Last week I was fortunate enough receive training delivered as part of the EQUIP trial – EQUIP stands for Enhancing the Quality of User Involved Care Planning in Mental Health Services, you can read more about it here. Anyway, I was a bit of a cuckoo in the community teams’ nest and I have to say they were very welcoming (I know it can be disconcerting to have a non-team member present at a team event!).
Having been involved in bringing the trial to the attention of Leeds and York Partnerships NHS Foundation Trust (LYPFT) I was curious as to what the training content would be – and anxious that it was on similar lines to the existing training provided within the LYPFT. I don’t want to blog the entirety of the training but I am happy to share some key reflections:
- Training was delivered by Lauren, Lindsey and Karina – experts by experience of using services, being a carer and an academic. This worked very well and brought the theoretical points to life, making the learning ‘real’; so helpful in understanding the impact that professionals way of being, interventions and ‘rules’ have on people.
- Role play can work – the trainers pushed some difficult conversations that served to highlight some of the stickier areas that we work within – confidentiality, information sharing, truth-telling versus saying a lot of words but saying nothing.
- People can’t be involved in shared decision-making if they don’t have the information upon which to make the decision.
- There is disconnection between what the research found to be important to service users and carers (engagement and delivery of the care plan) and what the professional found to be important (production of care plan, targets met). Noted that there are professional and organisational drivers, but to provide care support and treatment that is going to make a difference, we have to prioritise the person’s goals.
- Aspirational goals are the future – we can ditch SMART (hurrah, permission granted!). People’s goals are not always SMART and they don’t have to be. They need to be heard, understood and drive the care plan.
- Care plans are an output of working together with people to agree a plan but the journey to get to this point is where the value lies – involving the person, understanding priorities and being prepared to hear them even if they are in conflict to professional/organisational priorities, being flexible and responding to changing needs. It’s the process not the product.
- The role that an organisation takes in setting local ‘targets’ can work against improving quality of involvement and inhibit shared decision
- The trainers mentioned that they found the Trusts care plan to be the most service user focused amongst the Trusts they have worked with; that they found working with LYPFT to be a positive experience, that the staff have been positive, motivated and caring. Lindsey said that it gave her hope that care coordinators can and do support people very well in the community.
Delighted to have had the opportunity to participate, looking forward to thinking about what this learning means for LYPFT, community teams and most importantly for the difference this makes to people and carers.
Donna Kemp | Care Programme Approach Development Manager