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What is the challenge your project is going to address and how does it connect to your chosen theme?

Patients of Broadmoor Hospital are defined as hard to reach, with no access to the internet or opportunity to mix with people who aren’t staff and patients of the hospital. Additionally, they often become disenfranchised due to the institutional nature of the hospital and involving them in service development represents a challenge as patients feel disempowered.

Given this, traditional methods for delivering formal QI training needs flexibility to translate across organisational boundaries and into the high secure setting.  Using the Recovery College as a vehicle for co-producing a QI approach that provides knowledge and skills, addressing the specific needs of the patients, staff and environmental challenges of Broadmoor Hospital.   Furthermore, the impending move to new Broadmoor hospital provides an opportunity to work differently.

This work will be a platform to build forward towards our inclusive QI culture.  Services users, patients and carers voice will be central to this.

What does your project aim to achieve?

The overarching aim of this project is to establish a Trust-wide culture of inclusion in QI, ensuring patients and staff feel empowered and enabled to make changes to improve care and services. .  Whilst Broadmoor has unique challenges the learning approach and resources developed will transfer to other difficult to reach groups within our Trust.

To realise this goal staff and patients need access to QI training built around the unique needs of the high secure environment. By using co-production as the vehicle for developing this training approach and content, staff and patients will have complete ownership of the course content thus improving the likelihood they will develop and engage with QI initiatives within the hospital.

Therefore the specific improvement aim of this project is:

To co-produce a QI training approach and package for staff, patients and carers , informing and building towards equitable access to QI knowledge and capability, by June 2020.

How will the project be delivered?

This project will combine the power of co-production and QI methodology. The delivery will be flexible and creative underpinned by co-produced PDSA cycles to clearly understand the needs and what will work best for all.    This work will be based initially within the Recovery College, building on the principles of coproduced training and the strengths based approach this embodies.

This will be supplemented by Recovery College outreach, as some individuals won’t be able to attend formal taught sessions and the context of some conversations may be best had in their own improvement environments (i.e. wards).   Building on the strengths of experts by experience and QI experts, we will step away from traditional ‘chalk and talk sessions’ to create a flexible approach which supports sharing of QI knowledge whilst building towards genuine improvement.

What and how is your project going to share learning throughout?

This project will generate learning on the development and introduction of QI and co-production with a community of patients who are ‘hard to reach’, whilst generating knowledge of what has equipped staff and patients to engage in their own improvement projects.

Learning will be shared through the development of a community of practice focused initially internally, but then expanded across organisational boundaries.  As the project develops it will be shared with the on-line Q community and wider QI interested parties. A co-produced evaluation will be shared with patients, staff and wider QI community and the project will be published in service user/carer and peer reviewed journals and shared at events such as conferences.

One of the aims of developing coproduction within this unique setting is to apply the learning to other hard to reach groups within our diverse organisation,  embedding coproduction and QI within the culture of the Trust.

How you can contribute

  • We recognise the value of learning from others experience, so we would really like:
  • • To hear from others who have been working to coproduce their QI training, particularly where it is reaching across boundaries or within restrictive environments
  • • To gain peer support and challenge as we progress the work
  • • To build an on-going conversation with peers around QI & Coproduction

Plan timeline

4 Mar 2019 Coproducing priorities, approach and change ideas
1 Nov 2019 Move to the new Broadmoor Hospital site.
6 Jan 2020 Start formal recruitment and make appointment
3 Feb 2020 Scoping and engagement
6 Apr 2020 Start Testing change ideas
4 May 2020 Internal Community of Practice to start
8 Jun 2020 Refine change ideas, agree approach and next steps
6 Jul 2020 Evaluation of achievements and learning to date


  1. So excited by this project. It involves mental health services, recovery colleges and coproduction - everything I’m passionate about! I’m keen to have a connection to this work as we’re starting to codevelop QI and research skills courses in our Recovery College in BCPFT

  2. Guest

    Really interesting project and seems you've put lots of thought into the challenges of developing co-produced work in a secure setting. I wondered if you had a sense of the challenges or service areas that the QI activity might focus on? I appreciate the first step of the programme is to identify priorities, but it would be interesting to know if you're setting any expectations with patients about what is and isn't within scope of the project.

  3. Guest

    Helen Lycett 1 year, 7 months ago

    Thanks Nicola, we are really excited about it so it's good to hear others feel the same.

  4. Such an interesting idea - love that it is all about inclusivity & that you are already thinking about using existing structures like the recovery college to help deliver on it. Really interested to see how it progresses.

    Think there is so much scope for how this is evaluated & the learning will be beneficial for all Trusts that are providers of Mental Health Services.


  5. Hi

    I run the national prog for MH safety and improvement. We have 15 advisors with lived experience of services and some of them have QI expertise too, so I am sure they would be happy to help and advise if you needed.

    I also work in secure services and understand your issues. have a look at ELFT who train people with lived experience of services in QI. Its sometime helpful to have someone with this level of experience on your design team?

    Good luck

    1. Thank you for your comment Helen as we now progressing this actively as part of the proposal I would really like to link up and learn from your colleagues with lived experience.  Is there a forum where I could come and shadow to meet with you, and representatives to see and hear a bit more of the work in detail?   Is there a way we could plan in a telephone conversation initially?

      I have a couple of contacts with colleagues at ELFT so will make direct contact with them too.

      We are keen to learn from others with already established programmes or experts by experience delivering or working in their QI team or training.


    2. Thanks Helen, that's really helpful.


      BW Helen

  6. This sounds very interesting.  Working with patients and service users presents many challenges and developing approaches to for this cohort of patients who are likely to be disenfranchised and demotivated.   I would be interested in working with you on developing approaches.  We have some early learning to share from Solent NHS Trust in developing training for patients but if a very different setting.

    1. Fantastic Rob, look forward to linking up and will be keen to bring together learning from the other wider organisations that I know you support for QI with NHS Elect.  Great opportunity to cross organisational boundaries for learning not just crossing our internal boundaries!

  7. Dear Helen, Jimmy and Suzanne,

    anything about recovery colleges gets me excited and wanting to help out! Combine recovery college with a population group that has such great needs, faces such stigma and often has had so many adverse childhood events to overcome and the need to do this grows in importance.

    So what help do you want? If it’s ideas about how to refine a recovery approach for this population then I am willing to help. If it’s some clinical input to think through how the high level of ACES might change the way you have to convene the group then I am happy to offer some thoughts.

    Take care,

    wishing you luck

    best wishes


    1. Hi Anna,

      Thanks for getting in touch. Would love to hear your thoughts on this. Is there a way of getting in contact directly?

      Thanks Helen

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