

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005).

9 Links to any other associated documents

Staff volunteer handbook

10 References

11 Appendices

11.1 Appendix A Step-by-step guide for reimbursement

11.1.1 Step one

Involvement opportunity is identified, and the level of involvement determined.

11.1.2 Step two

If level A, no financial support.
If level B, out-of-pocket expenses and food and drink costs are paid.
If level C, out-of-pocket expenses and food and drink costs are paid.
If level D, Involvement fee and out-of-pocket expenses are paid.

11.1.3 Step three

For both level C and level D the total cost of engagement should be calculated before the actual involvement takes place.

11.1.4 Step four

The form in appendix B should then be completed with the relevant information and returned to the patient experience team for them to improve.

11.1.5 Step five

If only food and drink vouchers are needed (level C) these will be issued by the patient experience team. If level D the form will be authorised by the Patient Experience team.

11.1.6 Step six

The completed form will be sent back to the person leading the involvement, they should then issue this at the cash office for any out-of-pocket expenses to be issued prior to the involvement. If an involvement payment is required, this will be done via bank transfer.

11.1.7 Step seven

The persons involved in the involvement activity must sign the involvement form to state that they are happy to share with the trust their bank details so that they can be paid by the cash office and that they are happy for the funds either to be paid to themselves or a third party.

11.1.8 Step eight

All completed forms and receipts are to be returned to the cash office for auditing purposes.

11.2 Appendix B Payment and reimbursement form

Payment and reimbursement form (staff access only) (opens in new window)

11.3 Appendix C Citizens Advice Bureau information

Citizens Advice Bureau information for Rotherham, Doncaster and Scunthorpe. If the participant is located outside the trusts’ locality this information must be sought by the engagement lead if required.
The central website address for the Citizens Advice Bureau (opens in new window).

11.3.1 Doncaster

Website: Doncaster borough of Citizens Advice Bureaus (opens in new window)
Email: advice@citizensadvice-doncasterborough.org
Phone: 01302 243057

11.3.2 Rotherham

Website: Rotherham borough of Citizens Advice Bureaus (opens in new window)
Email: support@citizensadvicerotherham.org.uk
Phone: 0808 2787911

11.3.3 Scunthorpe

Scunthorpe Central Carlton Street
Scunthorpe
North Lincolnshire
DN15 6TX

Website: Scunthorpe borough of Citizens Advice Bureaus (opens in new window)
Phone: 017248 709415

Document control

Version: 1.
Unique reference number: 1093.
Approved by: Corporate policy approval group.
Date approved: 5 March 2024.
Name of originator or author: Patient experience team lead.
Name of responsible individual: Director of finance and estates.
Date issued: 14 November 2024.
Review date: 30 November 2027.
Target audience: Patient Experience and Involvement team, service managers, team managers, patients, service users and carers, members of the public.

Page last reviewed: December 06, 2024
Next review due: December 06, 2025

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