PPI TOOLKIT 2 To provide guidance to managers and staff in Derbyshire Community Health Services NHS Foundation Trust

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1 1 PPI TOOLKIT 2 To provide guidance to managers and staff in Derbyshire Community Health Services NHS Foundation Trust Planning before you start There are a variety of ways of finding out what patients and the public think and what they want. What is important for your service is to identify the ones that will provide you with the information you need to make the right changes. Some methods are simple and relatively low cost,others can take months a cost more. A good place to start would to be to ask patients and public how they would like to give their views on their local health services. Have you thought about this approach in your own service? Planning before you start Page 1 and 2 Stages of PPI Page 2 The Tools Page 3 Why use.? Page 4 It is important not to rely on a single method Ask yourself the following questions :- What information is required How will the information be used How much time is available What resources are available The nature of the service 1

2 2 It is important to plan at the outset for PPI to be successful You need to be clear why you need to involve patients / public Decide on the methods and approaches you wish to use Do you know how you will recruit participants and what expenses will be required? How will you support people with additional needs legal-and-policy/equality-act/ Planning before you start How will you evaluate and feedback? Stages of PPI PARTNERSHIP - Membership of commissioning groups; Improvement and Scrutiny Committees( ISC) ; Patient Participation Groups. PARTICIPATION- Expert Patients; Health Panels; Shadowing patients ; Story Telling FORUMS FOR DEBATE - Focus Groups; Interest Groups, Workshops and Panels; Public Meetings GETTING INFORMATION - Patient Surveys; Interviews; Questionnaires; Open Surgeries GIVING INFORMATION - Exhibitions; Leaflets and written documents ;Web-based information: Media 2

3 3 The Tools Tool Can be used for Giving Information Getting Information Forums for debate Involvement Comment Cards Displays and exhibitions Electronic Questionnaires Electronic voting Focus groups Graphic Facilitation Mystery Shopper Patient Diaries Presentations and talking to groups Process mapping Public meetings Round table workshops Storytelling Surveys and questionnaires Text messaging and social networking User panels Written Information 3

4 4 Comment cards Changes as a result should be publicised Needs to be accessible to all Easy way for service users to make an input Maintenance is vital but has staff time implications Displays and Exhibition s Promotion is very important. Involve communications team, local radio, press releases There are many ways to use creative approaches which make the experience of receiving information more effective and enjoyable. Through the use of visual material, this method may lend itself to reaching people with literacy problems. Electronic Questionnaires (see also surveys and questionnaires Give the questionnaire a short and meaningful title. Keep questions to a Minimum. Use plain English language. Information can be collected from a large group of people. Surveys are easy to design and administer. Simple analyses cab be completed very quickly. Display materials are expensive. Is this value for money? Response received will not be representative of all views. If incorrectly used, accurate information will not be gathered. When using an online survey there is no opportunity to clarify the meaning of a question. Online surveys may have a low response rate. Web based questionnaires may require more technical expertise. Electronic Voting Requires feedback to participants on what was done as a result of their involvement Many people are familiar of TV shows with this approach. It can be presented in an enjoyable way even though the issue may be serious. The total of the audience s views become available immediately. Accessible method for those who find it difficult to write or speak in public. This method cannot accommodate complex questions where people may want to record more than one answer. People lose interest if they have too many questions. To answer. 4

5 5 Focus Groups Need ground rules Requires effective facilitation Take manual notes This is an effective way of obtaining a great deal of information. Participants can explore ideas and views in depth. Some people may feel more able to speak in a focus group than in a more formal situation. Participants may feel they need to conform to the wider group view. Graphic Facilitation Relatively new way of engaging Communities Until you have the skills in house advisable to use the skills of an external facilitator Encourages participation and fun. Encourages people to think differently and in a different way. People obtain 80% of their information visually. It can record feelings as well as ideas and statements. Everyone can see and agree actions. Again good for those with literacy difficulties etc. Mystery Shopper Mystery shopper can be applied face to face, telephone based, correspondence based and internet based services. Market Research Society advice on best practice guidelines.htm People may need training. Some ideas may be difficult to represent graphically. This tool is less expensive than other forms of market research. As experiences are recorded immediately there is less recall error Than with interview surveys. The results may point immediately to practical ways of rectifying mistakes. There may be employee resistance. Knowledge of the exercise may change staff behaviour. The exercise may need to be repeated several times, in a wide cross section of situations, to obtain representative results. 5

6 6 Patient Diaries To gather qualitative information about patients experience in order to help shape service improvements. The length of time a diary runs will depend on the frequency with which the service user is in touch with the service. It has been found 2 4 weeks was a good time for dementia sufferers and their carers. This is a flexible method which can be adopted for use with people with disabilities or literacy problems. Enables people to give a great deal of information including sensitive matters in a way they can have control. The representatives of the findings will depend on the quality of the recruitment process. Presentations and talking to groups Talking directly to people in their own setting is a good way of getting your information across, using a variety of communication methods. It is an opportunity to focus on a topic and answer questions from an audience. It is a way of building an ongoing relationship and conversation with groups and building trust. It is inexpensive. Process Mapping This is a powerful interactive tool that can be used to help professionals to understand how complicated the experience of care can be from the services users perspective. Process mapping gets people talking and listening and gives a broader perspective of what is happening rather than what people think is happening. IT based slides can be intimidating, try to think of ways to engage your audience. It may involve evening meetings and some travel for the presenter who needs to be comfortable with public speaking. 6 It is a relatively quick and cheap tool to use. It generates more ideas for service Improvements. Opportunity for everyone to understand the issues, which reduced resistance to proposals for change. Potential cost of external facilitator. If not all key players can attend then they will not be engaged in the process.

7 7 Public Meetings This is the most traditional ways to consult local people. They are a good way of sharing information. However organising a successful public meeting requires thought and effort. Attention should be paid to the management of conflict around controversial issues. If well publicised this method can be high profile and allows a large number of people to be consulted at the same time, and an opportunity for local NHS to share their views. It gives people the opportunity to have their say in public. It may raise expectations about what can be achieved. The meeting may attract local activists rather than the wider community. It can lead to adverse media especially if meeting is controversial. Need to be able to manage and resolve conflict. Round Table Workshops Works well when there is a relatively clear topic to discuss to share concerns and generate ideas. Draws on a wide range of opinions. Risk that some table can be dominated by particular issues. Storytelling Takes place in a supportive group setting. The process is structures so that valuable personal experiences are used to draw out important themes and issues. It is an empowering experience. A process that may appeal more strongly to women than men. Needs to be managed sensitively and confidentially. 7

8 8 Surveys and questionnaires (see also Electronic Questionnaires) Used to gather views and comments, from a sample of local people on a range of issues. You can use surveys to find out what people think about a particular service. Can be conducted in various formats, postal, face to face and telephone reviews. Information can be collected from a large group of people. All respondents are asked the same questions. Telephone interviews are faster and cheaper, than face to face interviews. If incorrectly used, correct information will not be gathered. Text Messaging and Social Networking To reach young people and people who tend to engage in more traditional ways of communication to obtain real time feedback. Clients see this as a confidential and useful method of contact. Social networking pages are increasingly popular. Make it easy for service users to have their voices heard. Legal issues relating to confidentiality, data protection and privacy have to be addressed. Text messages are limited in the amount of information that can be exchanged. Will this method reach the target audience. Written Information Supports aspects of patient and public Involvement This is a widespread and widely understood form of communication. Credibility depends on producing material to a high standard. Care must be taken to consider the barriers that many people face in using written materials 8

9 9 User Panels Theses are system of a regular contact Between service providers and patients, carers and communities. Enables the sharing of experiences and expectations, which can then be used in service planning and review. Establishes ongoing two-way dialogue between service providers and users. Good way to sound out new ideas and proposals. Opportunity for partnership working with other organisations.. Once established, is a quick and Inexpensive method of gathering information. Care needs to be taken with recruiting to ensure that it includes a wide range of groups. This method is unlikely to lend itself to participation by people with literacy or language problems. Because of the flexibility panels can be overused to the point where participants suffer from respondent fatigue. Please contact the Patient Experience Team if you require any further information and/or assistance - Telephone: pet@dchs.nhs.net 9