04 Apr 2018

Using a truly collaborative approach, West London Mental Health NHS Trust and We Coproduce have created standards of care that describe what excellent patient-centred care on inpatient wards looks like.

The Trust commissioned We Coproduce (formerly West London Collaborative) to work with its community to create these new standards of care for inpatient units. The joint approach was ‘be brave, let’s dare to dream’.

For 12 months, the team co-created innovative community spaces to work collaboratively with patients, carers, third sector organisations, commissioners, GPs and staff from across the Trust. The process was carefully crafted; all patients involved had to have been on an inpatient ward within the last year, and frontline staff were required to be involved in hands on care – from ward managers to health care assistants and occupational therapists. Using recent Care Quality Commission (CQC) feedback, staff and inpatient surveys, feedback from ward forums and national research, a working group identified key issues impacting on how wards were experienced by staff, patients and carers.

These challenges were explored in the wider community; patients and staff coproduced forum theatre scripts to explore solutions which were performed by Face Up Theatre at an interactive event at The Lyric Theatre in Hammersmith. Audience ideas were captured and developed by a graphic artist, who designed a unique visual tool so the solutions could be mapped against exactly when they should happen.

The graphic was then taken back to the community for mapping, comment and finally prioritising. From here, priorities were agreed through voting, open discussion and negotiation – this led to the 21 new standards of care.

The 21 standards will be implemented across Ealing, Hounslow and Hammersmith and Fulham, and form part of a shared vision across local services. The standards cover 10 different themes: ward environment, treatment and therapies, staffing and support, trauma informed care, family and carer partnerships, wards as networks, control and restraint, food and nourishment, education and occupation, arts and spirituality and legal matters.

All 21 standards are here.

The Trust and We Coproduce are continuing to work together to improve patients’ and carers’ experience in local services. We will be looking at implementing some of the key themes locally in a coproduced way, for example:

  • The practice of restraint and seclusion, including support to patients and carers who witness this happening.
  • Effective care and discharge planning.
  • The implementation of a trauma informed care model: asking patients “What has happened to you?” rather than “What is wrong with you?” and identifying with patients events which they consider are having an impact on their current difficulties.

Carolyn Regan, Chief Executive at West London Mental Health NHS Trust, said:

“The Trust has to produce lots of data and meet a range of mandatory standards. Much of this is helpful and lets the public know how we are performing. But what really matters is the experiences of those who use our services or interact with us on a daily basis.

“We wanted to use these experiences to better inform how our inpatient wards provide care and treatment in the future. It is rare for an organisation to want to sign up to more standards, but by coproducing these we believe we can deliver a dramatic improvement on our inpatient wards and provide a service that genuinely does what patients and carers have said it needs to do to support a successful recovery.”

Jane McGrath, Chief Executive of We Coproduce, said:

“This piece of work has set a new standard for how West London Mental Health NHS Trust can work collaboratively with its wider community. The appetite to try something new and innovative has been central to how everyone was able to work together as equal partners. The commitment of the Trust to genuinely coproduce and share power has made a real difference – it transformed the process as well as the outcome.

“We now have our first mutually owned aspirations that address what matters most to those people who mutually inhabit an often complex space. Our task now is to embed them and to keep refining them until we get the experience spot on.”

Sarah Rushton, Director of Local and Specialist Services at West London Mental Health NHS Trust, said:

“We are delighted to launch the shared vision and standards today in what marks a significant milestone for our work with patients, carers, commissioners, local authorities and charitable organisations to transform the way we provide local services in West London.

“As a Trust, we need to be honest and acknowledge that we have some work to do to meet these standards but by coproducing them, we know that what we are working towards will provide a service that genuinely meets the needs of patients, and better supports a successful recovery from a mental health crisis.”

Dr Annabel Crowe, GP mental health lead for Hounslow CCG, said:

“I think this is an inspired and impressive piece of work. The fact that the standards have been coproduced makes them meaningful for patients, their carers and staff. I am confident they will lead to an improved experience for people on the wards.”

Having put in place the shared vision and standards of care, the partners will now work together to coproduce an implementation strategy to embed the standards across all units.

The Trust’s inpatient wards are located at:

  • Wolsey Wing, St Bernard’s Hospital, Southall
  • Hammersmith and Fulham Mental Health Unit, Hammersmith
  • Lakeside Mental Health Unit, Isleworth.

To view a graphic showing how the standards were coproduced, click here.