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.