Implementation, delivery groups and lived experience reference groups
Lived experience reference groups
Establishing a lived experience reference group is a valuable part of service development. It ensures that the voices of people with direct experience of psychosis, as well as families and carers, are embedded throughout the design and delivery of your Early Intervention in Psychosis service. By drawing on these perspectives, the service can be shaped around what matters most to people, helping to improve experiences of care and better support recovery
If setting up a lived experience reference group, you should consider volunteers’ time, practical and emotional support, accessibility of virtual meetings, and the reimbursement of any expenses.
You should also consider the timing of meetings to enable cross representation on clinical and lived experience groups or communication channels/methods to share what was discussed. For example, if a lived experience reference group meeting clashes with a multidisciplinary team meeting, cross representation will not be possible.
Local lived experience reference groups have found it useful to be introduced to Early Intervention in Psychosis staff, and a brief explanation of the structure and language used in the NHS and other services.
Implementation and delivery groups
At the initial set up of the Early Intervention in Psychosis , implementation groups were set up as an opportunity for teams to connect with stakeholders within the NHS and in the wider system.
Once services are up and running, the purpose of this group needs to be reviewed to best consider the delivery of the service, as well as the sustainability, future development, and evaluation of the service.
Top tip: We suggest that multiple people with lived and living experience are invited to the implementation/delivery group to ensure representation at each meeting.
Quality management system
You may already be familiar with the Quality Improvement Journey. Once your service is set up, you can start to test changes to ways of working, using a Plan-Do-Study-Act approach.
The Quality Improvement Zone offers tools and resources to support teams in identifying opportunities for improvement and testing changes in practice. A valuable first step is to engage staff in discussions about current challenges and areas where processes or ways of working could be improved.
Data is one way of measuring the impact of any changes to your practise on the key outcome measures for your service.
The Early Intervention in Psychosis toolkit creates run charts for all measures as highlighted in the section on data and measurement. The charts are a simple and useful tool for monitoring and evaluating performance of the team and illustrating the development of the service over time. The run charts within the toolkit are adapted and are a simple way of identifying where new ways of working have improved the efficiency of the service, where external factors are impacting on the service, and assessing the stability of the day-to-day functioning of the service.
Tests of change within the pathfinder sites include the cost-benefit of employing an Early Intervention in Psychosis healthcare support worker within an established team and setting up a peer support group.
Prompt questions
- What would you like to improve in your practice? What are the ‘pebbles in your shoe’?
- What new ways of working would you like to test in your team?
- What is the data story that emerges from baseline and subsequent data?
Activity: use the quality improvement tools in the resources to define problems, explore and test solutions and improve your service
For example, you may want to consider the source and appropriateness of referrals or process map the steps taken from the point of referral to accepting a person onto the caseload.
Quality Improvement Resources
- Quality Improvement Zone, with guidance, examples and tools for undertaking improvement work
- Plan – Do – Study – Act Cycles
- Plan – Do – Study – Act logs example
Service user, family and carer feedback
Feedback from service users, carers and families is a valuable way of informing improvement initiatives, assessing the impact of your service and providing assurance that people are satisfied with their care. It is also a valuable source of information to inform the development of a service. Both compliments and complaints should be discussed routinely within the team.
“Meeting online with different members of [our son’s] team has been invaluable in terms of the confidence we gained in respect of his treatment and reassurance he was on the right path”
Parent, CONNECT NHS Tayside
Resources
- Care Opinion – charity sharing people’s experiences with health and social care services
- Healthcare Improvement Scotland Care Experience Improvement Model
- ESTEEM service user feedback survey
- POPS UK – an online support group and other resources for parents, family, friends and carers of people who experience schizophrenia or psychosis