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Building capacity and capability to involve:
A report from the Patient and Public Involvement (PPI)
Learning and Development Project to NHS South West
Verity Sutcliffe, Project Lead
NHS
�
Acknowledgements
Thankstoeveryonewhohastakenthetimetoengagewith,andsupporttheprojectwiththeirvaluablecontributions.
Thanksto:• MembersoftheoriginalProjectTeam:TraceySweet,DrewWallbank,RachelAbel,
PhilippaDowling,GillGant,PatHair,LizHankin,SueLatham,LynneParamor,andKathTaylor.
• HowardLawes,ChristineWhiteheadandNHSSouthWestforsupportingtheprojectregionally.
• SouthDevonHealthcareNHSFoundationTrustforhostingtheprojectandcolleaguestherefortheirencouragement.
• The following for sharing their stories to create the staff guide on the benefits of involvement:GeoffKing,RachaelGlasson,JackyYoungman,PaulEllis,EmmaPateman,MarkNorman,JasonHepple,SherrieHitchen,andNigelLawrence.
• Thefollowingfortheirtime,effortandinsight,intheproductionof‘Making a Change’ an introduction to getting involved for patients, users and carers:NickHewling,TinaNorman,GwenButcher,AndyPalmer,KevinParish,TracyRobertsandSheilaTreadaway.
• AlisonLearforhercontinuousenthusiasm.
• AspecialwordofthankstoFinHeathformaintainingtheprojectsdrive,hisconstantsupportandhumour.
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Content
�. ExecutiveSummary pg.4�. Introduction pg.5�. Whatisinvolvement? pg.64. Whyinvolve? pg.75. Howisinvolvementandlearningaboutinvolvementcurrently
beingdelivered?pg.9
6. Howlearninganddevelopmentcansupportchange pg.��7. Apatientandpublicinvolvementlearninganddevelopment
frameworkpg.�4
8. Recommendationsforsustainability pg.�79. Appendices
A. DetailedPPIlearninganddevelopmentframeworkB. ActionsforconsiderationC. PPIKSFmatrixD. TransferableskillsrelevanttoPPIE. Whatislearninganddevelopment?F. Introductiontogettinginvolvedforpatients,users,carersG. A guide for staff on the benefits of involvement H. Projectoutline
pg.�0pg.�0pg.��pg.��pg.�5pg.�6pg.44pg.56
�0. References pg.59
4
1. Executive Summary
Thisreportprovidesinformation,guidanceandsupporttothosewhowishtodevelopcapacityandcapabilitytodeliverinvolvementandpatient/client-ledservices.ItreportsontheworkofthePatientandPublicInvolvement(PPI)LearningandDevelopmentProjectfundedbyNHSSouthWest.Thisprogrammeofworkwascommissionedtoestablishasustainableframework for learning and development in relation to PPI, defining what current and future healthandsocialcarestaff,aswellaspatients,carersandthepublicwhowishtobeinvolved,needtoknowinorderforinvolvementtobecomeaneffectivedaytodayrealitywithinourorganisations.
For the purpose of clarity the report begins by defining involvement. The rationale for involvementisdiscussedhighlightingtheseactivitiesascentraltotheachievementofmodern,successful,healthandsocialcareservices.
Anoverviewofprogressmadebyhealthandsocialcareorganisationsinregardstoinvolvementandtheprovisionoflearningopportunitiessurroundinginvolvementisprovided,demonstratingtheextentofculturalchangerequiredinordertodeliver.Therationaleforincreasinginvolvementrelatedlearningopportunitiessothatourservicesmaybecometrulypatient/client-centredisputforward,signifyingthisareaasaworkforcedevelopmentpriority.
Alearninganddevelopmentframeworkforinvolvementispresented.Underpinnedbyasetofprinciples,theframeworkprovidesanoutlineofcompetencesrequiredtodeliverinvolvement,andAppendixA,givesadetaileddescriptionoftheknowledgeandskillsneededbythosewithdifferingresponsibilitiesfordelivery.Theframeworkisapracticalresourceforallthoseinterestedindevelopinginvolvementcapacityandcapability,includingindividualswhoareinterestedinenhancingtheirowncompetence.
Inordertobuildandsustaininvolvement-relatedlearninganddevelopmentasetofrecommendationsismadethatidentifyclearactionsforNHSorganisationsandtheirpartnersintheprovisionofeducationandlearning.Whilsttheserecommendationshaveahealthcarefocus,theirrelevanceandpotentialapplicationtosocialcareisapparent.
It is clear from the research and investigations undertaken, that there are significant opportunitiesforincreasingtheinvolvementcapacityandcapabilityofcurrentandfuturestaff,aswellaspatients,usersandthepublic.Iftheseopportunitiesarenottaken,healthandsocialcareorganisationswillcontinuetostruggleinthedeliveryofinvolvementandthepublicwillbecomeincreasinglydisenfranchisedfromsuchprocesses.
InadditiontothedetailedlearningframeworkAppendixA,furtherappendicesofthisreportcontainanumberofresourcesconsideredusefulforsustainingthisareaofwork,including:B. Actions for consideration–asetofpracticalsuggestionsfororganisationstoconsiderinbuilding
upontheirinvolvementrelatedlearninganddevelopmentopportunitiesC. A PPI KSF matrix–anoutlineoftheKSFdimensionsrelevanttoPPI D. PPI related transferable skills–highlightingthetransferablenatureofmanyoftheskillsneededto
deliverPPIE. What is learning and development?–Adescriptionofthedifferenttypeofopportunitieswithin
learninganddevelopmentF. An introduction to involvement for patients, users and carers–apracticalresourcetosupport
understandingofinvolvementandassiststaffinrecruitingpeopletobecomeinvolvedG. Aguideforstaffonthebenefitsofinvolvement–apracticalresourcehighlightingthepersonaland
professional benefits of involving for staffH. Project outline–fulldetailsoftheoriginalprojectoutline
5
2. Introduction
In�005fundingwassecuredfromtheWorkforceandLearningDirectorateoftheSouthWestPeninsulaStrategicHealthAuthority(SHA)forthePPILearningandDevelopmentProject.The Peninsula’s PPI Network had identified that the provision of PPI learning and development wasunequalacrosstheregion,andopportunitiestoembedinvolvementwithinformalandinformalsystemsoflearningunderutilised.
SouthDevonHealthcareNHSFoundationTrustagreedtohosttheprojectandinMay�006aprojectleadbeganworkonthefollowingkeyobjectives:
�. IdentifytherangeofPPIlearninganddevelopmentcurrentlyprovidedbyNHSorganisationsintheSouthWestPeninsula,NHSorganisationselsewhere,andorganisationsoutsidetheNHS.
�. IdentifywhatallstaffneedtoknowiforganisationsaregoingtodeliverPPIsuccessfully,andidentifythedifferingneedsofstaffwithparticularresponsibilitiesfordeliveringPPIlocally.
�. RecommendabaselineofPPIlearninganddevelopmenttoberegardedasmandatorybyallNHSorganisations,andfurtherlevelsoflearninganddevelopmenttobeprovidedasrequiredtomeettheneedsofdifferentstaffgroups,professions,patientsandthepublic.
4. RecommendthecorePPIcompetenciestobeincludedinthelearninganddevelopmentofcurrentandfuturehealthandsocialcarestaffthatisprovidedoutsidetheNHS,i.e.inpreandpostregistrationtrainingprovidedbyUniversities.
5. Recommendhow,andthedegreetowhich,patients,carers,andthepublicwillbeinvolvedinthedesign,deliveryandevaluationoftheagreedcurriculum.
ForfulldetailsoftheprojectobjectivespleaseseeAppendixH.
TheprojectwastimelywithinitialinvestigationshighlightinganumberofotherorganisationsconsideringthisareaasapriorityinthedevelopmentofPPI,includingTheNationalResourceCentreforInvolvement.Internationalconferencesontheinvolvementofserviceusersandcarersinformaleducationhighlightedtheextentofglobalinterest.
6
3. What is involvement?
Involvement,participation,engagement,consultation-thesearealllabelsforaseriesofmethodologiesandpracticesthatencouragepublicsectororganisationstoinvolvepatients,clients,serviceusers,carers,citizensandthepublicintheirwork.
There are several ways in which involvement has been classified and various working definitions are likely across teams and organisations. It is recognised that a shared understandingisimportantandintheinterestofclarityandforthepurposeofthisdocumentandtheresourceswithinit,thefollowingdistinctionismade:
Involvement in individual careInvolvementinindividualcarereferstotheapproachandtechniquesusedtoensurethatcareisprovidedasapartnershipbetweenthepatient,serviceuser,carerandtheprofessional(s).Examplesincludeshareddecisionmakingandselfcareinitiatives.
Involvement in evaluating, planning and developing services Involvementinevaluating,planninganddevelopingservicesreferstoarangeofactivitiesundertakentoseektheopinionofthosewhousehealthandsocialcareservices,aswellasthosewhohaveaninterestinhowthoseservicesaredelivered,inordertoworkinpartnershipwithproviderstoimproveservicesforthefuture.
Inbothcasesinvolvementisaboutplacingequalvalueontheexpertisethatpeople–betheyusersorprofessionals–bringtothetable.
Itisclearthatthesetwotypesofinvolvementareinterdependent.Itisunrealistictoenvisagearobustsystemofactivepublicengagementinthedevelopmentofserviceswherepatientsremainpassiverecipientsofcareintheirindividualinteractionswithservices�.Thisprojectispremiseduponthisassertionandseesthedevelopmentofskillsandcompetenceinbothareasascriticalforthesuccessfuldeliveryofpatientandclient-ledservices.
� ForfurtherdiscussionseeCoulter(�006)
7
4. Why involve?
Involvementisnotnew,howeveritsintegrationasacentralresponsibilityofpublicsectorprovidersandcommissionersisunprecedented.
Health and social care policy is firmly committed to changing the relationship it has with its ‘consumers’fromonewherethingsaredonetoandforpatientsandclients,tooneinwhichpeople work together for health and well being. This represents a significant shift in working practicesandculturesthathavebeenestablishedovermanyyears,andrequireschangeamongstindividuals,teamsandorganisations.
Itisimpossibletoreadgovernmentpolicyorguidancewithoutinvolvedcitizensappearingasacentralthemeforallpublicsectororganisations.EachofthekeyhealthreformpaperssincetheNHSPlanhasreiteratedthatindividualsandtheircommunitiesareatthecentreofmodernprovision.FromthecentralroleofpatientvoiceinthestrengthenedcommissioningprocessesofPCTsandgeneralpractices,tothegrowthofdirectpayments�,pilotingofindividualisedbudgets�andexpansionoftheExpertPatientProgramme(EPP),itisapparentthatfarfrombeing a policy whim, involvement is most definitely here to stay.
Supportforthesepoliciesdoeshowevercomefromdifferingperspectives.Thevalueofinvolvingforsomeisrootedintheoriesofdemocracy,thesocialmodelofdisabilityandhealth.Hereinvolvingserviceusersandcarersisinextricablylinkedtoissuesofpowerandredressingasystemthatinthepasthasbeenunequal,indeeddiscriminatory.Forothersitistheapplicationofmarketingandbusinessprinciples,whereorganisationsmustbeawareoftheneedsoftheircustomersandprovideaservicethatbestmeetstheseneeds.Wouldabigretailerconsiderlaunchinganewserviceorproductwithoutconsultingitscustomers?Hereinvolvement is not about power but rather the added value it provides in being an efficient and effectiveprovider.Thesedifferingvaluebaseshavebeendescribedasthedemocraticandconsumeristapproachesrespectively4.
Thestrengthofdriverstochangeourcurrentsystemsofhealthandsocialcare,isveryapparent.Societalchangewherepassivityintheconsultationroomisnolongeraccepted,the sanctity of professional identity questioned, high profile investigations i.e. the Bristol inquiry;growthintheprevalenceoflong-termconditionsandtechnicaladvancesinhealthcareallmeanourcurrentsystemsofprovisionareunsustainable.Toinvolveandempowerpopulationstoshapehealthpoliciesandprioritiesaswellastoachieveindividualhealthandwellbeingisclearlyseenasanimportantpolicyprincipleforthesustainablesystemsofthefuture5.
The policy context is backed firmly by the performance framework. The Health and Social CareAct(�00�),requiresNHSorganisationstoconsultwithlocalpopulationsindecisionssurrounding the planning and development of services. In the first case of its type a DerbyshirePCTwasrequiredtooverturnadecisionregardingtheprovisionofGPservicesundertheAct,andplansareafoottostrengthenthislegalrequirement6.
� Forfurtherinformationondirectpaymentssee:www.dh.gov.uk/en/Policyandguidance/Organisation-policy/Financeandplanning/Directpayments/index.htm
� PilotingofindividualbudgetswasannouncedinOurHealth,OurCare,OurSay–DepartmentofHealth(�006a)
4 ForfurtherdiscussionseeBegum(�006)andRoseetal(�00�)5 WHO(�006)6 DepartmentofHealth(�006b)
8
Standards for Better Health (2006)�thekeyregulatoryframeworkforNHSorganisations,stipulatestheneedforinvolvement.CoreanddevelopmentalstandardsappearinboththePatient Focus andAccessible and Responsive Caredomainsmakinginvolvementpracticecentraltocorebusiness.Thedevelopmentstandardsarelikelytoposeachallengetoorganisationswhentheybecomearequirementin�008/9.ThroughperformanceindicatorsandtheDeliveryImprovementStatementtheCommissionforSocialCareInspectionhasforseveralyearsmonitoredsocialcareorganisationsinvolvementpractice.FurthermoretheHealthcareCommissionandCommissionforSocialCareInspectionaredevelopingjointperformance measures with the specific aim of determining what measurable differences have occurredasaresultofinvolvement.
7 DepartmentofHealth(�006c)
9
5. How is involvement and learning about involvement currently being delivered?
Whilsttherearepocketsofgoodpracticeacrosstheregionandnationally,thedeliveryofinvolvementasamainstreamedactivityoforganisations,apacewithpolicyandperformancerequirements,isnotevident.Ratherthanbeingembeddedinthedaytodayactivityofhealthandsocialcareorganisations,involvementhasbeendescribedasamarginalactivitylargelydependentonthecommitmentofindividualmanagers8.Evidencefrompatientsurveysdemonstrates that an active role for patients in their own healthcare is not sufficiently recognised orsupportedbyprofessionals9andalthoughthereareresourcesavailabletosupportstaffandpatients,toachieveshareduseoftheserequiresgreaterawarenessandtraining�0.
Therehasbeenlittleresearchandevaluationintotheimpactandoutcomesofinvolvementintheevaluation,planninganddevelopmentofservices,��withthemajorityofdiscoursecentredonprocess��andonlyasmallnumberofreportsattributingchangetotheinvolvementofserviceusersandcarers��.TherecentHealthSelectCommitteeonPPI�4concludedthatstructuresandprocesseswillhavelittleeffectifthehealthserviceisnotpreparedtolistenandmakechangesasaresultofwhatitlearns.Thedearthofevidencebreedsuncertaintyabouttherealityofinvolvingandenablesindividualstoquestionitsvalidity.
Thereisgrowingevidencetosupportandguideinvolvementinindividualcare.Selfcareinitiativeshavebeenshownto:improvehealthandqualityoflife,increasepatientsatisfactionand have a significant impact on the use of services�5.Howeverthepressureanddemandsofprovidingservicesinaclimateoftargetshavebeendescribedasbarrierstointroducingnewideasanddecreaseopportunitiesforselfcare�6.
Analysisandreviewsconsistentlyhighlightorganisationalcultureandprofessionalbarriersaskeytohowwellinvolvementisdeliveredwithinanorganisation.ChangingthenegativeattitudesofsomeprofessionalsregardinginvolvementhasbeendescribedasthegreatestchallengeforthefutureofPPI�7,andafacilitativeorganisationalcultureasthemostimportantfactorforsuccess�8.
Thereisatensionbetweenthedemocraticapproachtoinvolvementcentredontherights,perspectivesandneedsofserviceusersandcarersandtheconsumeristapproachfocusedontheneedsoforganisations.Thistensionhasthepotentialtoaffecttheprogressandoutcomesofinvolvementactivity,particularlyifsharedunderstandingandexpectationsarenotsuccessfullymanaged.Abasicprincipleforgettinginvolvementrightandovercomingthesetensionsisclarityofaim,honestyaboutscopeforchangeandensuringallthatareinvolvedareawareofthisfromtheoutset�9,�0.
8 Rose et al (�00�)Roseetal(�00�)9 Hasmanetal(�006)�0 DepartmentofHealth(�005a)�� Carr(�004)�� CommissionforHealthImprovement(�004)�� Crawfordetal(�00�)�4 HouseofCommonsCommittee(�007)�5 DepartmentofHealth(�005a)�6 DepartmentofHealth(�006d)�7 DepartmentofHealth(�004a)�8 Roseetal(�00�)�9 Crawford(�00�)�0 Carr(�004)
�0
The lack of awareness of involvement outside areas that have specific responsibility for deliveryorahistoryofinvolving,andthepartialprogressmadetowardsmainstreamingpractice,isinpartsymptomaticofthelimitedlearninganddevelopmentopportunitiesavailabletostaffandthepublictoincreasetheirunderstandingofthis‘new’systemofworking.Underdeveloped skills and competence amongst staff have been identified as one of five key issuesinthemainstreamingofinvolvement��.
Itisnotonlythecompetenceofstaffandpublicsectororganisationsthatrequiresdevelopinginordertodeliverrequiredchange,butalsotheknowledgeandskillsofpatients,usersandcarersthatmustbeinvestedin��,��.Theneedforanationalefforttoenhancetheselfcareskillsofthepublichasbeencalledfor�4.Provisionoflearningneedstogobeyondbasicskillsandtechniquesandincludeleadershipdevelopment,aswellasopportunitiesformentoringandshadowingtoensureasustainablesystemevolves�5.
Researchforthisprojectinvestigatedtheopportunitiesforlearningsurroundinginvolvementlocally,regionallyandnationally.Itisapparentfromthisexaminationthatprovisionisminimal. Nationally a diverse range of organisations was found to offer involvement specific trainingincludingNHSprovidertrusts,PCTs,voluntaryorganisations,privateconsultantsanduniversities.Acrossthesouthwestpeninsulaopportunitiescanbedescribedaslimitedandprovision generally ad hoc. These findings are supported by the literature�6wherealthoughthetrainingofstaff,particularlybyserviceusersandcarershasbeenhighlightedasakeycomponentforthesuccessfuldeliveryofinvolvement�7,examplesofpracticearelimited.SeeSection6forfurtherdiscussionofserviceuserandcarerinvolvementwithinlearninganddevelopment.Involvementwasalsofoundtofeatureasatopicwithinotherformallearningopportunitiesi.e.managementtrainingandpreandpostregistrationclinicaltraining.ItisakeyprincipleinNursingcurricula�8andagrowingrequirementinmedicaleducationasoutlinedinGeneralMedicalCouncilguidance�9,�0,��.Theemphasiswithinprogrammesoninvolvementandtheoutcomesfromthislearninginregardstocompetencedevelopmentremainlargelyuntested.Furthermorewhathasbecomeknownasthe‘hiddencurriculum’–rolemodelsencounteredduringpracticelearningthatunderminethevalueplacedoninvolvementtheoryintheclassroom, is seen to play a significant part in the failure of involvement practices to become mainstream amongst newly qualified staff. Greater emphasis needs to be paid to overcoming thisphenomenoniftheopportunitiesofformaleducationaretoberealised��.Giventhebreadthofinvolvementactivityandthetransferablenatureofmanyoftheskillstoundertakeit��i.e.communication,itwouldseemwisetoembedinvolvementlearningacrossandwithinopportunities,ratherthanittobeseenasanisolatedtopicorskillset.
�� Pickenetal(�00�)�� Levin(�004)�� Reesetal(�006)�4 DepartmentofHealth(�006d)�5 HASCAS(�005)�6 Oldfield and Fowler (2004)�7 Roseetal(�00�)�8 NursingandMidwiferyCouncil(�004)�9 GeneralMedicalCouncil(�997)�0 GeneralMedicalCouncil(�00�)�� GeneralMedicalCouncil(�00�)�� Hasmanetal(�006)�� SeeAppendixDfordetailsofthetransferablenatureofmanykeyPPIskills
��
TheKnowledgeandSkillsFramework�4hasinvolvementcompetenceembeddedacrossitsdomains–seeAppendixCfordetails–andprovidesanexcellentopportunityforincreasingthecapacityandcapabilityoftheNHSworkforcetodeliver.Arecentconsultationonselfcarecompetencies�5,furtherhighlightstheperceivedneedatastrategiclevelforworkforcedevelopmentinthisarea.
Anumberofresourcesforindividualisedlearningwerefoundtobeavailable,includingwebbasedresources,journalarticles,guidancepapersandemaildiscussiongroups.Howeverthereislittleornoco-ordinationoftheselocallyornationallyandfortheaveragehealthandsocialcareprofessionalthereislittletimetoseektheseout,evenifthereisthedesiretolearn.Furthermorethereislittlecapacityformanagerstosupportanddriveindividuallearninggivencurrentservicepressures.
Forthoseinorganisationsseekingtoincreaselearninganddevelopmentopportunitiessurroundinginvolvementtherehasbeenlittlesupportintermsofguidance,neitherintermsofwhatpeopleneedtoknow,norinpracticalillustrationsofsuccessfultrainingorindividualisedlearningactivities.Thisiscompoundedbythefactthatlearninganddevelopmentcompetencedoes not appear in the majority of person specifications for those leading PPI. Furthermore therealityoflimitedopportunitiesforindividualstoundertaketrainingduetoresourcesandcapacity to release staff, results in PPI fighting to be heard in an overcrowded environment.
Itisclearthatchangingtheestablishedmethods,practicesandcultureofinstitutionsandindividuals is a significant challenge, a challenge that requires time, a long-term strategy andamultidimensionalapproach.Itisalsoapparentthatthelackofinvestmentinlearninganddevelopmentsurroundinginvolvementandthelimitedintegrationofpatientvoicewithinsystems of learning has played a significant role in the current delivery of involvement as a whole.
�4 DepartmentofHealth(�004b)�5 SkillsforHealthandSkillsforCare(�007)
��
6. How learning and development can support change
Learninganddevelopment�6isakeycomponentoforganisationaldevelopmentandthereforeacriticalarminthereformandmodernisationofhealthandsocialcare.In�005,DepartmentofHealthguidancetoHumanResourceDirectorshighlightedtheroleofworkforcedevelopmenttoenablestaffandemployerstofurtherdeveloptheknowledge,skillsandresourcefulnesstobringaboutthelevelofculturalchangeneeded�7.WorkforcereformisrecognisedaskeytoensuringworkpracticessupportapatientfocusedNHS,witheducationandtrainingthatisdesignedtosupportstaffcompetenciesandenablestafftodeliverchangesinpracticeandculture�8.Despitesuchendorsementsandthesimplefactthatorganisationsshouldprovidelearninganddevelopmentinsupportoftheirbusinessplans�9,opportunitiesforlearningaroundinvolvementremainlimited.
Akeystrategytosupportlearningsurroundinginvolvementistheinclusionofserviceusersandcarersinthedesign,deliveryandassessment(whereappropriate)oflearningopportunities.Interesthasgrownrapidlyinthisareawiththewhitepaper‘OurHealth,OurCare,OurSay’advocatingsuchroles40,thethirdinternationalconferenceonpatientvoiceinhealthcareeducationduetotakeplaceinNovember�0074�,andexamplesofinnovativeprojectsinbothDevon4�andCornwall4�.
ItisarequirementofallSocialWorkdegreeprogrammesinEnglandtoinvolveserviceusersandcarersaskeystakeholdersinprogrammedesignanddelivery44.Howevernohealthrelatedprogrammeshaveasimilarstipulation.MentalHealthnursinghasatraditionofinclusionwithindividualsandgroupsbeinginvolvedincourseplanning,practicelearningandassessment.Involvementherehasnotbeenrestrictedtotestimoniesofpersonalexperiencebuthasincludeddeliveringsessionsonlegislation,policy,treatments,advocacy,self-help,andself-management45.Inmedicaleducationtheuseofpatientsineducationisnotnew,buthastraditionallyreplicatedthepassiverelationshipsofatypicalconsultationroom.Despitethisthereisevidencethatdirectcontactwithpatientscancontributetothedevelopmentofclinicalreasoning,empathy,professionalattitudesandcommunicationskills46.
Assessmentisseentoposeaparticularchallengeinregardstoinvolvementinlearning,howeverwheredonewellitprovidesthebasisforculturalchangedemonstratingthattherecipientsofcareareregardedascentraltovalidatingcompetenceandquality47.Indeedthe involvement of service users in the assessment of qualified professionals is not unheard of48 and should be developed further. The process of 360 degree appraisal offers significant opportunities for the integration of patient voice, as recommended by the Chief Medical Officer in
�6 FordetailsoftherangeofactivitieswithinlearninganddevelopmentseeAppendixE�7 DepartmentofHealth(�005b)�8 DepartmentofHealth(�005c)�9 AuditCommission(�00�)40 DepartmentofHealth(�006a)4� Seewww.uclan.ac.ukforfurtherdetails4� LearningtoInvolveProject:AprojectjointfundedbyDevonCountyCouncil,DevonPartnership
Trust,RoyalDevonandExeterFoundationTrustandtheExeterCentreforVoluntaryServices4� TimeforChangeProject:AprojectmanagedbyCornwallCountyCouncil44 Levin(�004)45 Bassetetal(�006)46 Hasmanetal(�006)47 DepartmentForEducationandSkillsandDepartmentofHealth(�006)48 ForexampletheDoctor’sInterpersonalSkillsQuestionnaire(DISQ)
��
hisproposalsforstrengtheningthesystemtoassureandimprovetheperformanceofdoctors49.
Byprovidinglearningopportunitiesforfuturestaffacultureofpatient/client-centredcareisinstilledfromtheoutsetandthefoundationsofinvolvementcompetencebuilt.Forcurrentstaff,involvementlearningshouldbeginwithinductionprogrammes,clearlyestablishingafacilitativeorganisationalculturefromthebeginningofemployment.TherecentPCTFitnessforPurposeprogrammehighlightedtheneedforinvolvementcapacityatthemostseniorlevels50.Byofferingcurrentstaff,atalllevelsofanorganisation,tailoredopportunitiestobeginbutalsoincreaseskillsandunderstandingsurroundinginvolvement,capacityandcapabilitycanbeincreasedandtrulypatient/client-ledservicesdelivered.
InSection7,alearninganddevelopmentframeworkforinvolvementispresented,demonstratingthecompetencesthatareneededacrossorganisationstodeliverinvolvement.InSection8,asetofrecommendationsismadetobuildandsustainopportunitiesforinvolvementrelatedlearninganddevelopment.AppendixBprovidesaseriesofpracticalideasfororganisationstoconsiderwhentakingthisareaofworkforward.
49 DepartmentofHealth(�006e)50 DepartmentofHealth(�006f)
�4
7. A patient and public involvement learning and development framework
TheProject’sprincipalfocushasbeentoestablishasustainablelearninganddevelopmentframework, defining what current and future health and social care staff, as well as patients, carersandthepublic,needtoknowinorderforinvolvementtobecomearealitywithinourorganisations.Theframeworkhasbeencreatedasaresourceforthoseworkingtoincreaseinvolvementrelatedcompetenceaswellasforindividualslookingtoenhanceanddeveloptheirownabilities.
Theframeworkhasbeendevelopedinaccordancewiththefollowingprinciples:
• Tosupporthealthandsocialcareorganisationstobecomepatient/client-led• Toenhancepublicaccountabilitywithinorganisations• Tofacilitatecreativethinkingandpractice• Recognitionoftheneedtodevelopandsustaininvolvementcompetence• Recognitionthataneffectivesystemwillrequireindividualswithdifferinglevelsof
competence• To be flexible to change to ensure sustainability
Theframeworkisdesignedtobedevelopmental,encouragingenhancementbothacrossandwithineachdomainaccordingtoindividualandserviceneeds.Theframeworkisnotrigidorprescriptiveanddoesnotrequirealinearprogressionthroughdomains,areasandlevels. Rather it should be seen as a dynamic tool, encouraging flexibility and creativity in the constructionoflearningopportunitiesandtheintegrationofinvolvementrelatedcompetencedevelopment, outside of involvement specific learning and development.
Therearefourdomainseachcontainingthreeorfourkeyareasofcompetence(seepage�6foradiagrammaticrepresentationoftheframework).Withineachareatherearethreelevelsofpractice:introductory,intermediateandexperienced(seepage�5foradetailedexplanationofthese).Thelevelsillustratethebreadthofcompetenceneededacrossorganisationsinordertodeliverandsustaininvolvementanditisrecognisedthattheyrepresentahighlevelofexpectation.Howevertheyaredesignedasaguideandshouldnotbeseenasabsolutebutasinspirationinthedeliveryofhighqualityservices.
AllorganisationsshouldviewtheintroductorylevelwithinDomain 1. Understanding involvement,andtheintroductorylevelofArea 1: Working with patient/client feedback and commentinDomain 4: Sustaining and developing involvement,asmandatoryforalltheirstaff.FordetailsofthecompetenceswithineachdomainseeAppendixA.
Thedetailedcompetencieswithintheframeworkarewrittenprimarilyforcurrentandfuturestaffwithinhealthandsocialcareorganisations.Howeverwithdueregardtothenatureofinvolvementandpartnershipworking,thesecompetencesareseentomirrorthoseneededbypatients,carersandthepublic,albeitwiththeoccasionalshiftinemphasis.Theframework,whilstnotovertinitsapplicationforusersandcarers,shouldbeseenasaresourceforindividualsandtheorganisationsthatrepresentthem,toselectcompetencestheyfeelaremostrelevanttoindividualdevelopmentneeds.
�5
Introductory Level• Thisreferstothecompetencethatallmembersofstaffshouldhaveinapatient/client
ledservice• Theaimofthislevelistoensureabasicawarenessandenableapplicationwiththe
supervision/supportofothers
Intermediate Level • This refers to the competence those with a defined responsibility for involvement
shouldhaveinapatient/client-ledservice• Defined responsibility refers to:
(�)Apersonwhohasbeenselectedornominatedwithintheirteam/areaofworkto:lead,oversee,andsupportothersintheteamaroundinvolvement.(2) Team leaders/ those with managerial responsibility of a defined system or team and consequentlyresponsibilitytoensureinvolvementpracticesembeddedinpractice(�)Anindividualwhoserolerequirestheabilitytoregularlydeliverinvolvementinitiatives.Forexampleacommissionerorclinicalgovernancelead.
Experienced Level • Thisreferstotheskillsandknowledgethosewithaleadresponsibilityforinvolvement
withinanorganisationshouldhaveinapatient/client-ledservice.• Lead responsibility refers to a dedicated role or significant aspect of a role in a
managerialposition.Suchapersonwouldberesponsibleforleadingtheorganisation’soverallstrategyinregardstoinvolvement.
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8. Recommendations for sustainability
Theresearchandanalysisundertakenthroughoutthecourseofthisprojecthasculminatedinaseriesofrecommendationstoensureorganisationsbuildcapacityandcapabilitysurroundinginvolvementinordertodeliverpatient/client-ledservices.InadditiontotheserecommendationsAppendixBprovidesaseriesofpracticalideasfororganisationstoconsiderwhentakingthisareaofworkforward.
Therecommendationshavebeengroupedunderthefollowingheadings:
A. AllOrganisations–encompassingallthoseconcernedwithincreasinginvolvementcapacityandcapability
B. NHSSouthWest
C. NHSTrusts–includingprimarycare,acute,foundation,ambulanceandpartnership
D. Educationproviders–outsideNHSorsocialcareorganisations
A. All Organisations�. Ensurethatlearninganddevelopmentopportunitiesareavailablelocallyfortheservice
users/patientsandcarersitinvolves.
�. AdvocateforLINkstobeprovidersoflearninganddevelopmentopportunitiesforserviceusersandcarersinordertodevelopinvolvementskills,bothinregardstoinvolvementinindividualcareandinvolvementinevaluation,planninganddevelopment.
�. Advocatenationallyforthemandatoryinclusionofserviceusersandcarersinthedesign,development,deliveryandassessmentofhealthandsocialcareeducationandlearning–buildingontheexperienceofSocialWorkdegreeprogrammes.
4. Advocateregionallyandnationallyforanincreaseinresearchactivitysurrounding:a. theoutcomesofinvolvingserviceusersandcarersineducation,learningand
developmentb. themosteffectivemethodsforteachinginvolvementskillsi.e.shareddecision
makingc. the cost and benefits of involvement
5. AdvocateregionallyandnationallyforthedevelopmentofevaluatedresourcesthatsupportgroupandindividuallearningsurroundingPPI.ThisshouldincludearesourcepackofactivitiesthatcanbeincorporatedintoavarietyofLearningandDevelopmentprogrammesinsupportofinvolvementi.e.TheWestminsterActivitydevelopedbyClinicalGovernanceSupportTeam.ThiscouldbeseenasarolefortheNationalCentreforInvolvement.
6. UtilisetheresourcesdevelopedaspartofthePPILearningandDevelopmentProject,includingtheframework:KSFmatrix:Guidetogettinginvolvedforpatientsusersandcarers: A guide on the benefits of involvement for staff.
�8
B. NHS South West
�. UrgeallNHSorganisationstoincludethelearningofinvolvementskillsandcompetencewithinprogrammesofessentiallearninganddevelopment.
�. Commissionersofeducationshouldensureallpreandpostregistrationcurricula(whereappropriate)includeevidenceofcompetencedevelopmentin
a. involvementinindividualcareb. involvementintheevaluation,planninganddevelopmentofservices
�. Commissionersofeducationshouldrequireeducationproviderstoevidencetheinvolvementofserviceusersandcarersinprogrammedesign,development,deliveryandassessment.
4. TheDirectorateofPatientCareandNursingandtheDirectorateofWorkforceDevelopmenttoestablishandmaintainsystemsforworkingtoincreasethecapacityandcapabilityoftheworkforcetodeliverapatient-ledNHS.
5. Reviewtherecommendationsofthisreportanddecideuponnextstepsfortakingforward.
6. Reviewprogressagainsttherecommendationsofthisreportbytheendof�008.
C. NHS Trusts
�. Buildworkforcecapacityandcapabilitytodeliverinvolvementasapriorityinbecomingapatient-ledorganisation.
�. EstablishsustainablesystemsforjointworkingbetweenPPIandLearningandDevelopmentfunctionswithinorganisationsinordertoembedacrosslearningopportunities
a. thedevelopmentofinvolvementcompetenceamongststaffb. theinvolvementofserviceusersandcarersinthedesign,development,delivery
andassessment(whereapplicable)ofprogrammes.
�. Thecommissioningofhealthandsocialcareservicesshouldrequireeachprovidertodemonstrateevidenceofaworkforcethatiscompetentinregardstoinvolvementandthattherearelearningopportunitiesinplaceforcompetencetobedeveloped.
4. Developopportunitiesforpartnershipworkingacrosshealthandsocialcareorganisationsinregardsto
a. theprovisionoflearningtodevelopinvolvementcompetenceb. theinvolvementofserviceusersandcarersinthedesign,development,delivery
andassessment(whereapplicable)ofprogrammes.
5. Developsystemstomonitorandevaluateactivitiestoincreasethecapacityandcapabilityoftheworkforcetodeliverinvolvementandshareexperiences(bothsuccessesandfailures)withothers.
�9
6. Develop,maintainandsustainpartnershipswithusergroups,user-ledorganisationsandthevoluntarysector,tosupport
a. thedevelopmentofinvolvementcompetenceamongstpatients,users,carersandstaff
b. theinvolvementofserviceusersandcarersinthedesign,development,deliveryandassessment(whereapplicable)oflearningopportunities.
D. Education Providers
�. Developastrategytoensurethatinvolvementasatopicisincorporatedacrossthecurriculaofhealthandsocialcareprogrammes,includingadetailedactionplanofhowthiswillbeestablished,developedandmonitored.
�. Developastrategyforthesustainableinvolvementofserviceusersandcarersinthedesign,development,deliveryandassessmentofallhealthandsocialcareeducation,includingadetailedactionplanofhowthesesystemswillbedevelopedandmonitoredovertime.
�. Recognisethatbuildingcompetencearoundinvolvementshouldbeakeycomponentofinterprofessionallearningprovision.
4. Workwithhealthandsocialcareorganisationstoensurepracticeplacementssupportinvolvementandworktowardsovercomingthe‘hiddencurriculum’.
�0
Appendix A:
Detailed PPI Learning and Development Framework Theframeworkhasbeencreatedasaresourceforthoseworkingtoincreaseinvolvementrelatedcompetenceaswellasforindividualslookingtoenhanceanddeveloptheirownabilities.Itprovidesanoutlineofcompetencesrequiredtodeliverinvolvementaswellasadetaileddescriptionoftheknowledgeandskillsneededbythosewithdifferingresponsibilitiesfordelivery.
Theframeworkhasbeendevelopedinaccordancewiththefollowingprinciples:• Tosupporthealthandsocialcareorganisationstobecomepatient/clientled• Toenhancepublicaccountabilitywithinorganisations• Tofacilitatecreativethinkingandpractice• Inrecognitionoftheneedtodevelopandsustaininvolvementcompetence• Inrecognitionthataneffectivesystemwillrequireindividualswithdifferinglevelsof
competence• To be flexible to change to ensure sustainability
Theframeworkisdesignedtobedevelopmental,encouragingenhancementbothacrossandwithineachdomainaccordingtoindividualandserviceneeds.Theframeworkisnotrigidorprescriptiveanddoesnotrequirealinearprogressionthroughdomains,areasandlevels. Rather it should be seen as a dynamic tool, encouraging flexibility and creativity in the constructionoflearningopportunitiesandtheintegrationofinvolvementrelatedcompetencedevelopment, outside of involvement specific learning and development.
Therearefourdomainseachcontainingthreeorfourkeyareasofcompetence(seeoverpageforadiagrammaticrepresentationoftheframework).Withineachareatherearethreelevelsofpractice:introductory,intermediateandexperienced(seeoverpageforadetailedexplanationoflevels).Thelevelsillustratethebreadthofcompetenceneededacrossorganisationsinordertodeliverandsustaininvolvementanditisrecognisedthattheyrepresentahighlevelofexpectation.Howevertheyaredesignedasaguideandshouldnotbeseenasabsolutebutasinspirationinthedeliveryofhighqualityservices.
AllorganisationsshouldviewtheintroductorylevelwithinDomain 1. Understanding Involvement,andtheintroductorylevelofArea 1: Working with patient/ client feedback and commentinDomain 4: Sustaining and Developing Involvement,asmandatoryforalltheirstaff.
Thedetailedcompetencieswithintheframeworkarewrittenprimarilyforcurrentandfuturestaffwithinhealthandsocialcareorganisations.Howeverwithdueregardtothenatureofinvolvementandpartnershipworking,thesecompetencesareseentomirrorthoseneededbypatients,carersandthepublic,albeitwiththeoccasionalshiftinemphasis.Theframework,whilstnotovertinitsapplicationforusersandcarers,shouldbeseenasaresourceforindividualsandtheorganisationsthatrepresentthem,toselectcompetencestheyfeelaremostrelevanttoindividualdevelopmentneeds.
��
Introductory level• Thisreferstothecompetencethatallmembersofstaffshouldhaveinapatient/client
ledservice• Theaimofthislevelistoensureabasicawarenessandenableapplicationwiththe
supervision/supportofothers
Intermediate level • This refers to the competence those with a defined responsibility for involvement
shouldhaveinapatient/clientledservice• Defined responsibility refers to:
(�)Apersonwhohasbeenselectedornominatedwithintheirteam/areaofworkto:lead,oversee,andsupportothersintheteamaroundinvolvement.(2) Team leaders/ those with managerial responsibility of a defined system or team and consequentlyresponsibilitytoensureinvolvementpracticesembeddedinpractice(�)Anindividualwhoserolerequirestheabilitytoregularlydeliverinvolvementinitiatives.Forexampleacommissionerorclinicalgovernancelead.
Experienced level • Thisreferstotheskillsandknowledgethosewithaleadresponsibilityforinvolvement
withinanorganisationshouldhaveinapatient/clientledservice.• Lead responsibility refers to a dedicated role or significant aspect of a role in a
managerialposition.Suchapersonwouldberesponsibleforleadingtheorganisationsoverallstrategyinregardstoinvolvement.
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,PP
ILea
ds,
PP
Icha
mpi
ons,
non
-exe
cutiv
edi
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ors,
co
unci
llors
,mem
bers
and
gov
erno
rs,
volu
ntee
rs
*Thi
sar
eaa
ndle
veli
sse
ena
sm
anda
tory
•A
nun
ders
tand
ing
ofth
inki
ngs
urro
undi
ng
the
role
oft
hep
atie
nt/c
lient
incl
udin
gth
eorie
sof
act
ivat
edp
atie
nt/c
lient
,cho
ice,
se
lf-di
rect
eds
uppo
rt•
An
unde
rsta
ndin
gof
how
diff
eren
tsy
stem
sfo
rinv
olve
men
tope
rate
ino
wn
or
gani
satio
nan
dho
wth
eyc
anb
eof
su
ppor
t•
An
unde
rsta
ndin
gof
diff
eren
trol
esth
at
supp
orti
nvol
vem
enta
ndk
now
ledg
eof
lo
calc
onta
cts
•K
now
ledg
ean
dsk
ills
tod
irect
lyp
artic
ipat
e,
over
see
orm
anag
ean
org
anis
atio
ns
syst
ems
fori
nvol
vem
enti
.e.b
eing
re
spon
sibl
efo
rthe
col
latio
nof
PA
LS/
Com
plai
nts
data
fors
ervi
ceim
prov
emen
t•
An
unde
rsta
ndin
gof
the
chal
leng
es/
issu
ess
urro
undi
ngd
iffer
ents
yste
ms
of
invo
lvem
enta
ndm
etho
dsfo
rove
rcom
ing
them
•
An
activ
ere
latio
nshi
pw
itha
loca
land
re
gion
aln
etw
ork
ofin
divi
dual
sw
orki
ng
arou
ndin
volv
emen
t•
An
awar
enes
sof
par
tner
org
anis
atio
ns
syst
ems
fori
nvol
vem
enta
ndh
owth
eyc
an
beo
fsup
port
Dom
ain
2: In
volv
emen
t in
indi
vidu
al c
are
Intr
oduc
tory
In
term
edia
teEx
perie
nced
Are
a 1:
Und
erst
andi
ng in
volv
emen
t in
indi
vidu
al c
are
•Aw
aren
ess
ofin
volv
emen
tin
indi
vidu
al
care
i.e.
pat
ient
cen
tred
appr
oach
,sel
fca
re•
Rec
ogni
sing
ser
vice
use
rsa
ndc
arer
sca
nbe
/are
exp
erts
inth
eiro
wn
cond
ition
•
Rec
ogni
sing
the
psyc
hoso
cial
con
text
of
the
patie
nt/c
lient
/car
ere
xper
ienc
e•
Awar
enes
sof
gov
ernm
entp
olic
yin
rega
rd
toin
volv
emen
tin
indi
vidu
alc
are
•W
ays
ofin
volv
ing
patie
nts/
clie
nts/
car
ers
inin
divi
dual
car
ei.e
.sha
red
deci
sion
m
akin
g•
Way
sof
invo
lvin
gpa
tient
s/c
lient
s/c
arer
sin
indi
vidu
alc
are
inm
yar
eao
fwor
ki.e
.in
apr
imar
yca
res
ettin
g•
Awar
enes
sof
issu
ess
urro
undi
ngri
skin
re
gard
toin
volv
emen
tin
indi
vidu
alc
are
Und
erst
andi
ng in
volv
emen
t in
indi
vidu
al c
are
•U
nder
stan
ding
risk
:ass
essm
ent,
taki
nga
nd
man
agem
ent,
and
itsim
pact
on
invo
lvem
ent
inin
divi
dual
car
e•
Und
erst
andi
ngw
hen
and
how
toin
volv
ein
in
divi
dual
car
e•
Und
erst
andi
ngg
over
nmen
tpol
icy
inre
gard
to
invo
lvem
enti
nin
divi
dual
car
e•
Awar
enes
sof
the
evid
ence
bas
esu
rrou
ndin
gin
volv
emen
tin
indi
vidu
alc
are
•U
nder
stan
ding
the
role
ofh
ealth
edu
catio
nan
dpr
omot
ion
with
inin
volv
emen
tin
indi
vidu
alc
are
•R
ecog
nisi
ngth
esh
ortt
erm
cos
tsfo
rlon
gte
rm b
enefi
ts o
f inv
olvi
ng p
eopl
e in
thei
r ow
n ca
re
Und
erst
andi
ng in
volv
emen
t in
indi
vidu
al c
are
•S
uppo
rting
team
san
dde
partm
ents
to
inve
stin
the
shor
tter
mc
osts
forl
ong
term
ben
efits
of i
nvol
ving
peo
ple
in th
eir
own
care
•P
rom
ote
and
ensu
rea
cul
ture
of
invo
lvem
enti
nin
divi
dual
car
ew
ithin
team
,dep
artm
enta
nda
cros
sor
gani
satio
n•
Up
tod
ate
know
ledg
eof
the
evid
ence
ba
ses
urro
undi
ngin
volv
emen
tin
indi
vidu
alc
are
Are
a 2:
Ski
lls to
pro
mot
e in
volv
emen
t in
indi
vidu
al c
are
•E
xpla
inro
le,r
espo
nsib
ilitie
san
dac
coun
tabi
lity
top
atie
nt/c
lient
/car
er•
Res
pect
dig
nity
,wis
hes
and
belie
fs•
Ask
pat
ient
/clie
nts
abou
tthe
irpr
efer
ence
san
dun
ders
tand
them
•K
eep
patie
nts/
clie
nts/
car
ers
info
rmed
an
dup
date
dab
outt
heir
care
•E
ncou
rage
indi
vidu
als
tod
oas
muc
has
ab
lein
rega
rdto
thei
rcar
e•
Com
mun
icat
ein
form
atio
non
risk
and
pr
obab
ility
with
sup
port
from
oth
ers
•A
cta
sa
care
reso
urce
forp
atie
nts/
clie
nts/
ca
rers
•P
rom
ote
self
care
ski
llsto
pat
ient
s/c
lient
s/
care
rs•
Iden
tify
patie
nt/c
lient
cen
tred
goal
s•
Sha
red
ecis
ions
with
pat
ient
s/c
lient
s/c
arer
sra
ther
than
pre
scrib
e•
Sel
ecta
ppro
pria
tea
ppro
ache
s/m
etho
ds/
tech
niqu
esin
line
with
indi
vidu
aln
eeds
•
Rec
ogni
seth
atp
eopl
esa
bilit
ies
and
desi
re
tob
ein
volv
edin
thei
rcar
em
ayc
hang
eov
er
time
•O
btai
nin
form
edc
onse
nt•
Und
erst
andi
ngo
f‘m
otiv
atio
nali
nter
view
ing’
te
chni
ques
and
thei
ruse
inin
volv
ing
indi
vidu
als
inth
eiro
wn
care
•C
halle
nge
prac
tice
that
doe
sno
tinv
olve
pa
tient
s/c
lient
s
•M
odel
and
dem
onst
rate
too
ther
sm
etho
dso
finv
olvi
ngin
divi
dual
sin
thei
row
nca
re•
Sup
port
othe
rsin
the
deve
lopm
ento
fth
eirs
kills
toin
volv
ein
divi
dual
sin
thei
row
nca
re•
Cre
ate
ane
nviro
nmen
tin
whi
chri
skis
as
sess
eda
ndm
anag
ede
ffect
ivel
yin
su
ppor
tofi
nvol
vem
enti
nin
divi
dual
car
e
�6
Are
a 3:
Sys
tem
s an
d pr
oces
ses
to fa
cilit
ate
invo
lvem
ent i
n in
divi
dual
car
e•
Awar
enes
sof
the
reso
urce
sto
sup
port
invo
lvem
enti
nin
divi
dual
car
ei.e
.Dip
ex
web
site
,loc
al/r
egio
nal/
natio
nals
uppo
rtgr
oups
•
Awar
enes
sof
lear
ning
and
dev
elop
men
tpr
ogra
mm
esto
sup
port
invo
lvem
ent
inin
divi
dual
car
ei.e
.Exp
ertP
atie
nt
Pro
gram
me,
WiP
PS
elfC
are
Ski
lls
train
ing,
pow
erq
uest
ions
•
Awar
enes
sof
dire
ctp
aym
ents
and
in
divi
dual
ised
bud
gets
(soc
ialc
are)
•Aw
aren
ess
ofE
ssen
ceo
fCar
epr
ogra
mm
e(N
HS
)
•Aw
aren
ess
ofth
edi
ffere
nta
ppro
ache
sth
at
supp
orti
nvol
vem
enti
nin
divi
dual
car
ein
di
ffere
nts
ettin
gsi.
e.a
cute
,prim
ary
care
•M
aint
ain
cont
acts
with
loca
lpro
vide
rso
fle
arni
nga
ndd
evel
opm
entp
rogr
amm
esto
su
ppor
tinv
olve
men
tin
indi
vidu
alc
are
i.e.
Exp
ertP
atie
ntP
rogr
amm
e•
Sup
port
indi
vidu
als
toe
nrol
inle
arni
ng
and
deve
lopm
entp
rogr
amm
esto
sup
port
invo
lvem
enti
nin
divi
dual
car
e•
Sup
port
indi
vidu
als
ina
cces
sing
reso
urce
sto
sup
port
invo
lvem
enti
nth
eiro
wn
care
i.e.
su
ppor
tgro
ups,
web
site
s
•U
nder
stan
dth
edi
ffere
nta
ppro
ache
sth
at
supp
orti
nvol
vem
enti
nin
divi
dual
car
ein
di
ffere
nts
ettin
gsi.
e.a
cute
,prim
ary
care
•A
dvoc
ate
acro
ssth
ehe
alth
and
soc
ial
care
com
mun
ityfo
rthe
pro
visi
ono
fle
arni
nga
ndd
evel
opm
ento
ppor
tuni
ties
that
sup
port
invo
lvem
enti
nin
divi
dual
car
ei.e
.Exp
ertP
atie
ntP
rogr
amm
e•
Ens
ure
info
rmat
ion
onlo
cala
ndn
atio
nal
reso
urce
sto
sup
port
indi
vidu
als
tob
ein
volv
edin
thei
row
nca
re,i
sav
aila
ble
for
staf
facr
oss
depa
rtmen
t/or
gani
satio
nto
su
ppor
tpat
ient
s/c
lient
s/c
arer
s
�7
Are
a 3:
Sys
tem
s an
d pr
oces
ses
to fa
cilit
ate
invo
lvem
ent i
n in
divi
dual
car
e•
Awar
enes
sof
the
reso
urce
sto
sup
port
invo
lvem
enti
nin
divi
dual
car
ei.e
.Dip
ex
web
site
,loc
al/r
egio
nal/
natio
nals
uppo
rtgr
oups
•
Awar
enes
sof
lear
ning
and
dev
elop
men
tpr
ogra
mm
esto
sup
port
invo
lvem
ent
inin
divi
dual
car
ei.e
.Exp
ertP
atie
nt
Pro
gram
me,
WiP
PS
elfC
are
Ski
lls
train
ing,
pow
erq
uest
ions
•
Awar
enes
sof
dire
ctp
aym
ents
and
in
divi
dual
ised
bud
gets
(soc
ialc
are)
•Aw
aren
ess
ofE
ssen
ceo
fCar
epr
ogra
mm
e(N
HS
)
•Aw
aren
ess
ofth
edi
ffere
nta
ppro
ache
sth
at
supp
orti
nvol
vem
enti
nin
divi
dual
car
ein
di
ffere
nts
ettin
gsi.
e.a
cute
,prim
ary
care
•M
aint
ain
cont
acts
with
loca
lpro
vide
rso
fle
arni
nga
ndd
evel
opm
entp
rogr
amm
esto
su
ppor
tinv
olve
men
tin
indi
vidu
alc
are
i.e.
Exp
ertP
atie
ntP
rogr
amm
e•
Sup
port
indi
vidu
als
toe
nrol
inle
arni
ng
and
deve
lopm
entp
rogr
amm
esto
sup
port
invo
lvem
enti
nin
divi
dual
car
e•
Sup
port
indi
vidu
als
ina
cces
sing
reso
urce
sto
sup
port
invo
lvem
enti
nth
eiro
wn
care
i.e.
su
ppor
tgro
ups,
web
site
s
•U
nder
stan
dth
edi
ffere
nta
ppro
ache
sth
at
supp
orti
nvol
vem
enti
nin
divi
dual
car
ein
di
ffere
nts
ettin
gsi.
e.a
cute
,prim
ary
care
•A
dvoc
ate
acro
ssth
ehe
alth
and
soc
ial
care
com
mun
ityfo
rthe
pro
visi
ono
fle
arni
nga
ndd
evel
opm
ento
ppor
tuni
ties
that
sup
port
invo
lvem
enti
nin
divi
dual
car
ei.e
.Exp
ertP
atie
ntP
rogr
amm
e•
Ens
ure
info
rmat
ion
onlo
cala
ndn
atio
nal
reso
urce
sto
sup
port
indi
vidu
als
tob
ein
volv
edin
thei
row
nca
re,i
sav
aila
ble
for
staf
facr
oss
depa
rtmen
t/or
gani
satio
nto
su
ppor
tpat
ient
s/c
lient
s/c
arer
s
Dom
ain
3: In
volv
emen
t in
eval
uatio
n, p
lann
ing
and
deve
lopm
ent s
ervi
ces
Intr
oduc
tory
In
term
edia
teEx
perie
nced
Are
a 1:
Goa
l set
ting:
•Aw
aren
ess
ofth
eim
porta
nce
ofa
cle
ar
purp
ose
from
the
outs
eto
fany
invo
lvem
ent
initi
ativ
e
•U
nder
stan
ding
the
impa
cto
fthe
goa
lof
your
initi
ativ
e,o
nse
lect
ing
ana
ppro
pria
te
met
hodo
logy
•
Wor
king
inp
artn
ersh
ipto
set
and
agr
ee
goal
s
•S
uppo
rting
the
orga
nisa
tion
tos
etit
sor
gani
satio
nala
nds
trate
gic
goal
sfo
rin
volv
emen
tin
partn
ersh
ip
Are
a 2:
Met
hods
for i
nvol
ving
:•
Awar
enes
sof
the
varie
tyo
fmet
hods
for
invo
lvin
gi.e
.rep
rese
ntat
ion
onc
omm
ittee
s•
Awar
enes
sof
the
prin
cipl
esfo
rsel
ectin
ga
met
hod
depe
ndin
gon
the
goal
ofi
nvol
vem
ent
and
the
cont
exto
fini
tiativ
ei.e
.loo
king
at
ser
vice
rede
sign
ord
evel
opin
ga
new
in
form
atio
n le
aflet
Met
hods
for i
nvol
ving
:•
Dev
elop
eds
kills
ina
num
bero
fin
volv
emen
tmet
hods
i.e.
que
stio
nnai
re
desi
gn•
Und
erst
andi
ngth
eap
plic
abili
tyo
fcer
tain
m
etho
dsfo
rdiff
eren
tgro
ups
i.e.c
hild
ren,
se
ldom
hea
rdg
roup
s•
Sup
porti
ngo
ther
sto
dev
elop
ski
lls
inin
volv
emen
tmet
hods
i.e.
thro
ugh
shad
owin
g
Met
hods
for i
nvol
ving
:•
Bre
adth
ofs
kills
ina
var
iety
ofi
nvol
vem
ent
met
hodo
logi
es•
Ran
geo
fski
llsa
ndk
now
ledg
efo
rinv
olvi
ng
dive
rse
grou
ps
Are
a 3:
Pla
nnin
g an
d de
liver
ing
an in
volv
emen
t ini
tiativ
e•
Get
ting
peop
lein
volv
ed–
indi
vidu
als,
gro
ups
•D
efini
ng ro
les
and
resp
onsi
bilit
ies
•S
harin
gex
pect
atio
nsi.
e.p
oten
tialf
orc
hang
e•
Impo
rtanc
eof
effe
ctiv
eco
mm
unic
atio
ni.e
.ja
rgon
free
•
Rem
uner
atio
n–
the
orga
nisa
tions
pol
icy
on
expe
nses
and
pay
men
t•
Awar
enes
sof
issu
ess
urro
undi
ng
repr
esen
tatio
n•
Awar
enes
sof
sou
rces
ofi
nfor
mat
ion
ong
ood
prac
tice
do’s
and
don
’ts
•U
nder
stan
ding
the
impo
rtanc
eof
in
volv
ing
dive
rse
grou
psa
ndin
divi
dual
s•
Rec
ogni
tion
of th
e ne
ed to
be
flexi
ble
and
deve
lopi
nga
ppro
ache
sac
cord
ingl
y
•A
dapt
ing
com
mun
icat
ion
met
hods
de
pend
ing
onin
divi
dual
and
gro
upn
eeds
•M
anag
ing
diffe
ring
expe
ctat
ions
am
ongs
tm
embe
rso
fag
roup
•M
anag
ing
conc
erns
ofr
epre
sent
atio
n•
Man
agin
gco
mpe
ting
inte
rest
s•
Ski
llsto
cha
lleng
ew
ithou
tbei
ng
conf
ront
atio
nal
•H
ighl
ight
ing
poor
pra
ctic
ean
dsu
ppor
ting
peop
leto
dev
elop
thei
rcom
pete
nce
•P
rovi
ding
sup
port
and
deve
lopm
ent
oppo
rtuni
ties
top
eopl
ebe
ing
invo
lved
•
Rec
ogni
sing
the
impo
rtanc
eof
gro
up
unde
rsta
ndin
g su
rrou
ndin
g co
nfide
ntia
lity
•G
ood
loca
lkno
wle
dge
ofg
roup
san
dor
gani
satio
nsto
invo
lve
from
div
erse
rang
eof
bac
kgro
unds
i.e.
gay
and
lesb
ian
grou
ps
•P
rovi
ding
gui
danc
ean
dsu
ppor
tto
othe
rsin
pl
anni
ngth
eiri
nitia
tive
�8
Dom
ain
4: S
usta
inin
g an
d de
velo
ping
invo
lvem
ent
Intr
oduc
tory
In
term
edia
teEx
perie
nced
Are
a 1:
Wor
king
with
pat
ient
/ clie
nt fe
edba
ck a
nd c
omm
ent
•H
earin
gan
dow
ning
feed
back
and
co
mm
ent
•D
ealin
gw
ithc
ritic
ism
•
Kno
win
gw
here
tota
kefe
edba
cka
nd
com
men
twith
iny
ourd
epar
tmen
t•
Awar
enes
sof
org
anis
atio
nals
yste
ms
forr
epor
ting
clie
nt/p
atie
ntfe
edba
cka
nd
com
men
t
*Thi
sar
eaa
ndle
veli
sse
ena
sm
anda
tory
•Id
entif
ying
tren
dsin
feed
back
and
com
men
t•
Taki
nga
ctio
non
feed
back
and
com
men
t•
Und
erst
andi
ngth
edi
fferin
gva
lues
pla
ced
upon
‘e
vide
nce
from
exp
erie
nce’
com
pare
dto
oth
er
type
s of
evi
denc
e i.e
. sci
entifi
c st
udie
s•
Awar
enes
sof
the
pow
ero
fpat
ient
/clie
nts
torie
s•
Sup
porti
ngo
ther
sto
wor
kw
ithp
atie
nt/c
lient
fe
edba
ck
•E
mbe
dpa
tient
/clie
ntfe
edba
cka
cros
sor
gani
satio
nalp
olic
yan
dpl
anni
ng
•E
mbe
dpa
tient
/clie
ntfe
edba
ckw
ithin
se
nior
man
agem
entp
roce
sses
Are
a 2:
Too
ls to
sus
tain
and
dev
elop
•R
ecog
nisi
ngth
ene
edto
revi
ewy
our
syst
ems
ofin
volv
emen
treg
ular
ly
•Im
porta
nce
ofc
omm
unic
atin
gou
tcom
eso
fin
volv
emen
tto
alli
nvol
ved
•N
HS
ON
LY-
Awar
enes
sth
atin
volv
emen
tem
bedd
eda
cros
sdi
men
sion
sof
KS
F
•K
now
ledg
ean
dus
eof
the
Pla
n,D
o,S
tudy
,Act
ap
proa
ch•
Rec
ogni
sing
the
valu
eof
usi
ngo
utpu
ts,
outc
omes
and
obj
ectiv
esfo
reva
luat
ing
invo
lvem
enta
ctiv
ity•
Und
erst
andi
ngth
edi
ffere
nce
betw
een
the
proc
ess
ofin
volv
emen
tand
its
impa
ct•
Pub
licis
ing
the
impa
ct/o
utco
mes
ofy
oura
ctiv
ity•
Und
erst
andi
nga
nda
pply
ing
nota
ble
prac
tice
•
Und
erst
andi
ng a
nd in
fluen
cing
pla
nnin
g/
com
mis
sion
ing
cycl
es•
Wor
king
with
new
gro
ups
•D
evel
opin
gsh
ared
und
erst
andi
ngo
fin
volv
emen
tacr
oss
partn
era
genc
ies
•Le
arni
ngto
take
and
man
age
pers
onal
risk
•P
roje
ctm
anag
emen
tski
lls
•C
reat
ive
thin
king
•S
uppo
rting
oth
ers
tole
arn
and
deve
lop
skill
san
dco
mpe
tenc
esu
rrou
ndin
gin
volv
emen
t•
NH
SO
nly
-Sup
porti
ngo
ther
sin
evi
denc
ing
thei
rKS
Fth
roug
hin
volv
emen
tact
ivity
•G
ener
atin
gev
iden
ceo
fwha
twor
ks
wel
lord
oes
notw
ork
inre
gard
sto
in
volv
emen
t•
Rec
ogni
tion
ofth
ene
edto
con
tinue
de
velo
ping
new
and
inno
vativ
ew
ays
toin
volv
e•
Lead
ersh
ips
kills
•
Dev
elop
ing
prot
ocol
sfo
rinv
olve
men
tw
ork
acro
ssp
artn
era
genc
ies
•E
nsur
ing
oppo
rtuni
ties
forl
earn
ing
abou
tinv
olve
men
tare
ava
ilabl
elo
cally
forp
atie
nts/
clie
nts/
car
ers
and
staf
f
�9
Are
a 3:
Invo
lvem
ent a
nd c
hang
e•
Rec
ogni
sing
invo
lvem
enta
sa
key
proc
ess
fors
usta
inab
lec
hang
e•
Rec
ogni
sing
that
con
flict
is n
atur
al in
cha
nge
proc
esse
s•
Und
erst
andi
ngo
fmet
hods
tom
easu
rec
hang
e•
Rec
ogni
sing
the
diffi
culti
es in
the
mea
sure
men
t of
cha
nge
•S
harin
gan
dce
lebr
atin
gch
ange
acr
oss
the
orga
nisa
tion
•R
ecog
nisi
ngth
eco
mpl
exity
ofc
hang
ein
the
publ
ics
ecto
r•
Sup
port
and
prom
ote
orga
nisa
tiona
lle
arni
ngfr
omin
volv
emen
tact
iviti
es
•P
rom
ote
acu
lture
ofe
volu
tion
and
refle
ctio
n in
rega
rd to
invo
lvem
ent
activ
ity
�0
Appendix B:
Actions for consideration
Inadditiontotherecommendationsoutlinedinthemainbodyofthereport,theprojecthasdevelopedanumberofpracticalsuggestionsfororganisationstoconsiderinregardstodevelopingworkforcecompetenceininvolvement.
A. NHS Trusts
�. Developa‘MindthePatientChecklist’thatenablesallnewandexistinglearninganddevelopmentprogrammestobeassessedfortheirpotentialinregardstoembedding
(a)involvementcompetencedevelopment(b)involvingserviceusersandcarersinthedesign,development,deliveryand
assessment(whereapplicable)ofprogrammes.
�. Investigatetheinvolvementofserviceusersandcarersinappraisalanddevelopmentreviewsforhealthandsocialcarestaffi.e.�60degreeprocesses,developingandevaluatingpotentialsystems.
�. Standardlearningoutcomesshouldbedevelopedtoenableinvolvementtobeembeddedacrosslearninganddevelopmentopportunities.TheseoutcomesshouldbelinkedtotheKSF.
4. Ensurethatinvolvementisfeaturedwithincorporateinductionprogrammesanddevelopinvolvementactivitiestofeatureaspartoflocalinductioni.e.‘conversations’5�,waitingroomobservations.
5. Developastandarddevelopmentalobjectivesurroundinginvolvementandencourageteams/departments/directoratestoincludethisasoneoftheiryearlyobjectives.
6. WorkwithNHSlibrary/resourcecentrestoestablishaninvolvementpackagethatsupportsindividualisedlearningandisannuallyreviewedandupdated
7. SupportindividualsinusingPPIworkasevidencetowardstheirKSFoutlines,developingacatalogueofexamplesthatcanbeusedtosupportothersindevelopingtheirPPIcompetenceandevidencingKSF.
8. Ensureallnewandreviewedjobdescriptionsareexplicitaboutindividual’sroleininvolvingusersandcarersbothwithinindividualcareandwithintheevaluation,planninganddevelopmentofservices.
9. PPILeadsshouldfacilitateandsupportthebuildingofrelationshipsbetweenusergroups,userledorganisations,thevoluntarysectorandlearninganddevelopmentteams.
�0.InvestigatethepotentialforsecondmentopportunitiesbetweenthoseworkingpredominatelyinPPIandthoseinLearningandDevelopmentteamsinordertodevelopskillsacrossthesectors.
5� ‘Conversations’arealisteningexercisebetweenstudentsandserviceusers/carersusedintheSocialWorkBAProgrammeatPlymouthUniversity
��
��.InvestigatethepotentialforshadowingopportunitiesbetweenthoseworkingpredominatelyinPPIandthoseinLearningandDevelopmentteamsinordertodevelopskillsacrossthesectors.
12. Make the development of PPI Learning and Development a specific aspect of a job role withintheorganisation.
��.DevelopandmaintainarelationshipwiththeNationalResourceCentreforInvolvementinregardstotheirlearningandsupportdomain.
�4.Developrelationshipswitheducationproviders,conferenceorganiserstoensureseminars,presentationsandeventssurroundingPPIcanbeaccessibletothoseintheSouthWestthroughtheuseofmoderntechnologyi.e.videolinks,podcasting.
�5.Investigateopportunitiesformakingstandardhealthandsocialcaretrainingprogrammesavailabletoserviceusersandcarerswhoareinvolvedwiththeorganisationi.e.computerskills,manualhandling.
B. The voluntary sector, including user-led organisation/ groups and LINks
�. Buildsustainablesystemsoflearningandsupportbetweenserviceusersandcarersi.e.buddyingandshadowing.
�. Learninganddevelopmentopportunities,tobuildthecompetenceofpatients,usersandcarerstodeliverinvolvement,shouldbevariedofferingbasicandintroductoryprovisionaswellasintermediateandleadershipcompetence.
��
Appendix C: PPI/ KSF Matrix
Are
a of
Involvement in individual care (Patient Involvement)
Involvement in evaluation, planning and development
(Public Involvement)
Esse
ntia
l KSF
D
imen
sion
s to
HealthandWellbeing�–Levels�-4HealthandWellbeing�–Levels�-4HealthandWellbeing�–Levels�-�HealthandWellbeing4–Levels�-4HealthandWellbeing5–Levels�-4HealthandWellbeing6–Levels�-4HealthandWellbeing7–Levels�-4
ServiceImprovement–Levels�-4
Und
erpi
nnin
g C
ore
Communication–Levels�-4
Quality–Levels�-4
EqualityandDiversity–Levels�-4
Health,SafetyandSecurity–Levels�-4
Spec
ific
KSF
dim
ensi
ons
with
re
leva
nce
HealthandWellbeing9–Level�HealthandWellbeing�0–Level4EstatesandFacilities�–Level�-4EstatesandFacilities�–Level�-4
Informationandknowledge�–Level�-4LearningandDevelopment–Level�-4
DevelopmentandInnovation–Level�-4CommissioningandProcurement–Level�-4
ProjectManagement–Level�-4PeopleManagement–Level�-4
CapacityandCapability–Level�-4PRandMarketing–Level�-4
��
App
endi
x D
:
Tran
sfer
able
ski
lls re
leva
nt to
PPI
Th
eta
ble
belo
wd
etai
lsth
esk
illsth
ata
rere
leva
ntto
the
deliv
ery
ofin
volv
emen
t,bu
ttha
thav
ew
ider
app
licab
ility
and
are
trans
fera
ble
too
ther
are
aso
fpra
ctic
e.T
heta
ble
isd
ivid
edin
toth
edo
mai
nso
fthe
lear
ning
and
dev
elop
men
tfra
mew
ork
asw
ella
sth
egr
oups
they
are
rele
vant
to
:All;
Pat
ient
s,u
sers
and
car
ers;
Sta
ff.
Dom
ain
1. U
nder
stan
ding
in
volv
emen
tD
omai
n 2.
In
volv
emen
t in
indi
vidu
al c
are
Dom
ain
3.
Invo
lvem
ent i
n ev
alua
tion,
pl
anni
ng a
nd d
evel
opm
ent
Dom
ain
4.
Sust
aini
ng a
nd d
evel
opin
g in
volv
emen
tTr
ansf
erab
le S
kills
for A
ll• P
artn
ersh
ipw
orki
ng
•Com
mun
icat
ion
skill
s•
Car
ers
awar
enes
s•
Cul
tura
law
aren
ess
•D
isab
ility
aw
aren
ess
•A
sser
tiven
ess/
con
fiden
ce
•C
omm
unic
atio
nsk
ills
•G
uide
tos
ourc
eso
finf
orm
atio
n•
Pro
vidi
ngin
form
atio
n•
Inte
rnet
as
aso
urce
ofi
nfor
mat
ion
•C
onfli
ct re
solu
tion
•C
arer
saw
aren
ess
•C
ultu
rala
war
enes
s•
Dis
abili
tya
war
enes
s•
Dea
ling
with
crit
icis
m
•D
ealin
g w
ith d
ifficu
lt pe
ople
•
Faci
litat
ion
skill
s•
Neg
otia
tion
skill
s•
Par
tner
ship
wor
king
•Te
amw
orki
ng
•A
sser
tiven
ess
and
confi
denc
e •
Cha
iring
mee
tings
•
Com
mun
ityd
evel
opm
ent
•C
ritic
ala
ppra
isal
•
Faci
litat
ion
skill
s•
Focu
sgr
oups
•
Pro
vidi
ngin
form
atio
n•
Inte
rnet
as
aso
urce
ofi
nfor
mat
ion
•In
terv
iew
tech
niqu
es
•B
eing
effe
ctiv
ein
mee
tings
•
Ope
nsu
rger
ies
•Q
uest
ionn
aire
des
ign
•R
esea
rch
skill
s•
Sur
vey
desi
gn
•C
halle
ngin
gw
ithou
tcon
front
atio
n•
Com
mun
icat
ion
skill
s•
Con
flict
reso
lutio
n•
Dea
ling
with
crit
icis
m
•D
ealin
g w
ith d
ifficu
lt pe
ople
•
Dev
elop
ing
cons
ensu
s•
Est
ablis
hing
role
san
dre
spon
sibi
litie
sin
ag
roup
•
Neg
otia
tion
skill
s•
Pre
sent
atio
nsk
ills
•P
roje
ctm
anag
emen
t•
Par
tner
ship
wor
king
•
Team
wor
king
•C
omm
unic
atio
nsk
ills
•C
halle
ngin
gba
dpr
actic
e•
Dev
elop
ing
cons
ensu
s•
Influ
enci
ng s
kills
•N
egot
iatio
nsk
ills
•M
easu
ring
outp
uts,
out
com
es
and
impa
ct•
Cha
nge
man
agem
ent
•Le
ader
ship
ski
lls•
Man
agem
ents
kills
•R
eflec
tive
prac
tice
•R
oute
cau
sea
naly
sis
•S
harin
gan
dce
lebr
atin
gch
ange
•
Sys
tem
sfo
rmon
itorin
gch
ange
•C
reat
ing
ale
arni
ng
envi
ronm
ent
�4
Tran
sfer
able
Ski
lls fo
r Pat
ient
s, U
sers
and
Car
ers
•E
mer
genc
y an
d fir
st a
id•
Cha
lleng
ing
prof
essi
onal
dec
isio
ns
•M
anua
lhan
dlin
g•
Med
icin
esa
ndth
eirm
anag
emen
t•
Pla
nnin
gfo
rem
erge
ncie
s•
Pra
ctic
alh
ouse
hold
man
agem
ent
•C
ompu
ters
kills
Tran
sfer
able
Ski
lls fo
r Sta
ff G
roup
s•C
usto
mer
car
e•
Bre
akin
gba
dne
ws
�5
Tran
sfer
able
Ski
lls fo
r Pat
ient
s, U
sers
and
Car
ers
•E
mer
genc
y an
d fir
st a
id•
Cha
lleng
ing
prof
essi
onal
dec
isio
ns
•M
anua
lhan
dlin
g•
Med
icin
esa
ndth
eirm
anag
emen
t•
Pla
nnin
gfo
rem
erge
ncie
s•
Pra
ctic
alh
ouse
hold
man
agem
ent
•C
ompu
ters
kills
Tran
sfer
able
Ski
lls fo
r Sta
ff G
roup
s•C
usto
mer
car
e•
Bre
akin
gba
dne
ws
Appendix E:
What is Learning and Development?
Learning and Development Category
Types Examples of subjects/ content
On-job learning and development
Reflective practice • Reflecting on own work• Supervision(e.g.
professional,clinical)Participating in specific areas ofwork
• Projectwork• Workattachments• Secondments• Workshadowing• ‘Acting-up’
Learningfromothersonthejob
• Receivingcoaching• Beingmentored
Learningfromdevelopingothers
• Coaching• Demonstrating• Teachingandtraining
Off job learning and development on one’s own
Distancelearning • Structuredstudymaterials• Writtenassignments
PrivateStudy • Readingjournalsandbooks• Researching• Writingarticlesandpapers
e-learning • Respondingtoquestionsandanswersinelectronicformat
• Searchingtheinternetforspecific information
• CD-rombasedinformation
Off job learning and development with others
Formalcourses • LearningEnglishasasecondlanguage
• Firstaid• Manualhandling• Anatomyandphysiology
Scenariobasedlearning • Whatifapproaches• Minutetaking
Roleplay • Chairingmeetings• Howtodealwithviolence
andaggressionLearningsets • For individuals in specific
typesofpostInduction • Introductiontothe
organisation• Healthandsafety
Conferences • Toidentifytrendsinarea
Reproducedfrom:TheNHSKnowledgeandSkillsFrameworkandtheDevelopmentReviewProcess,October�004
�6
Appendix F:
Making a Change: An introduction to getting involved for patients, users and carers
�7
�8
�9
40
4�
4�
4�
44
Appendix G:
A guide for staff on the benefi ts of involvement
45
46
47
48
49
50
5�
5�
5�
54
55
56
Appendix H:
1 Project Title “DevelopingaLearningandDevelopmentStrategyforPatient,CarerandPublicInvolvement”
2 Project Focus 2.1 ToestablishasustainableframeworkforPPIlearninganddevelopmentwithinthe
SWPeninsula.
3 Background �.� WithintheSWPeninsula,Patient&PublicInvolvement(PPI)isunderstoodasacoreobjective
fortheNHS.TheworkisvigorouslyledbytheStrategicHealthAuthorityandthereisanestablishedandeffectivenetworkofPPIleadsrepresentingallPCTsandTrusts.OverthelastthreeyearsNHSorganisationshavedevelopeddifferingapproachestostafftrainingonPPIandwhilsttherehasbeenausefulexchangeofideasandskillsbetweenPCTsandTrusts,thelevel,standardandaccesstothistrainingremainsvariable.Furthermore,thedegreetowhichPPIiscoveredintheSHA’scommissionedprogrammeofeducationisalsovariable.
3.2 The SHA’s Workforce and Learning Directorate has identified funding and South Devon HealthcareNHSTrustwillhostaprojecttoaddressthissituation.
4 Objectives4.� Reviewthecurrentnationalandlocalhealthandsocialcareperformancerequirementsin
relationtoPPI.
4.2 Consider the likely changes to these requirements over the coming five years. These are likely toincludechangesasaresultof• the“Choice”agenda• FoundationTrustdevelopments• changesinprovider/commissionerarrangements• increasingemphasisonworkingwithdiversegroups• thegreaterfocusonworkingwithhealthypeople• closerintegrationbetweentheNHSandSocialServices• promotingselfcare,e.g.ExpertPatientProgramme
4.� IdentifytherangeofPPIlearninganddevelopmentcurrentlyprovidedby• NHSorganisationsintheSWPeninsula• NHSorganisationselsewhere• OrganisationsoutsideoftheNHS
Inaddition,identifyareasofgoodpractice,innovationaroundarrangementsforprovidingtrainingandcosteffectiveness.
4.4 IdentifythecoreelementsofNHSorganisations’PPIstrategies,andrelevantlocalauthoritystrategies.
NHSSouthWestPeninsulaStrategicHealthAuthority
57
4.5 IdentifywhatallstaffneedtoknowifNHSorganisationsaregoingtodelivertheirPPIstrategiessuccessfully,andidentifythedifferingneedsofstaffwithparticularresponsibilitiesfordeliveringPPIlocally.
4.6 IdentifyareasofriskinNHSorganisations’currentandplannedfutureprovisionforlearninganddevelopment.
4.7 RecommendabaselineofPPIlearninganddevelopmenttoberegardedasmandatorybyallNHSorganisations,andfurtherlevelsoflearninganddevelopmenttobeprovidedasrequiredtomeettheneedsofdifferentstaffgroups,professions,patientsandthepublic.
4.8 RecommendthecorePPIcompetenciestobeincludedinthelearninganddevelopmentofNHSstaffthatisprovidedoutsidetheNHS,i.e.universitiesandPeninsulaMedicalSchool.
4.9 Consider how PPI learning and development fits with the learning and development providedaspartofotherformalopportunitiesandwhetherthereareopportunitiestoprovideaccreditation.ConsiderthisinrelationtotheKnowledge&SkillsFramework(KSF).
4.�0 Recommendhow,andthedegreetowhich,patients,carers,andthepublicwillbeinvolvedinthedesign,deliveryandevaluationoftheagreedcurriculum.
5 Stakeholders5.� PPI&learninganddevelopmentLeadsfromPCT’sandacuteTrustsintheSWPeninsula,
DevonPartnershipTrust,CornwallPartnershipTrust,TorbayCareTrust,WestcountryAmbulanceTrust.
5.� PPILeads–SHA
5.� Workforce&BusinessLead,Workforce&LearningDirectorate,SHA
5.4 EducationestablishmentsprovidingtrainingtotheNHSintheSWPeninsula
5.5 PPIForums,OverviewandScrutinyCommittees
6 Management6.� AProjectTeamwillbeestablishedtomanagetheproject.
6.� TheTeamwillbeledbythePatientServicesManageratSouthDevonHealthcareNHSTrust,tobeknownastheProjectChampion.
6.� AProjectLeaderwillbeappointedtoundertaketheproject.
6.4 TheProjectTeamwillcomprisethe• ProjectChampion• ProjectLeader• PPILeads–SHA• PPIleadsfromTorbayCareTrust,PlymouthTeachingPCT,EastDevonPCT,Plymouth
HospitalsTrust,RoyalDevon&ExeterTrust,WestCountryAmbulanceTrust• APPIForummember• Otherkeystakeholderswillbeco-optedontotheProjectTeamasandwhenappropriate
58
6.5 TheProjectLeadercanbebasedanywhereintheSWPeninsula.
6.6 TheProjectTeamwillmeetonaquarterlybasisandshortlybeforetheestablishedmeetingsofthePPILeadsNetwork.
6.7 RegularprogressreportswillbeprovidedtothePPILeadsNetwork.
7 Funding7.1 The SHA’s Workforce and Learning Directorate has identified £60K to support this project.
7.� AdetailedbudgetwillbedrawnuponcetheJobDescriptionoftheProjectLeaderhasbeenagreedandevaluated.ThebudgetwillalsoaddressITrequirements,accommodation,administrativecosts,travelcosts.
8 Timescale8.� TheProjectPlanandJobDescriptionoftheProjectLeaderwillbeagreedbytheendof
October�005.ThepostwillthenbeevaluatedandadvertisedbytheendofNovember�005withtheaimofhavingtheProjectLeaderinpostby�February�006.
8.� TheProjectwilllastforamaximumoftwelvemonths.
8.� AdetailedworkplanwhichwillidentifykeymilestonesandtargetdateswillbeagreedwiththeProjectLeaderassoonastheyareinpost.
The plan was amended at the beginning of May 2006, to reflect further thinking since the original was drawnupinOctober�005.
59
9. References
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Basset, T., Campbell P., and Anderson J., (2006)Serviceusers/survivorinvolvementinmentalhealthtrainingandeducation:overcomingthebarriers,SocialWorkEducation,Vol.�5No.4pp�9�-40�
Begum, N. (2006)Doingitforthemselves:participationandblackandminorityethnicserviceusers.Bristol:SocialCareInstituteforExcellenceandRaceEqualityCouncil
Carr S., (2004)Hasserviceuserparticipationmadeadifferencetosocialcareservices?Southampton:SocialCareInstituteforExcellence
Commission for Health Improvement (2004)InvolvementtoImprovement.London:CommissionforHealthImprovement
Coulter, A. (2006)‘Patientengagement:Whyisitimportant?’inAndersson,TritterandWilsonedsHealthy Democracy: The future of involvement in health and social care.London:InvolveandNHSNationalCentreforInvolvement
Crawford M., Rutter D., and Thelwall S., (2004)Userinvolvementinchangemanagement:Areviewoftheliterature.ReporttotheNationalCoordinatingCentreforNHSDeliveryandOrganisationR&D(NCCSDO).
Department for Education and Skills and Department of Health (2006) Optionsforexcellence:Buildingthesocialcareworkforceofthefuture,London:HMSO
Department of Health (2006a) Ourhealth,ourcare,oursay:anewdirectionforcommunityservices.London:HMSO.
Department of Health (2006b)Astrongerlocalvoice:Aframeworkforcreatingastrongerlocalvoiceinthedevelopmentofhealthandsocialservices.London:HMSO
Department of Health (2006c)StandardsforBetterHealth.London:HMSO
Department of Health (2006d) Supportforselfcareingeneralpracticeandurgentcaresettings–Abaselinestudy.London:HMSO
Department of Health (2006e) Gooddoctors,saferpatients:Proposalstostrengthenthesystemstoassureandimprovetheperformanceofdoctorsandtoprotectthesafetyofpatients.London:HMSO
Department of Health (2006f) PCTFitnessforPurposeChiefexecutivecompetencyframework.
Department of Health (2005a) Selfcaresupport:Acompendiumofpracticalexamplesacrossthewholesystemofhealthandsocialcare.London:HMSO
Department of Health (2005b)Anationalframeworktosupportlocalworkforcestrategydevelopment–AguideforHumanResourcedirectorsinhealthandsocialcare.London:HMSO
60
Department of Health (2005c)HealthreforminEngland:updateandnextsteps.London:HMSO
Department of Health (2004a) Patientandpublicinvolvementinhealth:Theevidenceforpolicyimplementation.London:HMSO
Department of Health (2004b) TheNHSKnowledgeandSkillsFrameworkandthedevelopmentreviewprocess.London:HMSO
General Medical Council (1997)TheNewDoctor.London:GMC
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General Medical Council (2003) Tomorrow’sdoctors.London:GMC
Hasman A., Coulter A., and Askham J., (2006)Educationforpartnership:Developmentinmedicaleducation.London:PickerInstituteEurope
Health and Social Care Advisory Service – HASCAS – (2005) Makingarealdifference:StrengtheningserviceuserandcarerinvolvementinNIMHE(NationalInstituteforMentalHealthinEngland),FinalReport.
House of Commons Health Committee (2007)PatientandpublicinvolvementintheNHS:Thirdreportofsessions�006-7Vol�.London:HMSO
Levin E., (2004)Involvingserviceusersandcarersinsocialworkeducation.Bristol:SocialCareInstituteforExcellence
Nursing and Midwifery Council (2004) Standards of proficiency for pre-registration nursing education.
Oldfield C., and Fowler C., (2004)Mappingchildrenandyoungpeople’sparticipationinEngland.DepartmentForEducationandSkillsResearchReportRR584.
Picken C., Popay J., Staley K., Bruce N., Jones C., and Gowman N., (2002)‘Developingamodeltoenhancethecapacityofstatutoryorganisationstoengagewithlaycommunities’inJournal of Health Service Research and Policy,Vol7No�.pgs�4-4�
Rees C.E, Knight L.V., and C.E., Wilkinson (2006)‘UserinvolvementisasineQuaNon,almostinmedicaleducation:Learningwithratherthejustabouthealthandsocialcareserviceusers’inAdvances in Health Sciences Education
Rose D., Fleischman P., Tonkiss F., Campbell P., Wykes T., (2002)Userandcarerinvolvementinchangemanagementinamentalhealthcontext:ReviewoftheLiterature.ReporttotheNationalCoordinatingCentreforNHSDeliveryandOrganisationR&D(NCCSDO).
Skills for Health and Skills for Care (2007)Consultationoncommoncoreprinciplesforselfcare
WHO (2006)NinthFuturesForumonhealthsystemsgovernanceandpublicparticipation.WorldHealthOrganisation
6�
Patient and Public Involvement (PPI) Learning and Development Project
Spring 2007 NHS
