Tuesday, July 30, 2013

How to improve patient engagement in mental health

  • Guardian Professional

red tick
Teams at South London Mausley foundation trust designed a single system to monitor patient experience. Photograph: Alamy
As Angela McNab highlighted, mental health services continue to suffer institutional disadvantage when compared to physical health. Similarly, despite a recent spike in interest, mental health does not enjoy comparable column inches and, where it does, it is typically for all the wrong reasons. Although there have been recent advances in awareness at the national level – including parity with physical health inNHS England's mandate and health minister Norman Lamb's efforts to raise its profile – there is still work to be done to engage with the public and improve patient care in mental health.
In the wake of the Mid Staffs scandal, patient engagement has been high on the agenda, the argument being, had we listened to patients' concerns, we would have spotted the negligence before it became endemic. While this is undoubtedly true, the patient voice can be much more than a safety barometer. At South London and Maudsley foundation trust (Slam), we provide the widest range of NHS mental health and substance misuse services in the UK, and believe that everyone who uses our services has a valuable contribution to make to service development and training.
In an effort to realise this and benchmark our performance, the trust needed a centrally overseen system to collect and manage patient experience data. This data would be fed into teams to help improve their services, but it would also provide a quality measure for the trust and commissioners (both local CCGs and specialist commissioners) and inform the design of care pathways. Slam faced unique challenges in this effort, with upwards of 250 distributed teams and even more physical locations. Unsurprisingly, our existing surveys were also many and varied, without standard content or uniform design.
To consolidate this process, Slam asked Fr3dom Health to design a single system to serve all teams and patients. The patient experience data information centre (Pedic) distilled our existing surveys into core and non-core content, producing a standard structure that teams could build upon to meet their specific needs.
Teams now deliver their surveys as print-on-demand physical questionnaires and via digital platforms. This approach eliminatesversion control issues – removing the possibility of out-dated, pre-printed surveys – and allows the patient and public involvement (PPI) team to monitor patient experience across the entire trust, ensuring teams are using the service. The care and PPI teams then manage and monitor surveys in real time through a single portal; logging in, downloading and printing surveys if required. In this case, patients freepost hard copies directly to Fr3dom Health for processing.
In terms of our performance and improvement objectives, this system very quickly delivered results, suggesting three areas in which the trust needed to improve its services – emotional support, privacy and dignity. It became clear that, though incredibly important in any healthcaresetting, these themes were particularly pertinent to mental health. Sharing Pedic data with patients and commissioners has allowed Slam to co-develop services, ensuring those that matter the most shape the services they use.
Slam's patients now have a meaningful voice that influences the way the trust operates. As every member of every team knows they must engage with the surveys and share the results, there has been a noticeable culture change among trust staff. Furthermore, it has allowed the trust and commissioners to set and monitor targets, something habitually done with patient safety – an area in which we aim for, and frequently achieve, in excess of 90% approval.
From streamlining care pathways to altering staff behaviour, feedback is empowering Slam's service users to shape the services they need. Given the inherent vulnerability of many mental health patients and the nature of their conditions, there is perhaps no other group better served by an open and honest experience initiative like this.
Dr Ray Johannsen-Chapman is strategic lead for patient and public involvement at South London and Maudsley NHS foundation trust
This article is published by Guardian Professional. Join the Healthcare Professionals Network to receive regular emails and exclusive offers.

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