This is what partnering with consumers looks like
The East London NHS Foundation Trust (ELFT) has dived deeply into partnering with consumers for service improvement. ELFT provides mental health and community services to a diverse population in over 100 community and inpatient sites.
This Institute for Healthcare Improvement blog describes the ELFT approach. Service users and carers are involved at every level of the organisation. They serve on the board; support recruitment, including having an equal role on interview panels; deliver training to all disciplines of staff; audit services through the service user-led accreditation service; and support and lead QI work across the Trust. Their improvement contributions can range from being members of a project team to initiating QI projects, to coaching staff improvement teams.
Service user and carer roles in improvement have enabled the Trust to tackle challenging issues. In one unit, for example, racially motivated abuse by some service users made it difficult for staff to provide the best care. The staff decided to start a QI project that was co-produced with service users, first to monitor the racist incidents and then to test different ideas. Together, they were eventually able to reduce the number of racist incidents in that ward by 92 per cent.
Service users and carers are well-trained and supported to be involved in improvement. The first step is the ‘Introduction to QI for Service Users and Carers’. After completing this introductory training, they are invited to join a one-day course to learn the fundamentals of QI methods; and those who wish to take on a leadership role can join the ‘Improvement Leaders Program’ to train as a QI coach.
ELFT offers some tips for other organisations looking to deepen consumer partnerships for improvement:
- Identify staff who see the potential value of inviting patients to join their improvement teams. Their openness can support a movement around improving service user involvement.
- Talk to service users. Ask what would help them be involved. Payment or other compensation may support and encourage involvement.
- Explore what emotional barriers might be in the way, including feeling intimidated or fearful of being ignored.
- Use basic QI principles. Start with one service user. Start with one ward. Start with one area and learn as you go.
- Ask service users, if willing, to tell their stories. It can be the first step to bringing service users into improvement work. It can also demonstrate to more sceptical staff members or leadership the importance of understanding more directly how service users experience care.
This Trust believes that health services are missing opportunities by not providing service users with the opportunities and skills to partner in improvement meaningfully. They note that as providers, we can make assumptions about what needs improving. Still, without the consumer perspective, we’re only looking at one side of the service quality coin: “We don’t actually know until we speak to those we serve.”
Accessed 17/7/23
IHI. What You Miss Without Patients on Your Improvement Team. Institute for Healthcare Improvement Blog, March 21, 2023 https://www.ihi.org/communities/blogs/what-you-miss-without-patients-on-your-improvement-team?utm_medium=email&_hsmi=252422919&_hsenc=p2ANqtz-_obAQ6gI5ADqL0cZYmOBy63KYRABac7W8H1CBJcAr6BtHsFuiayhcEJYfIK_rtcb4ImV66AirFzqkd2gUIvvdkJzJXhg&utm_content=252422917&utm_source=hs_email