Contents
  1. Overview
  2. Starting from zero – how do you involve service users in your work?
  3. Listening better in Dorset
  4. From a PPI rep perspective: important points to consider when involving service users
  5. Signposting

1. Overview

In our role as patient and public involvement (PPI) representatives for the Dorset Innovation Hub (DIH), we were invited to run a workshop at the recent DIH Summit on ‘understanding the perspectives of people accessing health and care’ which we were delighted to deliver alongside Frances Aviss (Head of Engagement at NHS Dorset) and Ian Gall (Chair of the Our Dorset Patient Experience Group). At the end of the workshop, we invited the audience to pledge an action, based on what they had heard, to take back to their organisations to work on. These pledges were written on leaves which then filled the branches of our PPI pledge tree. After the DIH Summit we were excited to read through these leaf pledges, but what struck us was a strong theme around wanting to engage more with service users.  We therefore felt it may be helpful if we jotted down in this blog some of our thoughts and reflections on service user involvement, to hopefully support those who are at an early stage in their service user involvement journey.

2. Starting from zero – how do you involve service users in your work?

There are some great existing organisations and groups in Dorset who have a key role in supporting the development and inclusion of service user voices in health and care research, service planning and development. Seeking advice and guidance from these experts is a good place to start.

A great way of starting is to learn from those who are already actively involving service users in their work. Is there anyone else in your organisation already working with service users? Can you link with them to find out how they have approached it and what their learning has been; they may even have some useful tools or templates that they would be willing to share? Or even looking to your counterparts within other similar organisations within the Dorset ICS (integrated care system) or maybe even thinking wider to Wessex or nationally. Its always a good idea to find trusted leaders in the community you are trying to engage with, they will often be able to help you to make an approach and guide you as to what will encourage people to be involved.

3. Listening better in Dorset

Using community-centred approaches that empower people and communities, is a key principle in service user involvement. To support in achieving this, Our Dorset have recently launched a website which summarises 11 different listening approaches: these including, community researcher model, neighbourhood conversations, trusted voices, and young listeners. Each summary contains an ‘at a glance’ key information, examples of where it has been used locally, as well as contacts for further information. When planning your service user involvement, have a look at this great resource and consider which approach would be most appropriate for the piece of work you are planning.

Listening better – Change your approach to conversations (ourdorset.org.uk)

4. From a PPI rep perspective: important points to consider when involving service users

The list below represents some of the reflections and observations from our time as PPI representatives, that we consider important for everyone to consider when they are thinking about service user involvement in a piece of work.

  • Involvement from the beginning. Inclusion of service user voices needs to be from the absolute beginning of a project, in other words from the moment you have the ‘idea’. If not, there is the danger that PPI then becomes an add-on which is not embedded into the project and cannot deliver the positive impact it has the potential to bring.
  • If possible, you should aim for a co-production approach. Co-production is a collaborative approach to the design and delivery of services that involves citizens, stakeholders, and other key groups in society. The goal is to create better services by involving people who use them in the process and recognising that they have valuable expertise.
  • What time and resources will be needed. Be aware that service user involvement will take time and resources to deliver well. It can’t just be seen as one meeting and then signed off as ‘job done!’ Time to build relationships and trust is vital as well as recognising that training may be needed together with briefs and debriefs for meetings. Service user involvement is an activity that needs to be considered, planned, and resourced. Building in time to give feedback to those who were engaged is important to ensure that they see the difference they have made and encourage future engagement.
  • What funding is available to support. An important component of resourcing is financial payment. Are there funds available to cover any expenses that service user representative may incur as part of their involvement? Are there funds available to recognise and acknowledge the time taken out to support a piece of work? It is crucial that you are clear from the start how the financial and payment side of things will work. See link to NHS England guidance on involvement payment in Signposting section below.
  • Which service user voices do you need. Think about which service user voice it is you need to help inform your work. What service are you developing, who currently accesses that service, are there more vulnerable sectors of our community that you would like the service to be more accessible to, who may be impacted by the service – these are all questions that may help you to unpick who should be involved from a service user perspective. Do you need generic service user voices or are you looking for representation from someone with a more specific lived experience e.g. cancer, mental health, visually impaired.
  • How to reach service users. Once you have identified which service user voice, the next question is then ‘how do we reach out to them?’ Who may be the gatekeepers to help you access those lesser heard voices in our community? Talking to some of the wonderful voluntary and community sector organisations we have in Dorset is a great way to start answering these types of questions (see signposting section below).
  • Be prepared for changes. It may sound obvious but be prepared to make changes based on what your service user representatives say. It has been observed before that sometimes there can be a preconceived idea, before service user involvement, about what needs to change and how. Once service user involvement is in place, you may hear something completely different which opposes that preconceived idea and may flag a need to go right back to square one. Going into conversations with an open mindset and really listening to what is being said by your service users will help you to unlock key information which will support project success and sustainability in the long term.
  • Do we all see the project as a priority. Make sure that the project you are working on is based on an agreed area of need i.e. something that service users also see as a priority. You may be able to look at quality data, such as complaints and feedback surveys, to gain an understanding of the issues that are flagging as important to service users.
  • Feedback impact of involvement. When service users have been involved in a project, it is also key to remember to let them know what has been done in response to their input and how a service has been changed or, if a service has not been change, why their input wasn’t acted upon. Hearing that type of feedback not only closes the loop but also provides a sense of achievement and acts as a motivator for involvement in future pieces of work.
  • Importance of communication style. Linked to the point above, when providing any type of feedback to your service user communities please, please, please, make sure that you think about the language that is being used i.e. avoid acronyms, use plain language, avoid complex or technical terms. Also consider if you need to provide information in languages other than English (see signposting section below).

5. Signposting

We were also keen to highlight some of the documents and links that may be helpful to you. This is by no means an exhaustive list – just some of the ones we are aware of.

Guidance documents to support and inform service user involvement:

  1. NHS England. Working in partnership with people and communities: statutory guidance. July 2022. NHS England » Working in partnership with people and communities: statutory guidance
  2. NHS Dorset. Together, working with people and communities, Version 4.0, August 2024. Together-working-with-people-and-communities.pdf (nhsdorset.nhs.uk)
  3. Our Dorset. Listening better in Dorset. Listening better – Change your approach to conversations (ourdorset.org.uk)
  4. NHS England. Working with our patient and public voices (PPV) partners. Reimbursing expenses and paying involvement payment. Version 3, October 2021. B0869_Working-with-patient-and-public-voice-partners-reimbursing-expenses-and-paying-involvement-payments.pdf (england.nhs.uk)

Contacts to support with reaching social user communities/populations:

  1. Dorset Race Equality Council: Dorset Race Equality Council | Registered Charity | Dorset (dorsetrec.org.uk)
  2. Dorset’s Voluntary & Community Sector Assembly: Dorset VCS Assembly
  3. Bournemouth Interpreters’ Group: Bournemouth Interpreters’ Group
  4. Specialist national and local charities for specific conditions – check the web to see what charities there are for the service user cohort that you would like to work with e.g. Age UK Age UK | The UK’s leading charity helping every older person who needs us and HealthUnlocked HealthUnlocked | The social network for health.
  5. People First Dorset – an organisation that brings people with learning disabilities together: People First Dorset | Learning Disability Charity | United Kingdom
  6. Churches Together in Dorset: Churches Together in Dorset | Facebook
  7. Dorset Community Foundation: Home – Dorset Community Foundation

We are always keen to keep the conversations around service user involvement active and progressing so would love to hear any additional thoughts you may have on this topic or indeed any examples you may be willing to share of where service user involvement has worked well. Please do contact us to continue this conversation via the central DIH email address: dorsetinnovationhub@nhsdorset.nhs.uk

Dorset Innovation Hub PPI Representatives

Debbie Clifton, Deborah Curtis, and Anne Jacob.

20/12/2024