University of Leeds
School of Healthcare Studies
Leeds Metropolitan University
School of Health and Community Care
Joint User and Carer Strategy
Report of the User and Carer Strategy Group
12th July 2003
Page
Contents 1
1. Membership 2
2. Introduction 3
2.1 Intention 3
2.2 Background 3
2.3 Commitment 4
2.4 Audit 5
3. Aim and Objectives 6
4. Realistic Strategies 7
5. Dissemination 8
6. References 9
7. Appendix 1: 10
Service User and Carer Involvement in the School of
Health and Social Care at Leeds Metropolitan
University
8. Appendix 2: 12
User and Carer Involvement in the Educational
Provision of the School of Health Care Studies,
University of Leeds.
9. Appendix 3 15
Action Plan Example for Strategy 4b
1. MEMBERSHIP
The User and Carer Strategy Group (UCSG) gained representation from School of Health Care Studies, School of Health and Community Care, Leeds Metropolitan University, School of Medicine, Leeds Teaching Hospitals NHS Trust, and users/carers.
Dr Peter Morrall, Chair, SHCS
Dr Fiona O’Neill, Lecturer, SHCS; SHCS user/carer co-ordinator
Sue Sherwin, Senior Lecturer, SHCC
Helen Quinn, Senior Lecturer, SHCS
Jerry Harris, Health Service user; Physiotherapist
Frances Chapman, Senior Lecturer, SHCC
Janet Hargreaves, Director of Clinical Practice, SHCS
Andrew Grice, Health Service user; Associate Lecturer, SHCC
Dr Amanda Kelsey, Senior Lecturer, SHCS
Barry Ewart, Medical Education Unit, SM
Lesley Pattenson, Head of Patient & User Involvement, Leeds Teaching Hospital Trust
Margaret Lascelles, Director of Learning and Teaching, SHCS
Key:
SHCS: School of Health Care Studies, University of Leeds
SHCC: School of Health and Community Care, Leeds Metropolitan University
SM: School of Medicine, University of Leeds
2. INTRODUCTION
2.1 Intention
The intention of the User and Carer (Health Services) Strategy Group (UCSTG) is to present a viable programme for implementation over a defined period of time (i.e. the academic year 2003/2004) from which further long-term strategies can be developed. The implementation of the strategy presented here requires the formation of another group (see section 4, subsection d) to oversee the associated action for this strategy, and crucially to develop a culture of user/carer focused educational and research programmes and practice.
2.2. Background
There is an unprecedented amount of activity aimed at improving and developing user and carer involvement in order to support the move to a more open, accountable and patient-centred NHS. The Health and Social Care Act (2001) places a legal duty on NHS organisations to involve and consult patients and the public in the planning and development of services. Moreover, the rapidly changing relationships between health professionals and users and carers, in which there is an increasing emphasis on sharing power is also leading to new models and processes for involving patients such as the 'Expert Patient' programme and models of shared decision making. The growing importance of community based approaches to health and health care that build and foster close connections with local communities and voluntary sector groups is also a significant element of this move. The role of health services is just one element in models of health and health care that emphasises the social context of health care and the importance of agencies, such as Social Security and Housing, that all contribute to health.
Within this rapidly changing climate, it is essential that education, training and research also change. All members of the NHS workforce must progress towards possessing the attitudes, knowledge, skills and abilities to enable them to make a positive contribution to the development of user/carer involvement, with the ultimate goal of working in partnership with users and carers.
A project funded by the West Yorkshire Development Confederation to look at ways of involving service users and carers in the development and delivery of pre-registration education for nurses/midwives has laid the foundations for developing a strategic approach to involvement for education providers in Leeds (O'Neill, 2002). This project looked at existing involvement activities in professional education in Leeds and elsewhere and identified a number of principles that should inform future developments:
1. User and carer involvement should be given a higher and more visible priority in the education of health professionals as part of the current policy agenda to improve the quality, responsiveness and accountability of health and social care provision and to prepare students to work in more collaborative ways.
2. In order to extend and develop involvement, there has to be investment and a strategic approach to support the development of a culture, systems and support across professional and organisational boundaries that values service users and carers and enables their involvement in educational and research activities.
3. Patient and service user involvement should be developed with a focus on opportunities for inter-professional education and research.
4. A system of payment or other recognition of the investment of time and expertise that is acceptable to all stake-holders is a pre-requisite for the development of successful involvement. This should tie in with the arrangements followed by other agencies in Leeds for payments to service users and carers and also be acceptable to people who are in receipt of benefits.
5. There needs to be a collaborative approach to the development of involvement across the University community in Leeds. Isolated approaches run the danger of contributing to the fragmentation that already exists and will inevitably result in the replication of work and a sense of ‘competition’ between education providers for the time and expertise of users and carers.
6. The work of the Community Education Development Officer in the Medical Education Unit at the School of Medicine provides a model of how to build collaborative relationships with community based groups and advocacy organisations. This model could be extended to include other education providers. This would foster inter-professional education as well as provide a more organised and unified approach in building active alliances with community and patient groups.
7. Closer and more established links should be made with the developing activity around involvement in NHS and Social Care organisations, the local authority and the community involvement framework in Leeds.
8. The training and development needs of people who may wish to be involved in professional education should be taken into account. Any training provided should link up to the network of training around lay involvement that is developing in Leeds and should operate from an empowerment model. The training and development needs of staff should also be taken into account.
9. A range of methods should be developed and involvement included at stages of curriculum planning, delivery, assessment and evaluation.
10. Users and carers should be included in a group set up to co-oordinate and develop involvement at a strategic level.
11. New approaches should be evaluated from the perspective of users and carers as well as students and University staff.
The work of the joint strategy group has built on these principles and there is visible commitment and support from stakeholders within the Universities and in the local health economy to take the strategy forward.
2.3 Commitment
This strategy is shared between the School of Health Care Studies, University of Leeds, and the School of Health and Community Care, Leeds Metropolitan University. Consequently, this strategy represents the approach taken by the two main health service education providers (nursing and some allied health professions) in Leeds. Underlining a commitment to inter-professional collaboration, the strategy also includes input from the Medical Education Unit of the School of Medicine, University of Leeds.
The School of Health Care Studies’ (University of Leeds) ‘Five Year Strategic Plan for Learning and Teaching’ (2003) includes an express undertaking to ‘involve users and carers with learning and teaching activities’. It is recognised that the School of Health and Community Care, Leeds Metropolitan University already has put in place formal structures and procedures for user/carer active participation in its educational provision (see Appendix 1).
2.4. Audit
A formal audit of current user/carer involvement within the School of Health Care Studies has revealed a high level and wide range of activity (see Appendix 2). This strategy is designed to co-ordinate, encourage and increase this good work both in the School of Health Care Studies and in other educational institutions. Underlying the strategy is the recognition of the need to foster and support links between educational providers in order to develop effective and innovative approaches to the involvement of users/carers.
3. AIM and OBJECTIVES
Aim
To enhance User and Carer involvement in research, educational health and social care provision and practice within Leeds.
Objectives
(i) To ensure that User/Carer contact within educational providers is mutually beneficial.
(ii) To be pro-active in increasing effective and genuine User/Carer involvement in educational provision.
(iii) To provide mechanisms for appropriate remuneration for User/Carer involvement, and adequate resources (for example training, administrative support).
(iv) To produce realistic, visible, achievable and timely strategies to achieve
meaningful User/Carer involvement in educational provision and
research.
(v) To `culturally embed’ User/Carer involvement within educational
organisations.
4. REALISTIC STRATEGIES
a) To develop a fair, workable, creative and responsive system to reward and acknowledge the investment of time and expertise by users and carers in educational activities. This system should be flexible and acceptable to all stakeholders including the University finance procedures and users and carers who may be in receipt of state benefits.
b) To put systems in place so that patient satisfaction data includes information regarding students in training, thus informing the process of quality assurance in student placements and developments in educational provision. It is essential that user and carer involvement permeates all levels and areas of educational provision. Exceptionally, there may be justification for the omission of direct involvement of Users and Carers, for example, in the delivery of specific modules. However non-direct involvement should still be feasible.
c) To include User and Carer involvement statement(s) in programme planning, development and evaluation documentation and quality assurance processes.
d) To install a multi-agency group to co-ordinate User and Carer activities and to appoint a facilitator for this group. The rationale for the group is to implement and oversee user and carer activities within the School of Health Care Studies and
will include representatives from other education providers and the wider health economy.
e) To develop and formally adopt a clear, consistent and acceptable system of empowering language in all relevant written and verbal communication.
f) To hold regular events to disseminate involvement initiatives amongst academic staff thereby encouraging networking and sharing of knowledge and expertise (the first of which should take place in 2003).
g) To ensure that overall responsibility for the implementation of user and carer involvement is owned at executive level.
It is essential that specific action is designated to each strategy by the multi-agency
group to ensure implementation is effective. An example of an Action Plan is
provided (for strategy 4b) in Appendix 3.
5. DISSEMINATION
Drafts of the strategy have been circulated to the following for information/feedback:
(i) West Yorkshire Workforce Development Confederation (Mental Health Resources
Sub-Group).
(ii) Leeds Patient and Public Involvement in Health Group.
(ii) Joint Strategy Board for Health - Leeds (Peter Noble, School of Medicine,
University of Leeds).
(iii) West Yorkshire Workforce Development Confederation/University of Leeds
Review Group.
We recommend that the strategy is disseminated to:
(i) West Yorkshire Workforce Development Confederation.
(ii) Leeds Patient and Public Involvement in Health Group.
(iii) Leeds Teaching Hospitals NHS Trust; Leeds Community Mental Health Trust.
(iv) Leeds Primary Care Trusts (5).
(v) Local Authority Overview and Scrutiny Committee.
(vi) Throughout the Faculty of Medicine, Dentistry, Psychology and Health, University of
Leeds.
(vii) Learning Disability: Adult Learning Commisioners; Learning Disability Business
Group.
(viii) South West Yorkshire Mental Health NHS Trust - Wakefield User and Carer Forum (P.A.L.S).
We also recommend (see section 4 sub-section f) that a dissemination event is held to launch the strategy and mark the commencement of the implementation phase.
6. REFERENCES
1. O’Neill F (2002) Developing a Strategic Approach to Users and Carers Involvement in Pre-Registration Nursing and Midwifery Education in Leeds. Leeds: School of Health Care Studies, University of Leeds.
2. School of Health Care Studies (2003) Five Year Strategic Plan for Learning and Teaching. Leeds: University of Leeds.
3. Department of Health (2001) Health and Social Care Act. London: HMSO.
7. APPENDIX 1: Service User and Carer Involvement in the School of Healthcare and Social Care at Leeds Metropolitan University
The School of Health and Social Care (HSC) at Leeds Metropolitan University (LMU) incorporates three professions:
1. Health Promotion and Education
2. Social Work
3. Nursing
Some courses are jointly developed and run by more than one of these professional groups. Such provision will be referred to as `joint provision'.
The involvement of each professional group is as follows:
1. Health Promotion
Service User involvement can be referred to as `Community Involvement' since in terms of health promotion, `users' are the community. Staff in the HP team have been involved in developing an audit tool to assess the involvement of communities in health promotion projects.
This team is also involved in a range of user groups, the School Head (Rachel Dixey) being vice chairperson of the Yorkshire Cancer User Partnership Group.
One of the Senior Lecturers from the HP team is currently carrying out a piece of research on user-led health education.
2. Social Work
The service user and carer input is developed throughout the programme. Service users and carers do guest sessions on some modules.
Service Users are involved with the students during their practice placements and give verbal and written feedback regarding the student's performance in placement. This feedback is sent to the student, the practice teacher and can be seen by the external examiner.
The degree for Social Work is currently being written and Service Users and Carers have been regularly consulted throughout this process.
The social work group have also developed strong links with Service User led voluntary agencies such as Touchstone, the Family Service Unit and Barnados. These are used as practice placements for students