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Mental health literacy programmes can help reduce stigma towards people who experience mental health challenges. Co-facilitated mental health literacy programmes, delivered by a person with lived experience of mental health challenges in partnership with a person with clinical experience in mental health services, may further reduce stigma. This qualitative study aims to explore participants’ satisfaction with a co-facilitated mental health literacy programme and facilitator characteristics influencing satisfaction.

The authors used deidentified post-workshop evaluation data from 762 community mental health literacy programme participants (86% response rate). Thematic analysis of qualitative data used a general inductive approach.

Findings indicate high satisfaction with the co-facilitation model used to deliver a mental health literacy programme. Three key themes related to co-facilitation satisfaction: how participants perceived the co-facilitation model overall; the impact of having two facilitators that offered different knowledge and perspectives about mental health challenges; and the impact of personal stories shared. The personal stories shared by facilitators were perceived as bringing the workshop content to life and providing insights into people’s experiences and well-being journey. Key themes influencing co-facilitation satisfaction related to facilitator knowledge, skills, values and attitudes.

Findings indicate the positive impact of incorporating people’s lived experience into the design and delivery of mental health literacy programmes. Findings highlight key facilitator characteristics and support needs when recruiting facilitators to deliver programmes. This includes good facilitation skills alongside personal experiences.

To the best of the authors’ knowledge, this is the first large study examining satisfaction with a co-facilitated mental health literacy programme for the general public.

The experiences of clinical facilitators working within non-conventional mental health settings have not yet been explored. The purpose of this paper is to explore the experiences of clinical facilitators when facilitating nursing student learning within a non-conventional mental health clinical placement.

This study adopted a qualitative phenomenological approach. The participants in this study were five registered nurses who had facilitated students at a non-conventional mental health clinical placement called Recovery Camp. Individual in-depth interviews were conducted.

The facilitators experiences could be understood through two main themes: facilitator skills and opportunities for student learning. Recovery Camp allowed the facilitators to build on their own nursing and facilitation skills, while examining themselves as a mental health nurse. “Being with” students (immersive engagement) enabled opportunistic and rare learning moments.

To the best of the authors’ knowledge, this is the first known study to explore the experiences of clinical facilitators working in a non-conventional mental health placement.

The purpose of this paper is to advance understanding about the facilitation process used in complex implementation projects, by describing the function of novice clinician facilitators, and the barriers and enablers they experience, while implementing a new model of care for managing hospital malnutrition.

Semi-structured interviews were undertaken with local facilitators (n=7) involved in implementing The SIMPLE Approach (Systematised Interdisciplinary Malnutrition Pathway Implementation and Evaluation) in six hospitals in Queensland, Australia. Facilitator networks and training supported the clinicians acting as novice facilitators.

Key functions of the facilitator role were building relationships and trust; understanding the problem and stimulating change through data; negotiating and implementing the change; and measuring, sharing and reflecting on success. “Dedicated role, time and support” was identified as a theme encompassing the key barriers and enablers to successful facilitation.

When implementing complex interventions within short project timelines, it is critical that novice clinician facilitators are given adequate and protected time within their role, and have access to regular support from peers and experienced facilitators. With these structures in place, facilitators can support iterative improvements through building trust and relationships, co-designing strategies with champions and teams and developing internal capacity for change.

This case study extends the knowledge about how facilitation works in action, the barriers faced by clinicians new to working in facilitator roles, and highlights the need for an adapt-to-fit approach for the facilitation process, as well as the innovation itself.

External facilitation has been shown to increase the implementation and aid sustainment of new clinical practices. The purpose of this paper is to describe the addition of facilitation to web-based training on dialectical behavior therapy (DBT) skills to promote adoption of this intervention among diverse mental health providers at US Veterans Health Administration facilities.

In total, 41 participants completed six web-based modules and met in two groups monthly over nine months by telephone with a facilitator who was also an experienced DBT skills group therapist. All participants agreed to conduct a DBT skills group as part of training. The facilitators employed a variety of engagement strategies to meet the evolving needs of participants during the training period. Participants completed an online evaluation of the modules and their facilitation experience at six weeks post-training and responded to an e-mail query at five months post-training about conducting a DBT group.

Overall, participants found the training and monthly interprofessional calls with the facilitator useful. Five months post-training, 33 of 41 participants reported conducting a DBT skills group, thus improving access to this intervention. Participants said the biggest barrier to training was finding time during clinic hours to complete the modules, despite assurances of support from local leaders.

This project provides evidence that virtual facilitation enhances training and promotes the adoption of new clinical practices.

Scholarship about communities of practice (COP) is uncovering evidence that interactivity between community members contributes to improvement in practice. Leadership and facilitation are crucial elements of successful COP implementation. The purpose of this paper is to describe an innovative COP facilitator ' s course and report on the experiences of participants in the first course.

In response to this need and emerging evidence, an on-line COP facilitator ' s course was developed and implemented in Alberta, Canada, in 2011. This course included a home-based COP practicum, introductory face-to-face session, an on-line discussion board moderated by faculty and on-line learning modules. Evaluation of the course was formalized in a qualitative study incorporating content analysis of postings, semi-structured interviews of successful participants and narrative responses to questions in a post course survey.

A total of 15 of 22 participants perceived they acquired basic knowledge about community facilitation by completing the self-learning modules and assignments. Many did not establish home-based COP and only partially participated in the interactive components of the course. Six participants successfully completed the course by establishing home-based COP and actively participating in the social and interactive components of the course. They perceived they met course objectives and greatly benefited from participation in the course, in particular when they pushed themselves to facilitate in new and different ways, and when they were actively engaged with their home-based COP where they could practice and receive feedback.

While the main reasons why participants dropped out or failed to complete all course components were reported, the experiences and perceptions of six participants who successfully completed all course components form the major part of the evaluation of the course and hence introduce bias. A more in depth analysis of why learners are reluctant to engage in participatory learning could be the focus of further studies.

The following key recommendations emerged in the study alongside recommendations for further study of best practices in supporting COP facilitation. First, a formal interview before enrollment into the COP facilitator ' s course is recommended to reinforce the comprehensiveness, time commitment and the practical applications intended within the course. Second, methods of “aggressive facilitation” with skilled COP facilitators can best model facilitation to those involved in the course. Third, supporting course participants to trial out a diversity of community facilitation skills in the safety of the course is crucial to success.

The collaboration, networking and interactivity of interdisciplinary health care workers is of tremendous consequence to health outcomes and a vital concern to practitioners and administrators. Little is currently understood of the leadership and facilitation of the COP models and these discoveries lend a timely contribution to the field.

Despite the popularity of team formulation, there is a lack of knowledge about workable implementation in practice. The purpose of this paper is twofold: first, to characterise team formulation, based upon examples from practice; and second, to identify factors perceived to support or obstruct workable implementation in practice.

An online survey recruited UK Clinical Psychologists (n=49) with experience in team formulation from a range of work contexts. Examples of team formulation in practice were analysed using both deductive and inductive framework analysis.

Four novel types of team formulation with different functions and forms are described: case review, formulating behaviour experienced as challenging, formulating the staff-service user relationship and formulating with the service-user perspective. A number of factors perceived to support and obstruct team formulation were identified including team distress, facilitating change, managing difference and informing practice. These were common across team formulation types.

The team formulation types identified could be used to standardise team formulation practice. Several common factors, including managing team distress, were identified as aiding workable implementation across team formulation types. Future research should investigate the key processes and links to outcomes of team formulation in practice.

This paper presents two original, practice-based and practice-informing frameworks: describing, first, novel forms and functions of team formulation and, second, the factors supporting and obstructing facilitation in practice. This paper is the first to highlight the common factors that seem to facilitate workable implementation of team formulation in practice.

The purpose of this paper is to share insights, research findings and discuss key issues related to graduate experiences with transnational nursing education (TNE).

The authors used a qualitative approach and sampled national and international nurse graduates to identify challenges and best operating practices in cross-border nursing program facilitation.

This research paper has provided a platform for graduates to lend their voices to the promotion of effective cross-border nursing education delivery and suggests that although international collaborations endeavor to maintain high academic standards in TNE, there is still a need to re-engineer, revise and adapt curricular content, learning, teaching and assessment practices to aid the nursing student.

Identified challenges affecting the facilitation and delivery of cross-border nursing education programs can act as levers to improving service quality of present and future cross-border programs to the nursing student. This will assist future nursing students to recognize culture shock and embrace their decision to pursue nursing.

The experience of being involved in TNE for nursing students may not be that much different than students of other disciplines. While not able to be generalized to the entire population, the reports by the nursing students in this sample appear to be valuable and worthwhile to continue supporting and encouraging other TNE opportunities.

This paper explores cross-border nursing education experiences from national and international perspectives. The authors were able to explore inherent TNE challenges from diverse population and cultural backgrounds.

This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University.

Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes.

Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”.

This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families.

The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool.

Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide.

The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development.

This paper aims to focus on facilitating large‐scale quality improvement in health care, and specifically understanding more about the known challenges associated with implementation of lean innovations: receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change. Lessons are drawn from the implementation of The Productive Ward: Releasing Time to Care™ programme in English hospitals.

The study upon which the paper draws was a mixed‐method evaluation that aimed to capture the perceptions of three main stakeholder groups: national‐level policymakers (15 semi‐structured interviews); senior hospital managers (a national web‐based survey of 150 staff); and healthcare practitioners (case studies within five hospitals involving 58 members of staff). The views of these stakeholder groups were analysed using a diffusion of innovations theoretical framework to examine aspects of the innovation, the organisation, the wider context and linkages.

Although The Productive Ward was widely supported, stakeholders at different levels identified varying facilitators and challenges to implementation. Key issues for all stakeholders were staff time to work on the programme and showing evidence of the impact on staff, patients and ward environments.

To support implementation, policymakers should focus on expressing what can be gained locally using success stories and guidance from “early adopters”. Service managers, clinical educators and professional bodies can help to spread good practice and encourage professional leadership and support. Further research could help to secure support for the programme by generating evidence about the innovation, and specifically its clinical effectiveness and broader links to public expectations and experiences of healthcare.

This paper draws lessons from the implementation of The Productive Ward programme in England, which can inform the implementation of other large‐scale programmes of quality improvement in health care.

This paper aims to describe the introduction of pay‐for‐performance in New Zealand primary health care; compare this policy development with analogous English initiatives; discuss the risk of unintended, adverse consequences of the New Zealand programme; and consider key lessons for the policy development of pay‐for‐performance in health care.

This article is based on description and analysis of policy developments for performance management in New Zealand and England.

It is not clear that the New Zealand Programme appropriately reflects the values and goals of primary health care providers. It encourages slow, incremental change by paying bonuses to Primary Health Organisations, rather than practices, for meeting targets on a small number of performance indicators. The bonuses account for a tiny proportion of the total income of PHOs and in general are for service improvement rather than to supplement practitioner incomes. It is important to align performance incentives with stakeholders' values and goals.

The paper discusses New Zealand developments in pay‐for‐performance in the context of English policy initiatives and considers lessons for all health systems.