Developing user-led standards has increased patient involvement and improved the quality of care at one mental health trust. Tony Leiba and Caroline Mathiason explain
Responding to the national drive to involve service users in the delivery of care, North East London Mental Health trust set out to develop and implement a set of user-led standards.
To support the delivery of this work, the trust partnered with consultancy Katalyst.
The trust aimed to develop a set of user-focused standards based on a set of values that reflect the principle of recovery. The idea was to promote individual responsibility for care and treatment and encourage patients to move towards well-being and recovery with a sense of hope, confidence and self-assurance.
Katalyst led a programme of listening and learning forums with users from across a range of services, focusing on the views of those who had traditionally been unheard. More than 90 users participated in this initial process and a further 60 were consulted or contributed to the development process.
The 225 suggestions for standards that were put forward were distilled into 70 clearly defined standards spanning nine core themes:
communication, listening and engagement;
philosophy of care;
dignity, respect and equality;
specific inpatient standards;
rights and responsibilities;
care and treatment;
confidentiality and sharing information.
The standards were formally adopted by the trust board last year and the process of implementing them has now begun.
The decision was made to phase the users' standards in by theme. Each set was piloted in a range of settings before being rolled out. This approach allowed the trust to identify any barriers to implementation as well as any enabling actions that would support delivery.
Each of the pilot periods ran for three months. A service support group made up of senior staff helped the teams carry out assessments of their performance before and after the pilot.
At the end of this phase, the teams were brought together to share their experiences and help develop good practice guidance for other teams across the trust.
A user quality action team was then established, drawn from people with experience of using or being in contact with the trust's services. The team was given training on getting direct feedback from other users. It now conducts outreach visits to meet and consult service users on their experiences of the standards.
The team meets every two weeks and people who want to join are asked to register with the trust's patient and public involvement department. The members all receive an induction, ongoing training and one-to-one support.
Members of the service support group help with the delivery of the standards. Their aim is to improve and sustain clinical practice, enhance personal development and to be trust-wide change agents and communicators.
A range of issues have been highlighted and fed into the management of future pilots and implementations. To begin with, the standards were met with cynicism, but as the pilots proceeded, staff appreciated the need for change and have worked to achieve constructive outcomes.