Expert by experience newsletter - April 2025

Editor: John Francis William Apted

If you want to get in touch please contact us on cnw-tr.improvementsupport@nhs.net

Have You Considered Capturing the Impact of Experts by Experience Involvement in Your Improvement Work?

The involvement of Experts by Experience (EbE) in Quality Improvement (QI) at Central and North West London NHS Foundation Trust (CNWL) is now established, as we have had about 80% of our projects on LifeQI demonstrating EbE involvement month-on-month. Efforts had rightly been directed towards supporting QI project teams evidence instances where they have had EbE involvement in their improvement work. While we are still working to embed this practice, we would also like to highlight the importance of capturing and articulating the impact of EbE involvement in your improvement work. As the healthcare landscape continues to evolve towards more patient-centred models, capturing and articulating the contributions and outcomes associated with EbE involvement has become increasingly important.

Importance of Capturing EbE Impact:

• Capturing the impact of EbE involvement helps develop shared learning on barriers and drivers that influence the outcomes of QI projects at both local and organisational levels.
• Insights gained can guide future EbE involvement practices to better integrate patient and carer voices in improvement work, ensuring their contributions are recognised, shared and actively sought after.

Cultural Change:

• Documenting successful EbE involvement and their positive outcomes can inspire a shift towards a more collaborative culture within CNWL. This transformation is crucial for establishing an environment where EbE involvement is prioritised and appreciated.

Building a Compelling Case:

• Evidence of impact and benefits of EbE involvement reinforces our EbE involvement commitments, encouraging teams to continue involving EbEs as our key partners for improvement.

Documenting the impact of EbE involvement in QI is thus essential for showcasing the value of EbE involvement here at CNWL, thereby fostering cultural change within the Trust. By prioritizing this, we can focus our improvement efforts on what is more meaningful to our staff and service users/carers, leading to improved health outcomes and better patient experiences. For guidance on how to capture the impact of EbE involvement in QI, refer to page 8 of CNWL’s EbE involvement toolkit.

Case study: My Involvement in the Therapeutic Observations and Engagement Improvement Programme: An Expert by Experience Perspective

The journey into my role as EbE Faculty on the Therapeutic Observations and Engagement Improvement Programme began for me through the Involvement Team. They advertised to the EbE members about this opportunity, and having expressed my interest, I was selected to be an EbE Faculty member for this programme.

Experience with this Programme

My experience with the Therapeutic Observations and Engagement Improvement Programme has been enlightening and impactful. My primary objective as part of this group is to provide the EbE perspective to help develop a deeper understanding of the incidents that lead to 1:1 or 2:1 follow-ups (which I am going to refer to as close observations) to help ensure that they are reduced. Reducing the number of close observations would help free up time that the staff on the wards need to put into close observations. I am happy that we have started seeing some progress with reducing the numbers of close observations as well as with patient experience regarding the "them vs us" mentality that can sometimes build up with patients.

The Value of an Expert by Experience in delivering workshops

The inclusion of an Expert by Experience in workshops offers a unique and valuable perspective. Having personally undergone close observation while sectioned, I have witnessed how such measures can inadvertently exacerbate feelings of resentment among patients towards staff. My role allows me to provide constructive feedback aimed at enhancing relationships within the mental health community. This process is not only rewarding for me but is also intended to help improve interactions on the wards, ultimately leading to a reduction in negative incidents and the identification of new changes that can be tested as part of this improvement programme.

Encouraging Collaboration with Experts by Experience

I wholeheartedly recommend that staff planning similar workshops consider involving Experts by Experience in both the planning and delivery stages. Even if an EbE member's role is primarily observational during presentations, their lived experiences can significantly influence how content is presented and received. The insights gained from these interactions can be invaluable, particularly in shaping the direction of projects aimed at improving mental health care.

For those involved in planning workshops, I encourage active engagement with EbE members, especially when implementing new changes. Gathering feedback from these individuals can provide critical insights that enhance the effectiveness of initiatives. Moreover, recognising and praising the efforts of teams when they excel during workshops can be incredibly validating for staff. Hearing positive feedback from EbE members reinforces the impact of their work and encourages continued improvement in mental health care practices.

I will conclude by stating that the collaboration between Experts by Experience and mental health professionals is essential for fostering a supportive and effective environment that benefits both patients and staff alike.