Abstract: It is increasingly recognised that the physical environment of psychiatric wards can contribute to service user well-being and recovery. However, service users and frontline staff are rarely involved in evaluating the impact of psychiatric ward design. We describe a participatory study, Design in Mind, which aims to redress this balance. We generated tools for assessing ward design by interviewing service users and staff in two London acute psychiatric wards. We then tested these tools on 53 inpatients and 61 staff of four London wards. Service users also took part in a photographic study of the best and worst aspects of ward design. All phases of the study used a model of ‘stakeholder involvement’. Service user researchers conducted the interviews, created the questionnaires and analysed all data.

We discovered that black and minority ethnic service users and those with a psychosis spectrum diagnosis have more positive views. Staff and service users have similar evaluations of specific design features but staff have a more positive assessment of the impact of ward design on service users. Service users photographs illustrated the importance of good maintenance and privacy and showed how poor design can disrupt their daily routines.

The measures we have created will now allow service users and frontline staff alike to take part in evaluation and development of psychiatric ward design. The use of photographs can also encourage active participation and help overcome language barriers.

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Abstract: This poster offers reflexive insights into conducting research about public and patient involvement (PPI) in research. It is based on the experience of conducting an interpretivist, qualitative social science research study, which aimed to explore perceptions of the impact of service user involvement on the usability of cancer research findings amongst researchers, service users and other stakeholders. The study had two phases: phase one involved semi-structured interviews with these three groups of participants to explore their perceptions about whether or not user involvement improves the translation of research findings into service development and policy change. Phase two used the Delphi technique to help develop further insights about the findings from phase one amongst those working in health policy and healthcare improvement sectors.

Being reflexive in research is about ensuring that everyday surroundings, identities and contexts are acknowledged as contributing to the shaping of the research process. In this study this includes growing knowledge and research in the field of PPI in research, and the researcher’s own identity and role as regional PPI lead for the National Institute for Health Reserach (NIHR) Research Design Service East Midlands (RDS EM). Within this context the study was designed to include PPI at key stages to enhance quality, and to ensure trustworthiness and credibility in order to address issues of ‘bias’. Drawing on ideas about reflexivity as well as Lincoln and Guba’s (1985) four categories of: ‘credibility’, ‘transferability’, ‘dependability’ and ‘confirmability’, the poster describes how aspects of PPI were developed in order to address these criteria. The poster contributes to debates about reflexivity, researcher identity and the associated advantages and challenges of involvement in research.

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Abstract: All National Institute for Health Research (NIHR) funding streams expect to see patient and public involvement (PPI) in every application they fund. Research Design Services (RDSs) are funded by the NIHR to help researchers develop their applications for national peer reviewed funding competitions. A service RDSs offer to researchers applying to nationally peer reviewed funding competitions is help and support with developing thoughtful and meaningful PPI at pre protocol stage. The 10 RDSs across England do this in a variety of ways but for the RDS East Midlands (EM), one of the ways we do this is via a lay review service for the Scientific Committee (SC). The SC aims to mimic a genuine funding committee.

The RDS EM SC has been running for the last four years but since October 2013, a remote ‘lay review’ service was set up. The aim was to offer additional perspectives into the research being planned, such as providing comments on ethical issues, recruitment issues and whether the planned PPI seems appropriate and relevant.  Since the lay involvement started in the SC, many academic, bureaucratic and lay issues have required careful thought and understanding. This poster highlights these issues and shares insights into what we did to overcome them.

Abstract: There is growing interest in public and patient involvement in all aspects of healthcare in the UK. However, little is known about the role of public and patient involvement within the new structures of Clinical Commissioning Groups and their decision-making processes. Public and patient involvement in decision-making within healthcare is thought to result in more responsive services and improved health outcomes. However, questions arise around the meaning and nature of ‘involvement’ and how it is established or what impact it may have.

This case study of a Clinical Commissioning Group aims to explore the involvement of public and patients in decision-making around healthcare services. The original idea for this study emerged from a discussion between a public member of the Clinical Commissioning Group board and the researchers.

Two types of meetings in which there is public and patient involvement are observed by researchers over a nine month period: Clinical Commissioning Group board meetings and public and patient group meetings. In particular, the researchers are looking at who attends meetings, agenda items, actions discussed and taken, and interactions between Clinical Commissioning Group board members and members of the public.

Members of the public and patients who are involved in this Clinical Commissioning Group have participated in the design, data collection and analysis of this research. Findings from the study are anticipated to be presented to the Clinical Commissioning Group and to public and patient members in a written report and via slide presentations.

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Abstract: The poster provides a summary of the results and recommendations of a ‘mystery shopper’ survey carried out at North Bristol NHS Trust (NBT) to find out how easy it was for patients to find out about clinical research opportunities. This replicated a national survey undertaken by the National Institute for Health Research (NIHR) of 40 NHS Trusts.

The mystery shoppers were five volunteers from the NBT research patient and public involvement panel.

What people will learn:

• How the survey was carried out and issues the mystery shoppers faced
• Our key findings
• Recommendations for improvement made by the mystery shoppers
• What we have been able to introduce immediately following their recommendations.

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Abstract: The Involvement Portfolio has been developed by the NHS R&D Forum Service User and Carer Working Group. It is a tool for those using health and social care services who are involved in voluntary or involvement activities such as consultation, committee membership, research and development, to record and provide evidence of their activities.

Many people using health and social care services are involved in a range of involvement and voluntary activities such as research, teaching and training. Much of this involvement goes unrecognised although the participants are gaining valuable skills and experience as well as contributing their experience and expertise. This tool allows people to record the skills and experience gained through involvement and voluntary activity as this can help with applications to undertake new activity, for educational or vocational courses, or to find employment.

In the portfolio, the portfolio holder has the opportunity to record their employment or other experiences including those gained through voluntary activity, or life experience such as being a carer or a parent, training events and experience of leading or facilitating training, ‘involvement activity’ and experience including taking part in committees, in consultation events, in NHS or social care research and development, or in curriculum development for educational courses. The portfolio holder has the opportunity to record the involvement activity they have taken part in, the type and level of involvement, the skills learnt, and any qualifications gained.

The portfolio was successfully launched some years ago and has now been refreshed and re-launched taking into account the lessons learnt and experience of its use.

Abstract: The role of patient and public involvement in the design and running of research trials is becoming increasingly important as researchers strive to discover the clinical questions that matter to patients and their loved ones. The National Institute for Health Research (NIHR) funds the national advisory group INVOLVE, which aims to build support for active public involvement in NHS and public health research. However, it is also important that public involvement begins at the grassroots level within individual research departments and NHS trusts. With this in mind, the Clinical Research Ambassador Group (CRAG) was set up in 2013. A 12-month structured involvement plan has been implemented to deliver training activities including Good Clinical Practice (GCP) and general research oversight.

Research meetings were hosted by the Heart of England NHS Foundation Trust (HEFT) and the Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation. A large turnout of patients, relatives, clinicians, researchers, managers and directors came together with the aim of promoting patient and public involvement. Meetings provided a platform for clinicians to present their research ideas so that interested patients and members of the public may be allocated to the project team from inception.

A database of 30 cross-specialty CRAG members has been developed and each member was invited to support research activity depending on their interest areas and level of  commitment, for example attending face-to-face meetings, email correspondence and teleconferences. Successful patient and public involvement collaborations have been set up in anaesthesia, emergency medicine, and trauma and orthopaedics.

The close working relationship with our CRAG group has been commended by various funding bodies and has hugely benefited HEFT research team activity.

Abstract: Securing greater patient and public involvement is a central theme of health policy in many countries (Coulter 2011) and is a growing healthcare phenomenon (Boote et al 2012, Staniszewska et al 2011, WHO 2006). However, the voice of the professional, in general, continues to have a stronger input and impact than that of the patient.

This paper will outline a framework for patient identified need that aims to address this imbalance by moving beyond the concept of ‘involvement’ at some point, to putting the patient voice first so that it sets the direction in determining research priorities, treatment and product innovations and methods of service provision.

Using a co-production methodology (Gillard et al), we have worked with patients, in different clinical and educational settings to develop this framework and identify some core underpinning principles that need to be present to foster good quality and effective patient and public involvement (PPI) that leads to innovation that is fit for purpose.

We will:

• feedback on the patient experience of using this model when working with health technology industry to inform the development of new products and the NHS and higher education in regards to service innovation and education and research priorities.
•  invite discussion on the potential value of the framework from their PPI experiences.

Abstract: UCLPartners is working to create an involvement and engagement network across our partnership. This will ensure public and patient involvement and engagement throughout research, clinical practice and service design, sharing best practice, developing guiding principles and providing a ‘matchmaking’ service to help partners work together. We will briefly share our first six months of work.

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Abstract: Organising cancer services around the needs and preferences of patients is essential but not typical of current arrangements. In November 2010, London Cancer undertook an exercise with patients, carers, and clinicians to answer the question “What does great care look like and how would we know?”, with the goal of driving major system change in integrated cancer care pathways. The collective responses of these individuals were combined in a list of ‘Top Ten Things Which Matter Most to Patients’.

From this work, London Cancer has developed focus for best care initiatives and measured improvements in the areas deemed most important. This poster will summarize the exercise and discuss the topics considered most important for patients, carers, and clinicians in providing quality integrated care and improving cancer services. We will identify some practical techniques for increasing patient and population involvement in service design and encourage discussion around horizonscanning in this area.

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Abstract: Solent NHS Trust is one of the few where a single Team straddles Research, Clinical Audit and Service Evaluation. Embedding patient and public involvement (PPI) in these areas links research to local services in a clear way. Our objective is to provide different opportunities to be involved, using innovative engagement. We are passionate about supporting and fostering development of those individuals, community and hard to reach groups. We have involvees who are contributing to research in long-term conditions who also engage in opportunities to change their local services. Many see rapid impact of their contribution when involved in a service evaluation (I will give an example of working with a group of parent carers of children with complex health needs). This way of working also links in with our patient experience and general public engagement of the Trust and our lay governors, local Healthwatch which matches national objectives from the National Institute for Health Research (NIHR) and NHS England Citizen.

As a Community Trust we host and conduct our own research with local universities, and Clinical Research Networks, Acute Trusts and so on. As a smaller trust we are able to be more ‘hands on’ with our involvement. I will give an example of working with a university researcher, a Trust research physiotherapist and a carer alongside a person with learning difficulties and how her involvement empowered her to engage in her own health care in a positive, safe and productive way using a study to prevent falls in people with learning difficulties.

Abstract: National Institute for Health Research (NIHR) Colloboration for Leadership in Applied Health Research and Care (CLAHRC) Northwest London facilitates a particular approach to healthcare improvement, with Patient and Public Involvement (PPI) being a core part. We believe involving patients leads to more appropriate and long-lasting improvements. We’ve observed improvement teams benefit from a facilitated approach to develop patient and public involvement (PPI) practice.

Mechanisms already exist to support this approach, but there is a tendency to create new ones; either because people do not know previous ones exist, or they do not feel they work in a specific context. We were interested in how existing mechanisms can be adapted/adopted to work for healthcare improvement teams.

We introduced three items to these teams to strengthen their PPI practice:

1. an emancipatory framework
2. a set of national standards for involvement
3. a guide to support the assessment of impact in involvement.

We tested various adaptations of them, observing the impact the items had in supporting PPI become everyday practice in the various teams’ specific contexts.

The poster will summarise:

• Why we selected the items
• What they aimed to achieve versus what actually happened in practice
• The extent which items support PPI to become part of everyday practice
• The impact of testing the items on their creators and facilitators
• Evidence that is already available
• Our process of adopting/adapting existing items into practice
• How to rapidly evaluate to improve implementation of PPI.