Q Exchange
Improving engagement, waiting experience and transition with Peer Support Workers.
- Proposal
- 2023
Meet the team
Also:
- Ruth Fyffe-Macleod, Clinical Psychologist
- Zoe Dodd, SHSC Peer Support Lead
- Will Hartley, Assistant Psychologist
- Lin Harrison, Principle Psychotherapist
- Joe Curran, Consultant Psychotherapist
- Teresa Clayton, Head of Experience
What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?
Experts by Experience have kindly supported our understanding of the experience of waiting for treatment. They report issues of feeling isolated and unsupported during long wait times for therapy. They have reported difficulty trusting / engaging with services when treatment becomes available – which can be related to previous negative experiences within the mental health system. These issues can lead to non-attendance at assessment, deteriorating mental health while waiting for treatment, and subsequent non-attendance when treatment becomes available.
We know that people from ethnically diverse backgrounds have particular barriers to accessing mental health services in an equitable manner, with data suggesting they are subsequently underrepresented in therapy.
Experts by Experience have also shared a sense of anxiety around the discharge process and the current lack of support to engage with the wider community offer in the city.
What does your project aim to achieve?
Our service delivers specialist psychotherapy for a range of conditions, though our current wait time for treatment (following assessment) is in excess of 18months.
We aim to support people prior to initial assessment and make the waiting time for treatment therapeutic, engaging and meaningful. We also plan to offer additional support to service users in their transition out of the service at the end of their therapy.
As part of this programme of work we aim to ensure additional support for people from an ethnically diverse background to maximise their opportunity to benefit from therapy.
The use of Peer Support workers will enable contact prior to assessment to offer information, support and reassurance to support attendance. During the waiting period for therapy to begin, the Peer Support workers will offer supportive conversations, co-facilitate groups and help with accessing community groups or activities – including those promoting social inclusion and physical health.
How will the project be delivered?
Supported by expert by experience feedback, national guidance and best practice, we wish to employ 2 half time Peer Support workers for 18months – at least one of whom ideally will be from an ethnically diverse background. This will allow for us to draw on a wide range of lived experience, both in terms of mental health difficulties and demographic background.
Alongside an appropriate induction, training and supervision from within the team, we are fortunate to have a designated Peer Support Lead who can offer support, training and links with the wider Peer Support Worker network within the Trust.
We plan to review our DNA rate for assessment and for commencing treatment as a metric of the impact of the change. An established Trust survey asking about the impact of having access to Peer Support Workers will also be used – alongside monitoring other feedback sources such as Friends & Family.
How is your project going to share learning?
There are a number of learning avenues that we plan to utilise with this project. Within the team the review of quantitative (DNA rates for assessment and treatment) and qualitative (Survey, Friends and Family) data will offer the opportunity to develop and refine the offer based on feedback from our service user and carer population. This will be connected into existing team governance structures.
We will look to share the learning via presentations at SHSC Quality Improvement Forum, Leaders Call ,Trust wide staff news bulletin alongside lived experience and peer support groups (both within SHSC and regional).
With the support of our Communications team, we would also look to share our learning externally – on our internet, Facebook and twitter platforms.
We would also look to share outcomes and learning with improvement communities – via Q, conferences and publishing article in appropriate peer reviewed journal and Care Opinion.
How you can contribute
- Feedback and suggestions on the proposal – highlighting what you think will work and what might need refining.
- Networking and connection with other Q members with interest or experience of working with Peer Support Workers to promote our learning.
- Support from the wider Q community to promote the approach and learning
Plan timeline
| 1 Sep 2023 | Recruitment |
|---|---|
| 1 Oct 2023 | Induction & Training |
| 1 Nov 2023 | Phased role introduction – including co-facilitation of groups |
| 1 Feb 2024 | Role implementation (ongoing supervision, networking opportunities and support) |
| 1 Apr 2024 | Review of key metrics |
| 1 Oct 2024 | Review of key metrics |
Comments
Simon Wheatley 24 Mar 2023
Thanks to everyone who has contacted us directly or left comments on the Q website offering feedback, support and guidance.
These are very much appreciated.
We have adapted both our Q bid and planning / implementation ideas based on these and will continue to do so if fortunate enough to make it through to the next stage.
Thanks again.
Lin Harrison 22 Mar 2023
I'm passionate about the SPS service developing paid peer roles and think this would both enhance our direct clinical offer and improve our culture as a service. We are working currently on several projects to increase service user voices in our work and want to continue to build the engagement of Experts by Experience. Providing paid peer work role(s) would be a valuable addition to this culture change piece. These workers could also link in with other peer workers employed by the Trust and elsewhere locally to make a culture change difference on a wider scale and provide much needed support for each other.
Helen Crimlisk 25 Mar 2023
Quite agree Lin, we have seen so much value of peer workers elsewhere and nice to see a well evaluated project in this field
Catherine West 15 Mar 2023
This project would be hugely beneficial to this service.
So many of our service users are socially isolated and find it incredibly difficult to navigate the wait for treatment period and psychotherapy treatment itself. The power of having a voice from a peer support worker who has been through these waiting and treatment processes, will be invaluable. In addition, support at the end of treatment to engage with the wider community is vital to maintain therapy gains in many cases.
Simon Wheatley 17 Mar 2023
Thanks for the supportive comment Catherine, and for emphasising how important it is to get expert by experience / peer support in place for people.
Dr James F Munro 14 Mar 2023
Hi Simon + team,
This looks like a really worthwhile project. I had a few thoughts from a Care Opinion perspective:
1: Waiting is a significant issue as you say and the time waiting can be improved in various ways. Your bid reminds me of a report from National Voices in 2020 on this topic which may include other themes you could add into this project (it’s not limited to MH, but still very relevant I think).
https://www.nationalvoices.org.uk/publications/our-publications/patient-noun-adjective-understanding-experience-waiting-care
This report also used CO stories to illustrate key themes.
2: Care Opinion would be happy to support project dissemination via our monthly research chat, when you have published the evaluation in some form.
3: In some places, volunteers help people post their stories on CO (esp. in secure MH of course). Peers support workers could also assist people in your project to do this (if they had time and you felt it was consistent with their role). Indeed, sharing a story on CO while waiting can in itself be meaningful and empowering.
Good luck!
Simon Wheatley 14 Mar 2023
Thanks so much for this James - very helpful. The report findings can definitely help shape implementation of the project and the offer of support from Care Opinion going forward is brilliant. Thanks again.
Jenny Marshall 14 Mar 2023
This would be a hugely beneficial project for this service. Clients who feel ready and motivated to access therapy are often disappointed with the lengthy waiting times for treatment to start after the initial assessment. Having designated Peer Support workers to help during this waiting period will hopefully improve the overall experience, and retain the motivation to access mental health services.
Simon Wheatley 14 Mar 2023
Thanks Jenny - the energy in the team to improve care for service users from the very start is really noticeable.
Helen Crimlisk 13 Mar 2023
I'm so pleased to see this project here.
We need to think differently about waiting lists and ensure that where possible "waiting" becomes an active part of an intervention - offering alternative sources of help such as with Peer workers, signposting to other sources of help, supporting motivation and preparation for the intervention of psychotherapy and enhancing the quality of experience and outcome when people do get the intervention.
In some circumstances, it may be that experiencing peer worker interventions may mitigate distress and even be successful enough that further interventions are not needed or can be less intense.
Good to see the focus on training, support, supervision and feedback (especially with the wonderful @CareOpinion!
Simon Wheatley 13 Mar 2023
Hi Helen - thanks for your support, helpful comments and reflections.
Greg Hackney 10 Mar 2023
We know that having representative workforce of our community improves the outcomes of our service users. This sounds like a really great initiative to improve early engagement and improved service user experience
Simon Wheatley 10 Mar 2023
Thankyou for the supportive comment.
The team are working hard to support service users and promote equity of access and believe this project will help with this.
Comments are now closed for this post.