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!

Co-producing Quality Improvement with Service Users in Tower Hamlets

Learn about the benefits of service user involvement in this blog written by service users and staff working at the Isle of Dogs QI team, with the supervision of Francisco Frasquilho (Coach and Improvement Advisor supporting Reshaping Community Services) and Emma Binley (Improvement Advisor supporting Reshaping Community Services).

“If you look at history, innovation doesn’t come just from giving people incentives; it comes from creating environments where their ideas can connect.” – Steven Johnson

Without service users being part of quality improvement work, even with all the best will in the world, work risks losing direction and purpose as other system pressures impinge and take over. Working collaboratively with service users has been vital to the progression of the Reshaping Community Services QI priority area. This particular journey began with two people who have personal experience of mental health services and wanted to share their learning and knowledge. They are both intent on helping others understand their experiences and keen to build relationships both within the team and with other partners, such as the local recovery college. This has now grown to involve more services users and staff over the last few months.

We have been working together with the Isle of Dogs and South Poplar Community Mental Health Teams (CMHT) on the Reshaping Community services QI project and the team was keen to share their experiences with others. The stories of their journeys are illustrated below in their own words*.

What has it been like working together on the QI project?

 “My Care Coordinator spoke to me about this opportunity. Because I had attended Recovery College and other courses in the past, I thought that I would come along.  Initially I thought that all I would do is presentations about my illness; but it’s more than that. My opinion is important and the workshops have shown me that I am important and that I can make a difference. We work as a team of equals. We have built a relationship based on respect and shared ideas.  I liked how the team’s Operational lead explained our ‘being equal i.e. everybody is a service user because we all use our GPs, Dentists’. Our experiences of using different services make us equals. I like how our workshops are structured. We have a lot of questions but we don’t necessarily have answers. The good thing is that we think about how, where and what kind of answers we are looking for including the possibility of not getting an answer. The workshops are supportive because we have a say on how the service can be improved. I hope that this experience will help others; both staff and service users and will hopefully lead me to future employment.”

“My Care coordinator talked to me about this project and encouraged me to attend. He told me that the project would be about how we can improve the service. We were asked about our experiences and how we felt. We were also asked about ideas, what small changes can be done quickly to make amendments and big changes to make the service better. The timing of the workshops was perfect for me. I was experiencing isolation and motivating me to get out of the house was a challenge.  The meetings gave me something to look forward to, they gave me a sense of value, of purpose. That’s the way it makes me feel and that’s why I also feel emotional. It has happened at the right time for me. Things are falling into place.  I’m just so happy. Every time I’m coming out, I’m learning new things, learning importance of coming out of the house, of having a focus. The meetings have helped me develop; I’m gaining and building my confidence. I really like the questions we ask ourselves as it makes us think. I am changing and I am positive that we are going forward.”

“In my current role, I have little face to face interaction. The project has given me the opportunity to understand our team’s role in the wellbeing in the life of service users. For me it has been enlightening and brought me a sense of purpose. I can see the direct results of working with service users and it has been a unique experience. This work has allowed me to focus my attention on the service user primarily; much of this stems from the idea that we are all service users. Therefore we should provide services that we would be happy to use ourselves and this helps shift the focus of how we would like to provide services. Working with service users has facilitated to understand the needs of those who use our service which motivates us to improve everything that we do.”

“Participating in this project has been a really good opportunity for me. At the start, I recognised that I was anxious working with service users as face to face contact is limited in my daily role. As I got to know everyone in our team, I also related to how our service users felt.  I thought at times that I didn’t know enough and that I myself was not confident. Working together has made me realise that our confidence and learning is not limited by how we identify ourselves, i.e. as a staff or as a service user. I am really looking forward to our continued learning.”

Why is this collaboration between service users and staff useful?

1. The way you [as a staff member] relate to us – make us feel comfortable, saying that you are a service user yourself. Sharing your experience with us – revealing that you have diabetes, for example. This is part of our change idea of how to make people relax.
2. Genuinely asking us what we think …. Prompting question in a non-judgemental way
3. Willingness to meet either as part of the project or outside like the Recovery College.
4. Showed us that we are important and we can make a change
5. Talking about possibilities and hope
6. Trusting us
7. Respecting each of us and listening to our views. Everything is discussed in the room and not in third parties.
8. Making us feel valued and important.

It is this sense of working alongside, and with others, that has amplified this work. The inspiration has been powerful and energising. This work continues to grow. If we are serious about improvement work then we must have service users at the core of it.

* Names were removed to respect wishes to remain anonymous.

Shaping Recovery in the Community

Since the start of 2017 the Trust has been working alongside pilot sites in Tower Hamlets and Newham looking at improving the ways we deliver patient centred care. Each team began with a number of appreciative inquiry workshops around what they value in terms of patient care and what gets in the way, what “grinds their gears”. From this work each team is developing their own focus. For example, the Isle of dogs is looking at developing systems that help the flow of activity into and within their teams, in order to look at reducing work that doesn’t add value to the patient’s experience, and making space to increase recovery focused work. Our Newham test site is also looking at the nature of their activity and ways to identify what works well and increase this.

As part of the wider Trust priority we are looking to work alongside other teams who are developing recovery focused training, as well as looking at ways to use the new eCPA and DIALOG+ tools guide and support activity.

Some changes being tested with these teams are different ways of managing referrals screening and assessment, looking at daily team huddles and use of a central information board to support team decisions. We have also been sharing experiences and learning across other priorities, such as the Enjoying Work projects. The Isle of Dogs team have started to look at how this can improve service users and staffs experience of our community teams.

We looking forward to working with more teams to look at ways to improve staff and service user’s satisfaction with the care we deliver, and continue the conversations around this. We are also very excited about hearing from service users and teams around ways to take this forward and will be focusing on this in the coming months.

Service User Perspective: Barriers to Engagement with QI Projects

Tony Fulham

Thana Narashiman , QI Communications Assistant, interviewed Tony Fulham; service user in July 2017, about his personal journey and barriers to engaging with QI Projects at the Trust and offered his advice.

Please share with us some barriers you faced to getting involved in Quality Improvement (QI) Projects?

I believe the biggest barrier to engaging was myself. I had ‘false pride’ and was not able to manage change well. The change of personal status – from being employed full time to becoming the victim of a serious crime which caused me severe trauma.

As a result of this incident, I was medically diagnosed with Post Traumatic Stress Disorder (PTSD) arising from the trauma. I was referred to my local mental health services at East London Foundation Trust (ELFT).

My engagement with the services caused me confusion as I wasn’t sure what it was all about. I was not aware of what resources were available to me to access and meeting the criteria for treatment was itself quite confusing and alien to me as I was functioning under adverse shock.

What other personal barriers were you facing?

I felt that my identity totally changed. It was also those environmental changes – I wasn’t aware of my local community and my neighbours and became increasingly isolated, that led to change.

Once I accessed Mental Health Services there was a lot to learn and I found it hard to take it all in.

I also lived with survivor’s guilt and had to come to terms with my personal circumstances through understanding what was back then PTSD and how it had impacted me with those changes within myself for my self-understanding.

I struggled for self-awareness of me with coming to terms with my personal change of circumstance(s) once I was discharged from local Community Mental Health Team (CMHT) services.  I was left confused about state entitlements like entitlement to Department Work and Pensions (DWP) benefit allowances, housing needs etc. and to accessing these services were very fragmented I feel at the time looking back now.

What experiences did you gain from confronting the challenges?

I stumbled across the ELFT Working Together Group and became involved through tenacity as I was approached to be the new chair of a local HealthWatch Mental Health Task Group.

From all of this, I wanted to learn more about recourse to the state benefits system in order to help other people like myself. I successfully trained as a generalist  advice worker within a local advice centre. I truly enjoyed this engagement as I got to meet people in my community which helped addressed my isolation and trepidation within society.

I also learnt how to use a computer & discovered new soft skills within me which were invaluable. All this helped me to build upon my confidence.

What were your experiences of attending other ELFT meetings?

My first Tower Hamlets Working Together Group was very new – and sadly it was not a warm welcome. The group’s focus is on reintegrating people who’ve been discharged from the service. From my observation, it seemed to be very much “the old guard”, people had been in the group for years and years. It put a lot of people off from attending, I felt I was alone again.

I had a basic experience of chairing meetings with the NHS and so volunteered to become the new Chair of the Tower Hamlets Working Together as I thought it would help my recovery. I also wanted to influence positive change and felt the group needed a fresh approach.

What can you share with us regarding any other barriers that we can change?

A simple matter : meeting rooms not being very welcoming with no windows and not a dark room and also no windows can be opened due to Heating and Ventilation (H&V) system.

Since meetings were alien to me, I really did not know the “rules” of a meeting so simply felt I couldn’t leave the room when needed to.

I didn’t have any personal reference or the training to know how to behave and I felt like an actor, not truly being myself. So any training would be useful for all.

What are the opportunities moving forward?

As part of my engagement here and with the People Participation Team in general, I am now involved with the monthly ELFT QI steering group and I am going to be co-chairing the meeting with the current chair, Erayna soon.

I have also been engaged wider as part of local Metropolitan Police Safer Neighbourhoods meetings and Community Safety Board – as I wanted to give back to the community when I was within my local CHMT.

What is your passion?

“I want to make a big impression” : “6 foot manhole imprint” and “something that’s long lasting.”

I would like to witness improvements to the Mental Health service for people entering the service in the future and to use my lived expert experience to a better use.

Prior to being a victim of a serious crime where I nearly lost my life, I was a more of a taker and now I want to be a giver. It has really changed my life seeing life more positively now.

I don’t want to be a passenger anymore –  I wish to be involved in QI to acquire new skills and training and be a driver of change for both carer, service users and staff members to share back.

Tony Fulham

Service User

21 August 2017

Violence Reduction on Adult Inpatient Units; what has been achieved so far at ELFT?

Between 2012 and 2015, Tower Hamlets Adult Mental Health inpatient wards reduced violence by over 40% and by 60% on the acute admissions wards, using a Quality Improvement approach.  Since then we have scaled up the work to City & Hackney in early 2016 and Newham in mid-2016. Forensics also launched its own Collaborative in late 2016, testing the extent to which ideas developed in general adult units is effective in Forensics, as well as developing their own ideas.

Overall, violence reduction work across ELFT has meant that we have seen a 42% reduction in incidents of physical violence across our East London services since 2013 (see figure 1).

Figure 1

The change ideas that have helped in general adult settings work on 2 main drivers:

1. Increasing teams ability to identify and predict risks of violence and to take action proactively as a team. Two change ideas work on this; Safety Huddles and the Broset Violence Checklist
2. Creating a culture of much greater openness and transparency around the issue of violence with the whole ward community, including service users. Two ideas work on this: using Safety Crosses and having proactive discussions around violence and safety in ward community meetings. (See articles on City & Hackney and Newham Adult Mental Health Services)

For more information about these ideas see the other articles in this newsletter and this article, published in February 2017 in the Journal of Mental Health Nursing>>

Local reductions

Since the beginning of the work, local collaboratives have achieved the following reductions:

Tower Hamlets has reduced violence across all 6 wards by 40% and restraints by 60%, using Datix data. There has been a 57% reduction in violence and a 77% reduction in restraints across the acute wards.

In City & Hackney, violence has reduced by 40% across the unit and upwards of 60% on the acute wards, according to Datix data. Gardner Ward and Joshua Ward in City and Hackney have sustained 65-75% reductions in violence for 6-9 months. There has also been a 54% reduction in use of restraint on Conolly Ward and there are early signs of reduction on Bevan Psychiatric Intensive Care Unit (PICU).

In Newham , Topaz Ward has seen a reduction of 66%, Emerald Ward has seen a reduction of 74% and Sapphire has seen a reduction of 84%. Jade Ward are also seeing very positive signs of change, with no incidents at all between 30^th September 2016 and 12^th January 2017.

Forensics has just seen early signs of a 51% reduction in physical violence across Bow, Broadgate, Clerkenwell, Shoreditch and West Ferry wards. Shoreditch and Bow have seen individual reductions of 82% and 51% respectively.  For more information see our article – Perspectives from Forensics; Early signs of reduction and an exciting journey ahead for further specific detail on the directorate’s journey for far and the impact this work has had.

In 2017-18 we will be looking at extending the work to Luton and Bedfordshire and focusing dedicated work on restricted practices, as well as consolidating the work in existing Collaboratives and developing a Quality Control strategy (see this article).

For any queries get in touch with Jen Taylor-Watt, QI Lead for City & Hackney & IAPT  and Lead Improvement Advisor for Violence Reduction and/or Andy Cruickshank, Associate Director of Nursing for QI and Senior Improvement Advisor for Violence Reduction.

Reducing physical violence and developing a safety culture across wards in East London

Violence is the biggest cause of reported safety incidents at East London NHS Foundation Trust. Evidence suggests the utility of structured risk assessment, discussion of violence in ward community meetings and the use of restraint and seclusion in psychiatric wards. The Tower Hamlets Violence Reduction Collaborative brought together six wards with the aim of reducing violence by 40% by the end of 2015. A collaborative learning system was used to test a bundle of four interventions on the four acute admissions wards and two psychiatric intensive care units. A 40% reduction in physical violence was seen across the six wards. Physical violence reduced from 12.1 incidents per 1000 occupied bed days in 2014 to 7.2 in 2015. Across the four general acute admissions wards there was a 57% reduction in physical violence. Key elements of the system that have been addressed through this work have been developing a more predictive approach, and developing a more open and shared experience of violence and aggression on the wards.

Click on the image to read the full article

Reducing Physical Violence on the Globe Ward

Please learn more about this completed ELFT QI project from the adjacent poster.

ELFT staff, service users and carers can access full details of this project on QI Life.

The project code is 100909, please log onto your QI Life account before clicking the logo below.

Role of peer support workers in improving patient experience (BMJ Quality)

The aim of the project was to improve patient experience for people in Tower Hamlets Specialist Addictions Unit in order to increase satisfaction by 25% in 12 months starting in August 2014.
The team used the model for improvement as part of ELFT’s quality improvement programme to support iterative cycles of testing and learning. This involved support from the Trust’s quality improvement team.

Please click the PDF to the left to read more about this ELFT QI Project published in BMJ Quality.

Active QI Projects – April 2020

This is the monthly report generated from Life QI, showing all active projects within all the directorates.

Improving Access to Tower Hamlets Early Intervention Service (THEIS)

The aim: We will complete assessment, allocate a Care Coordinator and initiate NICE concordant treatment for 95% of patients referred with first episode psychosis within 14 days of referral receipt by April 2016

Tower Hamlets Home Treatment Team HTDS Project

Click on this poster to learn about a QI project presented at our Annual QI Conference, March 2016

Implementation

How do we ensure we hold the gains of improvement work through effective management of implementation?

Not sure how to move to the next stage if you’ve got a high believe your change idea is working? Unsure about the difference between the testing and implementation phase? Watch this video, in which Jen Taylor-Watt, one of our QI Leads, answers these questions.

The first 10 minutes of the video is an explanation of the theory and the last 12 minutes provides examples from the Tower Hamlets Violence Collaborative.

Supporting resources are also below….

The Sequence of Improvement

Testing Vs Implementation

Testing – Trying and adapting existing knowledge on small scale. Learning what works in your system.

Implementation – Making this change a part of the day-to-day operation of the system

The key test of how embedded your changes is: How confident are you the change would persist even if you/your leads were away for a month?

How do we implement effectively?

(The Improvement Guide – Chapter 8)

For further information and examples of successful implementation please click here to download our guide here>>

Use our Implementation Action Plan for your Ward/Team

Click to download

2016 QI Conference Poster Presentations

Please find all posters presented at our 2016 Annual QI Conference below. We held a competition before the event for people to vote on their favourite poster, the winner was announced at the conference on 22nd March as Reducing the length of time it takes to complete the disciplinary process. Please learn more about all of these great QI projects by clicking on the posters below. Click here to access published ELFT quality improvement projects.

Turn Around Times and Quality Improvement of 48 hour Reports and Amber Alerts	Improving access to psychology and decreasing the DNA rate at psychology appointments in City and Hackney Assertive Outreach Team and the Community Rehab and Recovery Team	Tower Hamlets Violence Reduction Collaborative – Brick Lane Ward	The Bridge Club
Improving Engagement Levels & Prosocial Behaviours on Morrison ward	Improving physical health monitoring of City and Hackney Assertive Outreach Service Patients	Improving physical health monitoring of City and Hackney Assertive Outreach Service Patients	Improving Support to informal carers in the extended primary care team
Reducing background noise levels on Cedar Lodge dementia ward City and Hackney MHCOP	Reducing violence at the Coborn Inpatient Unit for Children and Young People	Tower Hamlets Violence Reduction Collaborative – Lea Ward	Paper light on Rosebank Ward
Providing Psychological support following facial injury	“Are you listening?” (Reducing the number of complaints leading to formal investigation)	Tower Hamlets Violence Reduction Collaborative – Roman Ward	Healthy Lifestyle for Longer Living
Reducing Restraints on West Ferry Ward John Howard Centre	Reducing Violence on Clerkenwell Ward – Low Secure Services, Forensics Directorate	Improving the NHS England Reported IAPT Recovery Rate for Richmond Wellbeing	Improving Experience of Continence Service
Increase in assessment of Treatment Resistant Schizophrenia and consideration of Clozapine	Increasing monthly clinical supervision rate	Improving Quality of Communication by the Council of Governors	Reducing the length of time it takes to complete the disciplinary process Winning poster at QI Conference 2016!
Reducing bed occupancy and length of stay on Ivory (older adult) ward	Improving and increasing service user and carer involvement in Quality Improvement projects	Newham occupational therapy QI project	Reducing incidents of pressure ulcers
Tower Hamlets Home Treatment Team HTDS Project	Improving patients and staff experience of ward rounds	Tower Hamlets Violence Reduction Collaborative	Enhancing engagement, improving capacity in psychological services
Improving access to community mental health services	Improving Access to Chronic Fatigue Service	Reducing waiting times in secondary care PTS	Right Services at the Right Time at the Right Place
Improving Access to the Physio Service in Community Health Newham	Cardiovascular mortality prevention in NAFOS

Update on our Service User and Carer Involvement project

Stella and Syeda, Service User Involvement

By Stella Lam and Syeda Tahir

Hello everybody, hope you are all well.

In the last blog we talked about doing a Quality Improvement (QI) project on Service User and Carer Involvement. We have begun raising awareness of the QI programme by going out into the community to speak to people and promote opportunities to get involved e.g. tailored introductory sessions and training. The project is currently a pilot, focused on Tower Hamlets, with plans to use our learnings to launch similar involvement support in the other boroughs and directorates.

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Improving patient experience in Tower Hamlets SAU

This month we caught up with Wiktor Kulik from Tower Hamlets Specialist Addictions Team to find out about their QI project aimed at improving patient experience in tower hamlets SAU.

How did you identify the improvement idea for your project?

TH SAU helps people struggling with complex addiction, often with comorbid mental health problems and other complexities. This group is particularly difficult to engage.

Attendance at appointments is directly related to clinical and other outcomes and depends a great deal on patient’s experience of the service.

The start of the project also coincided with an appointment of a new peer support worker, who was ideally placed to help with this kind of work.

Did you identify any barriers to your project? If so how did you overcome them?

The typical barrier is finding time and will for the additional effort required to improve quality. Asking busy teams to add yet another activity to already a long list of requirements.

What helps on the trust level- QI team is so actively promoting the ideas and the board is fully supportive of this approach. What helps on a team level is to try and design data collection and change ideas to be as simple and effortless as possible. If the change idea can reduce the workload – even better. my advice would be to try and use as much as possible the data that is already collected.

Another thing that helps engage teams is sharing the data, especially if it shows an improvement

What are your early results and latest data showing us?

The early results were really promising – number of people attending peer support led groups increased as did the satisfaction. Since then it is a bit more challenging to improve this even further.

Staff satisfaction fluctuated due to the wider system changes and uncertainty over the teams future.

Has the QI training helped you run your project?

QI training brings a variety of lessons. What and how to measure – the need for baseline data and when a change is an improvement.

But the best element of it was watching other projects develop and borrowing ideas from others.

Finally, how would you sum up your personal learning experience of QI and its benefits.

Learning improvement methodology and leading the projects has been an amazing experience. I try and use simplified methods in my personal life and am sure it will benefit my future patients as well.

Increasing service user and carer involvement in Tower Hamlets

By Syeda Tahir and Stella Lam, Service User Involvement Leads in the QI team

Stella and Syeda, Service User Involvement in QI team

“The drive for quality improvement has been well under way and has shown remarkable signs of a culture change. We want to continue growing culture this by ensuring that service users/carers are also part of this change and feel included in the journey alongside us.

Just as an overview Trust wide there are currently over 100 active projects of which less than a quarter have any service user or carer involvement. With these statistics in mind we are starting a very exciting project with the sole aim of increasing service user/carer involvement in QI within Tower Hamlets Adult Mental Health Directorate.

We’ll be testing some new ideas out to see what works for service users/carers and staff, and we’ll be looking at involvement in terms of ‘Big I’ and ‘little i’. When we say involvement with a ‘Big I’ that means service users and carers are part of a project team, who work on the improvement project on a regular basis. Involvement with a ‘little i’ is when service users and carers contribute towards projects on less frequently, and perhaps just on a consultation basis. 

We are very interested to hear from anyone who would like to be involved to help us achieve our aim.We hope you will join us in this wonderful opportunity.”

Please get in touch with either Syeda Tahir  or Stella Lam for further information or any queries.

Tower Hamlets Violence Reduction Collaborative

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By Andy Cruickshank, Borough Lead Nurse/ Associate Clinical Director Tower Hamlets

On Thursday 12 March, the Tower Hamlets Violence Reduction Collaborative met for the second time. A great deal has happened in the 6 weeks since we last met.

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Blog on Tower Hamlets Violence Reduction Collaborative

By Andy Cruickshank, Borough Lead Nurse/ Associate Clinical Director Tower Hamlets

On Friday 30 January, we held the first ever learning set for what has been titled the Tower Hamlets Violence Reduction Collaborative. This is a way of creating a community who learn together and from each other, about what they have tried to do to reduce violence on our wards.

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Tower Hamlet’s ‘Making People Better’ programme

by Dr Nick Bass

Why do you come to work? Are you proud of what you do? Would the service you provide meet the standards you require for your own friends and family?

Despite all the effort and time we put into our work, if the answer to the above is that there is ever anything about the service we deliver that could or should be done better that means there is an opportunity – or obligation even – for Quality Improvement. The purpose of this programme  is to enable anyone and everyone with a responsibility for the service (clinical, non-clinical, managerial, support services) and those who make use of the service (patients) and their carers to contribute directly to that improvement. It is about going further than identifying problems but in trying to come up with solutions to those problems – problems that staff and patients experience as priorities and which staff and patients are best placed to try and fix.

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Reducing Violence on Acute Wards

As the Trust’s quality improvement programme starts to take shape (with the strategy agreed by the Trust Board, the project structure coming into place, and our procurement of a strategic partner due to complete in February), we’d like to share with you the quality improvement journey of one of our teams that has been testing this approach for the past year as part of a pilot. In this article, Paul McLaughlin, Modern matron on Globe Ward at the Tower Hamlets Centre for Mental Health tells us what they have been doing to improve quality.

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