An example of co-production – LYPFT’s Multi Agency Clinical Risk Training Project. By Leanne Winfield

I’ve been asked to write a blog about co-production in action, and I have a very good example which I was involved with that I’d like to share with you. The Multi Agency Clinical Risk Training Project started in 2016 with a series of workshops, open to a wide range of staff from various statutory and voluntary organisations, carers, and service users, to look at the issue of clinical risk training.

Guided by Heather McDonald from Leeds and York Partnership NHS Foundation Trust (LYPFT), the project looked into the training various organisations provided on clinical risk, and if there was a way of both making the training more relevant, and consistent between different sectors (NHS, adult social care and the voluntary sector).

From the workshops many ideas were generated, and there was a lot of enthusiasm towards the project. A steering group was formed, which I became a member of, alongside Heather and other service users. We co-produced a training package, drawing on our own personal experiences and the themes that resulted from the workshops.

The training was then delivered to participants in sessions which cut across different job roles and sectors, and prompted the attendees to take a broader look at the concept of ‘risk’, and their own experiences – both within and outside their professional roles. The steering group worked as equal partners both in the planning and delivery of the project.

The basis of the training was two real life case studies detailing the experiences of myself and another service user. During my session at two points in the account participants were faced with a ‘What would you do?’ exercise. Then, after feeding back, I continued with what actually happened. This approach worked really well, and we gained very good feedback from the participants. They hadn’t been sitting watching a powerpoint all day!

Over 2016 and 2017 I was involved in delivering training to four cohorts, with participants drawn from various roles and sectors, and also a group of student mental health nurses. Additionally, as part of the project, I was able to access a funded place on the ASIST (Applied Suicide Intervention Skills Training) course as a participant.

Due to our involvement in this project we were nominated, and shortlisted, for the Developing People Award in the LYPFT 2016 Trust Awards. For the 10 awards a total of 115 nominations were received, so it was an honour to be named as Runners-Up.

Overall I’ve really enjoyed being part of this project, and it shows what can be achieved with proper co-production. It was great to be recognised as equals regardless of either being Experts by Learning or Experts by Experience. Hopefully our success can inspire future projects, and make a strong case for what can be achieved with co-production.

 

Thanks to Leanne Winfield for her contribution.

My Story: The importance of hope and some positives about co-production. By Chris Thompson

Chris Thompson:  has lived experience of being a mental health service user and is a member of the Public Partnership group in the School of Human and Health Sciences at the University of Huddersfield and is a member of Recovery College. He is passionate about talking openly of his experiences to combat stigma and improve understanding of mental illness. He has also started a self-help group called RECONNECT, for people who have suffered from Stress Anxiety and Depression at work. As a retired marketing director of an international company, he has professional experience of working in an environment where power and coercion are everyday occurrences. Despite being unable to attend the seminar Chris has made this contribution through a pre-recorded video.

Seminar 6: Presentations

As promised, presentations from yesterday’s seminar on co-production in coercive environments.

  • Introduction by Pamela Fisher & Christine Rhodes: download here
  • Co-production of mental health services: the art of the impossible? by David Pilgrim (Keynote): download here
  • Power Sharing Within Coercive Environments? by Charlotte Scott: download here

Thanks to the speakers for providing these materials.

Seminar 6: Co-production in coercive environments

University of Huddersfield 6 July 2017

We warmly invite you to participate in the 6th seminar of the series.

Encouraging debate across boundaries between service users/survivors and carers, academics, and professionals from voluntary and public organisations.

This seminar will focus on whether or not co-production is at all feasible when working with non-voluntary service users. The Mental Health Act 2007 amended the earlier 1983 Act allowing a broader range of professional staff to undertake roles associated with compulsion amongst other functions. Within England new roles have been established, including that of the Approved/Responsible Clinician, and the Approved Mental Health Clinician. The Care Quality Commission (CQC 2013) has expressed concerns that some hospitals have allowed cultures to develop where control and containment are prioritised over treatment and care.

REGISTER YOUR INTEREST HERE

To make enquiries or to apply for a travel bursary (available to service users, carers, and professionals in voluntary organisations, please email: s.rooke@leedsbeckett.ac.uk

Follow us on twitter @ESRCcopro

The programme

9.30 Registration (with tea and coffee available)

10.00 Opening with Christine Rhodes Pamela Fisher

10.15 Keynote: Professor David Pilgrim CO-PRODUCTION OF MENTAL HEALTH SERVICES: THE ART OF THE IMPOSSIBLE? This presentation begins by describing the general rationale for co-production. Applying these general considerations to mental health services, we need to take into account a range of peculiarities about mental health problems, social norms defining them and the capability of professionals to respond in a way that is accessible and acceptable. The use of coercion in services and the unusual situation of patients being detained without trial fundamentally alters the capacity of patients and staff to trust one another and work towards mutually agreed goals. Even when patients are ‘voluntary’ the risk to them of coercion, with all its threats to citizenship are constant. The prospect of true co-production in these circumstances (between professionals and patients) is constantly jeopardised. One scenario to counter these constraints is to abolish mental health law, so called. Thereafter risk management in society would bracket mental state, for example by using a form of Dangerousness Act instead. But if mental health law, so called, is retained then we can only experiment with forms of local practice, which offer a dynamic and precarious balance between State paternalism and democratic voluntarism. That balancing act will always be in the context of constraints created by services, which have developed professional norms concerned primarily with risk management. This is the art of the impossible, which will lead to some limited success but probable frequent failure.

11.15 Discussion of arising themes (with tea and coffee available)

12.00 Charlotte Scott POWER-SHARING WITHIN COERCIVE ENVIRONMENTS There is a clear tension between the value base that seeks to empower and promote the rights of individuals who receive mental health services, and the statutory powers that enable mental health practitioners to deprive an individual of their liberty in order to receive assessment or treatment for perceived mental health needs. In this presentation I will outline my understanding of the concept of coproduction in the context of statutory mental health practice, specifically during a Mental Health Act assessment when a decision is made as to whether a person will be detained against their will. I will consider how The Mental Health Act is underpinned by principles that aim to promote participation during decision making (‘The Guiding Principles’), considering how this translates to practice – drawing upon my research findings and experience when working under the Act. Discussion points will include the ways in which the views and knowledge of those who have been assessed under the Act can be given more focus in research, considering how coercion is experienced, how we define ‘power’ in this setting and how and if it is possible to shift the balance of power from those practitioners who have the power to deprive an individual of their liberty towards a shared notion of shared decision making.

12.45 LUNCH

1.45 Team Hudd’ Service users and carers, in co-production with the University of Huddersfield and external partners, will facilitate a round table discussion on the topic of power sharing in coercive environments. A service user will introduce the session by talking about his experiences in mental health settings. Followed by further input from service user/carer’s who will talk about their experiences with suggestions on what did and didn’t work. This will be followed by discussion at each table on the issues raised with feedback to the wider group on the key points identified.

3.00 Tea and coffee and identification of the main points arising from presentations and discussions

3.30 Additional networking opportunity

Speaker Biographies

David Pilgrim PhD is Honorary Professor of Health and Social Policy at the University of Liverpool and Visiting Professor of Clinical Psychology at the University of Southampton. He trained and worked in the NHS as a clinical psychologist before completing a PhD in psychology and then a Masters in sociology. With this mixed background, his career was split then between clinical and academic work as a health policy researcher. His publications include Understanding Mental Health: A Critical Realist Exploration (Routledge, 2015) and Key Concepts in Mental Health (4th edition, Sage, 2017). Others include A Sociology of Mental Health and Illness (Open University Press, 2005- winner of the 2006 BMA Medical Book of the Year Award), Mental Health Policy in Britain (Palgrave, 2002) and Mental Health and Inequality (Palgrave, 2003) (all with Anne Rogers). His most recent book, Child Sexual Abuse: Moral Panics and States of Denial is to be published by Routledge. All of this work is approached from the position of critical realism and so the philosophy of science and social science is an overarching framework in relation to any topic.

Charlotte Scott is a Social Worker with a background in work within Community Mental Health Team’s. She is an Approved Mental Health Professional (AMHP) and has working experience of carrying out statutory work under the Mental Health Act. Currently she is in the final stages of carrying out research for a PhD, exploring how AMHPs make decisions during Mental Health Act assessments including reflections from those who are assessed under the Act on their experience of this.

Team Hudd

Matt Ellis has worked in Social Care for over 25 years and in Mental Health as a qualified Social Worker for 15 years and Approved Mental Health Professional. He is known for his innovation and leadership pioneering creative approaches. He managed the Garage Project, a Mental Health Service for Young People that won a NIMHE (National Institute for Mental Health) positive practice award in 2005. He also chaired the local collective for Creative Minds winner of the HSJ award for ‘Compassionate Patient Care’ in 2014. More recently Matt was responsible for establishing a Recovery College in Kirklees, West Yorkshire

and has been working with the Health Information and Innovation Directorate in South West Yorkshire Partnership NHS Foundation Trust in supporting “recovery” development with 4 other colleges. Matt has now obtained the role as Principle of Calderdale and Kirklees Recovery Colleges. Matt is passionate about co-production, strengths based and creative approaches which value the contribution of those with a “lived experience”.

Donna Kemp is an academic at the University of Huddersfield. Her clinical background is as a mental health nurse, having worked in a range of settings including adult in-patient, community and crisis care. Donna was witnessed power and coercion in her professional and everyday life.

Eric Greenwood is a Lecturer/Practitioner in mental health social work at the University of Huddersfield. He is also an Approved Mental Health Professional (AMHP) in Kirklees with specialist training and responsibilities for carrying out duties under the Mental Health Act 1983 (amended 2007) and has worked in the area of mental health for over 10 years. Eric has worked in an Assertive Outreach Team which specialised in working with people with complex mental health needs, who had not engaged with mainstream mental health services.

Alison Morris is the Public Partnership Group (PPG) administrator, in the School of Human and Health Sciences at the University of Huddersfield. She is responsible for coordinating the smooth running of Service User and Carer involvement in the school. She has a back ground in youth theatre and has previously worked for various third sector organisations and charities. Alison has a son with additional needs and is a campaigner of disability rights. She also teaches healthcare professionals in hospitals and classrooms about her experiences and the communication needs required when working with both people with additional needs and their families.

Christine Rhodes is a partner of the ESRC seminar series. She works as an academic at the University of Huddersfield as the Director of Teaching and Learning in the School of human and Health Sciences. Her clinical experience is as a health care professional, as a nurse, midwife and health visitor, mainly working with people in community settings. Christine also has a lifetime of experience as a carer to a younger sibling with a complex learning disability and is very familiar with the thorny issues of power and coercion on a professional and personal level.

Hayley Roebuck is an expert by experience and has had lots of service user involvement across several departments in the School of Human and Health Sciences at the University of Huddersfield over the last twelve months. She is currently a volunteer for the music therapy service at Womencentre, having previously been a service user and volunteer for the Mothers Apart service at Womencentre. She is also an occasional volunteer for Recovery College Kirklees and Touchstone and attends the Mental Health Partnership Board and Mental Health Provider Forums in Kirklees. She believes passionately that people receiving mental health services should be “worked with” and not “delivered to” and has first-hand experience of the benefits of co-production both as a service user and as a volunteer.

Mary Rogers is a carer and a member of the University of Huddersfield Public Partnership Group. She provides insight to students and lecturers into care issues. Developing the direction of research, assessments and involvement in curriculum development in favour of Service Users and Carers. Mary has significant experience as a carer of her daughter and other family members as well as her own personal experiences and she has a wealth of expertise in working with Health Care professionals at all levels and funding authorities/ agencies.

Mary trained originally as a Pharmacist Technician and she has also worked with Doctors as a Receptionist in a busy GP practice. She has been a support assistant working with Special Needs children in a local High School before her Caring role prevailed. Mary was awarded a BA Open degree in Art Histories and Humanities mainly through the Open University, but also Huddersfield University. Mary has been a volunteer fund raiser for the local Carer’s Trust, Crossroads Care in Mid Yorkshire raising £50,000 over 3 years and became a Carer’s Trust (national) Ambassador for Yorkshire helping raise £6 million for Young Carers through the efforts of The Co-Operative Food Group she was presented to HRH the Princess Royal. She achieved The Duke of York’s Community Initiative Award on behalf of Carers Trust Mid Yorkshire from HRH the Duke of York.

Chris Thompson has lived experience of being a mental health service user and is a member of the Public Partnership group in the School of Human and Health Sciences at the University of Huddersfield and is a

member of Recovery College. He is passionate about talking openly of his experiences to combat stigma and improve understanding of mental illness. He has also started a self-help group called RECONNECT, for people who have suffered from Stress Anxiety and Depression at work. As a retired marketing director of an international company, he has professional experience of working in an environment where power and coercion are everyday occurrences. Despite being unable to attend the seminar Chris is introducing.

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What is a Patient Champion?

What is a Patient Champion?

A conversation between Leanne Winfield, Patient Champion and Pamela Fisher, Principal Lecturer, Health Promotion & Public Health, Leeds Beckett University.

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Pamela: Tell me about being a Patient Champion.

Leanne: I am a ‘Patient Champion’ with my local NHS Clinical Commissioning Group (CCG) in Leeds West. A Patient Champion is a member of the public who works with the NHS to ensure that the needs of patients, and the wider public, are considered by staff throughout the commissioning cycle. My particular roles are as a member the Patient Participation Group at my GP surgery, and as a member of the Equality and Inclusion Group at Leeds and York Partnership NHS Foundation Trust. In these roles I aim to promote the needs of all patients, not just my personal viewpoint.

Pamela: Pamela: We are holding seven one-day seminars are being held over two years in collaboration with the Universities of Huddersfield, Oxford (St. Catherine’s College) and York. The seminars are helping to develop new ways of working and researching within mental health. The starting point is that co-production should involve authentic power-sharing, and that this requires a fundamental re-imagining of the relationships between service users, carers and professionals. They are run with the Economic and Social Research Council. Is your work in a Leeds also a good example of co-production?

Leanne: The purpose of a Patient Champion is to bring another perspective to discussions, and ensure that relevant engagement work has taken place. With the CCG I have also been involved in producing and delivering some training for other Patient Champions and staff members on the topic of co-production. This was developed with the ethos of co-production, working with staff members on an equal basis, and the process demonstrated a really good example of co-production. People were valued regardless of whether they were experts-by-learning or experts-by-experience. The training was well received, and we will be running it again later in the year.

Pamela: Our seminars have seen a group of diverse stakeholders, who have contributed different forms of expertise, taking part. The starting point for the seminar series has been that all forms of expertise – service user/survivor, professional and academic – should be viewed as equally valuable. I’d imagine it’s unlikely that you would be able to be so effective as a Patient Champion if you were unable to draw on her own experiences as a ‘user’ of mental health services.