Patient and public involvement facilitators: Could they be the key to the NHS quality improvement agenda?

Abstract

Objective Research into patient and public involvement (PPI) has not examined in detail patient and public involvement facilitators’ (PPIFs) roles and activities. This study analysed PPIFs’ roles using qualitative data gathered from three different UK health‐care organizations. Design Thematic analysis was used to examine cross‐sectional data collected using a mixed‐methods approach from three organizations: a mental health trust, a community health social enterprise and an acute hospital trust. The data set comprised of 27 interviews and 48 observations. Findings Patient and public involvement facilitators roles included the leadership and management of PPI interventions, developing health‐care practices and influencing quality improvements (QI). They usually occupied middle‐management grades but their PPIF role involved working in isolation or in small teams. They reported facilitating the development and maintenance of relationships between patients and the public, and health‐care professionals and service managers. These roles sometimes required them to use conflict resolution skills and involved considerable emotional labour. Integrating information from PPI into service improvement processes was reported to be a challenge for these individuals. Conclusions Patient and public involvement facilitators capture and hold information that can be used in service improvement. However, they work with limited resources and support. Health‐care organizations need to offer more practical support to PPIFs in their efforts to improve care quality, particularly by making their role integral to developing QI strategies.

Responsibilities and capabilities of health engagement professionals (HEPs): Perspectives from HEPs and health consumers in Australia

“…This study refers to them as health engagement professionals (HEPs). In the United Kingdom, they are known as patient and public involvement facilitators (PPIF) whose primary responsibility is to involve patients in service improvement projects 8 . In Australia, HEPs are specialists in developing engagement frameworks and techniques for health service organizations to meet the requirement of the National Health Service and Safety Quality Standards' 1 Partnering with Consumers Standard .…”

“…Partnerships take place at the individual, service and organization levels to facilitate person‐centred care such that care prioritizes the relationship between patients and clinicians for the best health outcomes. But successful consumer partnerships are not without challenges—it requires health services and consumers to redefine their roles and responsibilities, increases costs and conflicts between health consumers and professionals, leads to slower progress in change and could result in tokenism 6,8,10,11 …”

“…Existing research has examined the roles of health consumers (also known as patient advisors in the United States and Canada) who are patients who convene on a regular basis to improve service delivery in patient advisory councils (also known as consumer representative groups in Australia) 11,12 . The role of HEPs has been researched in the United Kingdom where they are known as patient and public involvement facilitators (PPIF) who play the roles of gatekeepers (ie determining which patients get access to patient and public involvement (PPI) activities), mediator (ie facilitating conversations between staff and patients in committees) and negotiator (ie encouraging health‐care professionals to involve patients in projects and implement changes) 8 . Although the study 8 has identified some of their responsibilities, the authors recommend that further research be conducted to provide clear definitions of their specific roles and the nature of their responsibilities.…”

“…The role of HEPs has been researched in the United Kingdom where they are known as patient and public involvement facilitators (PPIF) who play the roles of gatekeepers (ie determining which patients get access to patient and public involvement (PPI) activities), mediator (ie facilitating conversations between staff and patients in committees) and negotiator (ie encouraging health‐care professionals to involve patients in projects and implement changes) 8 . Although the study 8 has identified some of their responsibilities, the authors recommend that further research be conducted to provide clear definitions of their specific roles and the nature of their responsibilities. Thus, this study is conducted to examine the roles of health engagement professionals (HEPs) who are in paid positions and are embedded within health service organizations in Australia.…”

“…Third, although there is ample empirical evidence on consumer engagement and how it should be conducted, the roles of HEPs are not well‐understood. Because of this, they could be constrained by limited training and mentoring opportunities and inadequate financial and physical resources 8 . Research on community engagement professionals (CEPs) has identified the need to understand their knowledge, skills and abilities in order to ensure that they can facilitate partnerships that contribute to the outcome of engagement 14 .…”