So back in 2016 my local trust Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) started to revisit its Involvement Strategy (now called the draft “Partnership Strategy”) and as part of that we decided to go to the people and held severn listening events countywide, rather than just focusing on Cambridge or Peterborough alone.
The main thing people wanted was a forum or a more formal board they could join to influence the decisions made within CPFT.
They also wanted more involvement opportunities that went beyond ward inspections, filling in forms or other things the trust suddenly decided they needed a service user for. That often felt one sided rather than user led or proactive involvement as equal partners.
The other key message was how pleased everyone was with the trust going to them and how the events were organised and delivered locally with service users facilitating the events in collaboration with staff.
In January 2017 myself and other service users really pressed management to act on this information and it was decided we’d form the Partnership Strategy Group (PSG) that would “put meat on the bones” of the draft Partnership Strategy and “bring to fruition the aspirations within” giving the strategy a beating heart and not just a document of well meaning words, collecting dust on a shelf a year later.
We did however decide that rather than update and publish the draft Partnership Strategy ourselves, it would be much better to focus on forming a diverse forum first and have them finalise the draft Partnership Strategy with the intention of presenting both at the same launch event in the future. That way we launch the trusts newly completed Partnership Strategy along with the actual Forum showing we are already bringing to fruition the ideas within. However this is all to be decided by the Forum and we hope to have agreed upon the name as these are just recommendations from the PSG.
So we met with senior management and asked the SUN Network to come along as support and play the role of co-production arbitrator if necessary. We also felt it was important to collaborate with the SUN Network as we are all service users or people with lived experience.
We all decided that the PSG (like the proposed forum) should have third sector organisations on it and those organisations could invite interested service users also, which they did.
CPSL Mind and Lifecraft, along with SUN Network joined the PSG the day it was formed. As we move into the operational stage of the Forum we aim to ensure physical health organisations are included. However we have had leaders of each trust directorate which includes physical health, now the trust has integrated them into CPFT services.
Having such a diverse mix was great and we focused on what the people wanted and put together solutions or ideas on how we could achieve these aspirations.
The main one of those ideas we came up with was the “Partnership Forum” which would have a mix of service users, governors, staff and third sector organisations all meet every month to share what we are all working on and ensure our efforts are more coordinated, whilst working in collaboration and with transparency. This also reflects the main purpose of the Forum and avoids giving people labels such as “Service User” or “Patient” that can be contentious.
In 2016 we found pockets of great practice in the trust but no overall coordination so the Partnership Forum is all about joining this up and ensuring much more partnership working begins to spread throughout the trust and more people like myself are invested in and embraced as equal partners and leaders in their own right, rather than just passive recipients of involvement.
By having service users working within the governance structure as equal partners then we can ensure our voice and influence is embedded throughout the trust. By doing this we ensure the trust gets things right first time and services really do meet the needs of those using them. This also saves CPFT unnecessary costs they would’ve incurred otherwise and shows the organisational will to involve the public and demonstrate transparency throughout the organisation.
The PSG organised the first workshop to find out what people wanted the forum to look like on 22nd November 2017 in Huntingdon. The workshop was very successful with a packed out room and many gave their opinion on how the forum should work. We also went on to organise another workshop on 14th March 2018 in Peterborough to ensure we truly had a diverse range of opinions, which is exactly what we got!
Some felt it should be a more formal council or board and others a more informal approach without an interview process which can often become a barrier and weed out the very people we need to listen to the most! In fact a key point from the Peterborough workshop was to have as little barriers as possible.
The Pop Up Forum idea we came up with in the PSG was floated and like with the 2016 listening events everyone felt a pop up forum that went to the people was an excellent idea and ensured there was a more informal way to get involved, have a say or just to stay informed.
The “Pop Up Forum” idea was that when we had enough service users working within the trust at strategic level we could have two of them at a time to go out to various relevant community groups and share their current work and what projects they’re working on.
At the same time these community groups or charities can feedback through the pop up forum and ensure their opinions are represented by the forum and their voice is not only heard but acted upon.
By making links with key community groups we really have something very special as we align our objectives and ensure the services being designed or currently delivered actually meet the diverse and sometimes complex needs of those using them.
These Pop Up Forums would also help ensure new patients accessing services were signposted by the trust to the relevant community groups in their area as we build strong partnership working with these various groups doing some truly fantastic work.
Currently we have advertised involvement roles that require an interview stage and have had eight people apply which suggests this may have acted as a barrier for some. I know when I first started I would’ve been put off or intimidated if I had to be interviewed so this is something we may need to tweak or rethink after learning from those who went through the process.
My hope is once we all get through the interview stage and start to establish the forum we can negotiate a slightly different approach and ensure the Partnership Forum is just that!
We have had our CEO and other very senior managers passionate about this project leave and new ones come into post so it has been challenging to keep the vision intact and I sincerely hope my trust continues to work with us and not take over with all our hard work and progress we’ve made.
Often large organisations can take over these projects when they start to take off so it’s really important we establish a clear working relationship from the start that recognises this is very much a joint collaborative project.
The challenge with these projects seems to be the relationships between those in power and whether they wish to exert their power over us or be willing to actually work with us which sometimes means stepping back and empowering us to just get on with certain things and avoid micromanaging every decision.
Pop up Forum aside those of us who join the forum as Involvement roles will hopefully meet monthly in order to support each other and share our experience and expertise. I see this as slightly more formal than the Pop up Forum as we will be meeting with not just each other but with staff, governors, third sector organisations and it will be open to the public. We also plan to move the location around the county as CPFT covers a vast geographical area.
At these more formal open meetings we intend to work closely with the governors who hold more authority and powers to hold the trust to account, so it’s vital we work with them so any serious issues arising can be dealt with by the governors themselves.
We also have many staff at CPFT who are service users or have lived experience and they are often extremely passionate about improving services also and will be vital members of the proposed Partnership Forum.
Third sector organisations are continuing to take on more responsibilities as our NHS struggles financially with underfunding so again these are going to be vital members of the forum, ensuring the trust understands how far reaching some decisions can be and can often carry unintended consequences. It also makes sense to maintain and improve collaborative partnerships with colleagues in the third sector.
After meeting with our trusts new CEO (Tracy Dowling), it has filled me with renewed confidence and determination that we will achieve the above and overcome current and future challenges that will inevitably occur. Working through these challenges and differing opinions is where strong relationships are forged and this is what co-production is all about.
I often say “if it’s easy, it probably ain’t co-production!”
I’d like to dedicate this blog to Elizabeth Mitchell who was lead governor at CPFT for many years and an invaluable member of the PSG. We all had huge respect for Liz and she will be sorely missed and never forgotten. Our thoughts are with her family.
If you have any questions or know of other examples of good practice, please leave a comment