18 May 2018

Big I involvement: the challenges of people participation

In this blog, People Participation Lead Su Goulding shares her thoughts on the challenges of getting people involved in QI projects.

I am the People Participation Lead (PPL) for Tower Hamlets Adult and Older Adult Mental Health and Adult Community Learning Disability Service. Over the past two years I’ve been involved in engaging those who use our services, and those who care for them (our experts by experience) to get involved in people participation and in Quality improvement Projects as part of their recovery journeys. Part of my role is also to support teams and services in ensuring that the experts by experience are meaningfully involved at all levels of the trust, including Quality Improvement, specifically Big I (and Little I) involvement in Quality Improvement Projects.

How we engage people

I think the key to engaging people is firstly to make sure that people are aware that there are opportunities available to them and actively promote these and to support people who are interested in getting involved to do so. After this, it’s all about building mutual relationships, working with people on an equal footing towards a shared goal: making things better. In Quality Improvement, engaging experts by experience in Big I involvement as early in the project as possible is ideal.

People Participation and the QI team encourage project leads to identify experts by experience from within their own services where possible as they will have a unique insight that others may not have.  On the occasions that this is not possible, then the PPL will work with the team to identify an expert by experience from their network. Opportunities are advertised, with a brief description (although there is a great role description template on the Microsite) via email, post, Working Together Groups. If there is a specific project that I know is of special interest to someone I will make contact directly with the person who may wish to get involved.

After someone has expressed an interest in Big I involvement, an initial introductory meeting, with the support of the PPL where thought necessary by the either the expert by experience or project team will take place, to discuss the project, answer any questions, and collaboratively decide on the role and commitment. This is also where the nuts and bolts of Reward and Recognition and DBS checking are explained. Once someone has joined the Project Team good communication (as with so much else) is vital to ensure continued involvement within the project team.

The struggles regarding service user involvement

Some of the struggles regarding Big I involvement in projects have been in ensuring  that Big I involvement is secured as early in a project’s life as possible, as project teams are sometimes anxious about involving people when the project is in its early stages. Meaningfully involving experts by experience is a huge part of my role and it is easy to minimise the concerns that projects may have in Big I involvement when the staff members may not have worked in this way before. Making Big I involvement ‘business as usual’ rather than something to be considered when a project is well underway is a struggle at times from my perspective and occasionally it has felt like the QI forum is having to ‘convince’ projects about Big I involvement. But in Tower Hamlets, if my experiences over the past two years are a measure, we are definitely moving in the right direction.

Finally, one of the struggles in securing Big I involvement in Projects is ensuring that those interested in joining projects are matched to projects looking for Big I involvement. This is something we are working very hard to address in Tower Hamlets, so please watch this space!

Practical solutions to get people involved

If you are thinking about Big I involvement for your project here are a few practical tips and solutions to get people involved. If you or any of your project team have any worries or concerns about involving people then speak to your PPL. We are here to support you too and are happy to help!

Are you or any of your colleagues working with anyone using your service who might be interested in joining the project? If so, then approach them and ask if they’d like to be involved! The worst that can happen is that they say no! If this isn’t successful then speak to your PPL and either fill out a role description or work with them to come up with a brief overview of the aims of the project to advertise to the PP network.

When an expert by experience expresses an interest, arrange to meet for a chat about the project. Bear in mind that not everyone is immediately drawn to run charts and data collection; focus on what the project wants to achieve and possible change ideas. Work together to establish what support the expert by experience needs to engage with the project and ensure tht this happens. Remember that not everyone has easy access to emails; find out people’s preferred methods of communication and always make sure you that the reward and recognition payment forms are completed on time!

Last, but very much not least, remember that our experts by experience are just that, they have expertise in their experience of mental or physical health that, as experts by profession, we may not have. By working together on QI projects we can learn by sharing our expertise and ultimately be successful in continuously improving our services.

Oh, and enjoy! It is a pleasure and a privilege that people will dedicate their time, knowledge and experience of using services to make things better!

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