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The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration.

The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice.

Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care.

Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic.

Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors.

The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise.

This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

The National Institute of Health Research MHRN established the Feasibility and Support to Timely recruitment for Research (FAST-R) service in 2011, to provide rapid patient and carer feedback on research documents, prior to ethical review. The aims were to improve the feasibility of studies, to speed up regulatory processes and enhance study set up and completion. The purpose of this paper is to explore whether and how the FAST-R service benefits the review process.

An independent evaluator analysed the comments made by FAST-R members on 85 studies over the past 3.5 years. The evaluation team reflected on the nature of these comments and the implications for future practice.

The FAST-R members’ comments fell into seven categories relating to: the quality of the information, the informed consent process, care and protection of participants, practical arrangements for participants, data protection and confidentiality, recruitment and research design. Based on the evaluation team’s experience of research document review, some of these comments were similar to those made by ethics committees. In other cases, the FAST-R Panel provided a different kind of input by identifying concerns specific to service users and carers.

Patient/carer involvement in reviewing research documents brings added benefits to existing processes because their views are informed by their knowledge and experience. They are able to question assumptions and highlight concerns that people lacking their perspective might otherwise miss. These findings suggest that patient/carer involvement should form an integral part of ethical review, and that the FAST-R model might be usefully applied to other areas of health and social care research.

This original work adds value to the practice of patient and public involvement in research.

To provide an overview of the learning from four practical programmes that explore different aspects of patient participation in healthcare provision.

To describe the origin and rationale for each project or programme, and to summarise the learning from it.

At a variety of levels, involving patients in the design of care services can provide new insights, and leads to more patient‐focused and locally appropriate solutions. Engaging patients appropriately is not a trivial exercise, and those that are engaged need appropriate support, but the resulting solution is often more widely applicable than is first anticipated and can be cost‐neutral.

The active participation of patients in the design and provision of care is a widely voiced public and professional aspiration, but is genuinely realised only rarely. The paper describes the principles, benefits and learning common to four practical expressions of that aspiration.

User involvement in research is entering the mainstream of traditional mental health research. In practice, there are diverse ways in which the process of involvement is experienced by mental health service user researchers. This paper aims to explore two diverse experiences of involvement by the researcher.

Auto-ethnography is the research methodology used in this study; it combines a process of reflective writing and critical analysis which enables the author to explore experiences of being both a service user and academic researcher. Two accounts of the author’s involvement in mental health research are presented: one which builds on a consultation model and the other based on co-production principles.

Experiences of power-sharing and collaborative decision-making, alongside disempowerment, are discussed, leading to exploration of the theoretical and practical processes for promoting participation of users in research.

The research is limited because it is undertaken by one individual in a local setting, and is therefore is not generalisable; however, it provides useful insights into the diverse processes of involvement that many service users experience.

Recommendations are presented to support the involvement of service users in research, with final remarks offered considering the possible future implementation of this still emerging tradition.

This paper reflects on the experiences of one service user academic involved in research and highlights diverse experiences of both empowering and disempowering involvement, providing recommendations for best practice.

A number of approaches have been developed in recent years to try effectively to engage service users in the process of planning and delivering health‐care services. The consumerist methodology for the strategy described in this paper was designed to maximise staff involvement in capturing user views, in order to develop services at a district general hospital. This strategy – the Patient Care Development Programme (PCDP) – provides a framework for both staff and patient involvement in shaping and influencing the development of health‐care services. Uses the findings from applying the strategy to modify care packages, roles, skills, layouts, protocols and procedures, in response to both the “shortfalls” and the service strengths that the patient’s view uncovers. Discusses the results of an evaluation of the programme which has been replicated in another part of the UK. The PCDP now forms part of a clinical governance framework and is being used to develop multi‐agency integrated care pathways.

The purpose of this paper is to investigate the perceptions of the integration of digital technology into a Pre-Registration Nursing degree programme. This process illuminated student perceptions of the impact of the digital technology platform on the context of work-based learning and also potential employability in the future.

Adopting design research as an overarching methodological approach for this study enabled application of the phenomena of complex curriculum justification, design and development to an observable context. In its rawest form, this was a pragmatic and relatively a theoretical approach, nevertheless underpinned by robust mixed-methods framework, incorporating anecdote circles. Braun and Clarke’s (2006) six-phase approach to thematic analysis was adopted as a systematic, yet recursive, approach to inductive qualitative analysis.

Results of this pedagogical study were consistent with the stance that technology enhanced learning has a tangible impact on the socio-cognitive learning of students by providing a mechanism for engaging with decision making, problem solving and reflexive praxis. In particular, the Nurse Navigator System was perceived as a mechanism of enhancing the potential for the establishment of communities of practice in which the co-construction of meaningful knowledge about patient care could be established.

This pedagogical study was context specific to the curriculum model operationalised at the University of Sunderland and as such the perceptions captured are not generalizable but rather provide an insight into student perceptions of the implementation of the digital technology in the context of work-based learning and also the perceived impact on employability that this might have in the future.

Pivotal to the success of this, though, is the capacity of clinical and academic staff who can facilitate this sufficiently well in practice and a period of preparation for students so that they can understand the distinction between cognitive, psychomotor and affective domain learning and the places and integration of each across an academic curriculum.

The study revealed the concept of social interactivity for affective domain learning was impacted positively upon by the integration of technology enhanced learning (i.e. the Nurse Navigator System).

This pedagogical research provides a fundamentally unique consideration of the perceived potential impact of a digital technology platform to affective domain learning. Since this is imperative to the tacit knowledge nursing students gain during their education and training for this specific vocational and academic field this is of great value to educationalists in the nursing and allied health fields. The methodological approach adopted also has capacity for transferability to these professions.

To describe the purpose, establishment, work and achievements of the Expert Patients Programme (EPP) of the NHS Modernisation Agency's Clinical Governance Development Programme.

The Expert Patients Programme (EPP) is one initiative of the Clinical Governance Support Team (CGST) which provides support for health professionals in implementation of the NHS Clinical Governance Programme arising out of the early work of the Patient Experience Team (PET). “Expert patients” are those with experience of self‐management of long‐term conditions and the programme centres on developing a model of peer support for patients with similar conditions. The EPP team has built on work at Stanford University in the USA where patients and their carers provide peer advice and support – an initiative termed “lay‐led self‐management”. The EPP team developed a six‐week course facilitated by trained lay people based on the Stanford “Chronic Disease Self Management Course” (CDSMC). This course was incorporated in a pilot study which ended in 2004 and in which the NHS collaborated with accredited voluntary organisations. A total of 98 per cent of Primary Care Centres in the UK took part. The methodology and benefits of the support programme are outlined.

Evaluation by questionnaire confirms data from other countries on showing improvement in patients' conditions and a decrease in their use of health services. Access to the EPP programme is to be widened and will be available throughout the NHS by 2008.

An account of the formation, activities and outcomes to date of the EPP programme are provided.

With the advent of the Darzi review in 2008, and more recently the White Paper “Equity and Excellence: Liberating the NHS” (2010), the NHS in England is being redesigned to provide high quality, person‐centred services with improved capacity and performance. In this change oriented scenario, stakeholder consultation has a critical role to play given the widespread advocacy in government policy and healthcare literature. In order to support informed decision making, the purpose of this paper is to: explore healthcare infrastructure planning through various approaches to stakeholder consultation within English Primary Care Trusts (PCTs); and develop a conceptual approach to strategic asset management (SAM) based on the findings of stakeholder consultation and engagement exercises.

A multi‐method triangulation approach including action research has been adopted to evaluate current stakeholder consultation practices with a local PCT and to explore their approach to healthcare infrastructure planning through: a literature review of stakeholder engagement and theory; evaluation of a local consultation exercise; and a web based document review of consultation practices within 149 English PCTs.

PCT estate managers and healthcare planners have to operate within constantly changing dynamic healthcare environments and need to reduce uncertainty and indecision that often surrounds the debate of reconfiguration of healthcare facilities and services. Consultations by the PCTs vary in: the level of detail provided to the public; sample sizes; detail and transparency of the consultation; distribution and analyses of the consultation; and techniques and approaches.

The findings of this study can be used by healthcare policy makers to: inform how clinical commissioning groups (CCGs) could be better involved during patient and public engagement; and determine practical ways of putting patients at the heart of General Practitioners (GP) commissioning.

The research identifies gaps within current stakeholder consultation practices in English PCTs and develops a conceptual approach to SAM that accounts for stakeholder consultation; decision making levels within healthcare infrastructure planning within a wider competency based organisational view, which currently does not exist.