The story so far …

Solent NHS Trust is a provider of community and mental health services in Hampshire. In 2016, we launched a Quality Improvement Training programme – this was developed to equip our teams with the confidence and skills to both identify and carry out improvement projects in their services. Three years on, this has evolved into a stepped programme from an introduction module to leadership training.

Really core to the vision for our QI programme was that projects should be delivered in partnership with patients (families, carers and so on) and we have patients or others on most of our project teams. Partnership working is a core component of all of the training.

Listening to feedback

We spoke to some patients about how it felt to be working with our teams on improvement projects, and whilst they enjoyed it, they said that initially it was very overwhelming to be in a room full of clinicians; they struggled with some of the language used and weren’t always confident to speak up. They suggested some ‘pre-training’, a module specifically designed to introduce patients and others to QI, give them an opportunity to meet others and know a bit about the organisation.

We are evaluating this fully, but from my point of view, this has been an utterly rewarding and positive way to work. Co-designing training in this way has undoubtedly taken longer, but I am in no doubt it is significantly better.

Designing the course

We wanted to design this course in partnership with patients. We approached those that had been through the programme to see if they’d like to be involved, and we also invited members of the Southampton Children’s Hospital Youth Board. NHS Elect worked with us on the facilitation. To date, we’ve held two sessions – both on a Saturday – in a central Southampton location. We made sure that refreshments and drinks were readily on tap, and we have given thank you vouchers and paid expenses to those that have worked with us.

In the first session, we worked on how to get people engaged, and what they might like out of any training, addressing issues such as:

• Good locations and times
• What would make this attractive?
• Who should attend (the group were very clear that clinicians and ‘patients’ should learn together)?
• What might be the content?

The group sketched out some posters for us to get designed and printed for session two.

In session two, we added in some clinicians to the group. We took back the posters for their review (having something tangible and professionally printed was a good idea) and worked on the content. We then ran through some of the suggested content (such as an introduction to the NHS, and introduction to QI) and had a think about how engaging and useful it was, and what might work better. By the end of the session, we had an outline for the training and an idea of how this could be presented. We also agreed that what really helps is to have stories of how other people have been involved and to have those who’ve been patients working on projects part of the group delivering the training. More details on the content will be coming soon.

Has this been a good way to work?

We are evaluating this fully, but from my point of view, this has been an utterly rewarding and positive way to work. Co-designing training in this way has undoubtedly taken longer, but I am in no doubt it is significantly better. By the end, we will have amended pretty much everything that we started with, but we are able to use content and ideas that are much more likely to be appealing to future participants. We’ve also gathered stories of what’s worked and what hasn’t on other modules, and ideas for other types of engagement. We’ve been told quite firmly for instance, that lots of consent forms within social media are a definite turn off, that food is a must at an event, and that location matters. Taking Southampton residents to the Portsmouth football ground was considered a bad idea! We will end up with a ‘training package’ that we are relatively confident in, with patient partners who are happy to deliver this alongside us (indeed lead much of it) and some ideas about different platforms for engaging.

What happens next?

The next phase is to write the content, and then test it. We expect to be changing and refining this as we go forward, based on the experiences and views of those that participate or help with delivery. The first training event will be early in the Autumn.
Critical elements

• Be very clear what you are hoping to achieve when you set out, but be very prepared to change this according to what everyone in the room needs to get out of the process. This is likely to change.
• Go somewhere central, and make sure there is food and drink!
• Pay for the time of those participating, as well as expenses
• Be very flexible! Things change on the day
• Make it interactive: we used Sli-Do and that was very popular
• Don’t expect perfection: the end product isn’t the finished product
• This is a partnership – and it is fun! Keep that in mind …