People Participation

I’ve been a concerned relative, a patient with a stable, chronic condition, a doctor and an NHS chief executive.

As a patient and carer, I value small acts of kindness not specified in job descriptions. As a doctor I’m curious about the appetite for positive risk taking among fellow clinicians. I also feel the frustration of clunky systems and processes which get in the way. As a CEO, I want small acts of kindness to take centre stage and frustrations to be minimised. I therefore promise to be a very active, involved and engaged patient!

Involvement. Engagement. Feedback. Coproduction.  Co-design. Participation.  Some of the terms which describe the welcomed increasing interest in service user input into healthcare.

Some years ago, we in ELFT embarked on a journey of greater people participation. The rationale seems obvious; get service users to help you make them better.  Simple, right? In reality this has been more difficult to achieve than anticipated. There have been many barriers and concerns, e.g. issues of confidentiality, stress on the participants, fear of appearing tokenistic, governance issues, how to ensure ‘real’ representation, fear of reprisal. Patients and carers also expressed additional concerns including lack of resources, lack of confidence and a fear of not being taken seriously, to name but a few. These shouldn’t stop us because with focused effort they can be overcome. The benefits are definitely worth the effort.

People participation is now part of nearly everything we do. The People Participation Sub Committee of our Board led by ELFT’s Trust Chair holds us all to account. Variation in practice is still evident across the organisation despite many years of embedding this work. From where I am I can tell that strong people participation is linked to better outcomes, happier staff, financial viability and stable leadership. People participation is now core to recruitment and training and to our continuous quality improvement work. The positive impact is wide ranging. People participation shouldn’t be questioned.

Having taken steps to engage service users and carers with some success; being open, admitting failure and asking for help, it is now time for me and my colleagues to be bold. It’s time to take engagement to the next level. It’s time to reduce variation in engagement, to spread good practice with more robust accountability and to take our learning beyond ELFT. Watch this space!

As a CEO, I must avoid hearing what I want to hear and not knowing what I need to know. I must listen, especially to messages which make me uncomfortable. I am amazed by the generosity of patients and carers, in the wish to help make things better for themselves and others. I hope they never stop.

Why is patient and carer involvement crucial to fulfilling my leadership duties? Because they are my ears, my eyes and my conscience.