Enhancing Patient Experience in Secure Mental Health Services

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Pioneering an innovative approach to capturing patient feedback in high secure mental health services led to significant improvements in patient involvement and service quality. Key learnings include finding champions, building trust through visible changes, perseverance, and the invaluable role of service user volunteers in fostering rapport and obtaining genuine feedback.


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  1. Giving patients the key: Unlocking patient experience and involvement in secure mental health services Nottinghamshire Healthcare NHS Foundation Trust Nigel Groves Kath Alder Michael Salter @InvolveT1

  2. Quick summary of what we did We pioneered an approach to capturing feedback from patients in national high secure mental health services. From the only real opportunities for patients to have a say being: ineffective, closed patients meetings a survey To: wealth of feedback from patients (39% increase from 2016) improvement to patients sense of being listened to patients play a bigger part in how things run day-to-day, and influence bigger decisions good, regular attendance at various involvement meetings/patients council/committees better understanding and dialogue between staff and patients Feedback Action Plans (actions that roll over 3months escalated to Associate Director of Nursing Significant improvements to services due to patient feedback (evidenced in Board reports) The first NHS organisation to post stories and feedback from patients in a secure forensic setting on Care Opinion. This could be replicated in any inpatient service.

  3. Five of the most important things we learned

  4. FIND THE CHAMPIONS in positions of influence and secure their commitment to the work early on. Choose carefully what to ask of them so that it has most impact

  5. BUILD TRUST BY SHOWING WHAT YOU RE CHANGING It takes a lot of faith for patients to be open about their experiences, especially when they are negative, and the patient will remain in your care. Ensure that patients see what has happened as a result of them giving feedback.

  6. PERSEVERE! Things that are worth doing, don t usually happen quickly or easily! We changed our culture, but it required perseverance and energy.

  7. VOLUNTEERS ARE INVALUABLE Service user volunteers are able to build long-term rapport and trust with patients and it is this trust and rapport that means they capture the richest, most honest and intimate feedback.

  8. SHOW AND TELL Once you ve made it work in one service, be quick to share it with others. None of what we did was rocket science it has started to work elsewhere already, and it could work in lots of other services.

  9. We have to be brave and transparent in exposing situations where things are not right in our services. We will do whatever we can to work with patients to make things better, and when there are things we can t change, I expect staff to give honest answers not to give false hope, or to shy away from a problem. Head of Clinical Operations

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