Title: Evaluating the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care
Funder: Department of Health and Social Care

Abstract: Title EURIPIDES is the short title for Evaluating the Use of Patient Experience Data to Improve the Quality of Inpatient Mental Health Care study. Background All NHS providers collect data on patient experience although there is little evidence about what to measure, how best to collect this information or how to use data to improve service quality. Given significant investment in local solutions, new top-down approaches are unlikely to be widely adopted. It is more important therefore to learn from what is a large, ongoing natural experiment. We propose to study inpatient mental health services on the grounds that these are important and costly services, which are unpopular with service users and places where many serious incidents occur. Research question Which of the many different approaches to collecting and using patient experience data are the most useful for supporting improvements in inpatient mental health care? Aims After completing a systematic review to identify evidence-based patient experience themes relevant to mental health care (Aim 1), we will identify, describe and classify approaches to collecting and using patient experience data to improve inpatient mental health services across England (Aim 2). We will use this information to sample diverse sites for 10 in-depth case studies (Aim 3), where we will interview those who deliver and receive these services to identify what works for whom, and where using a realist approach. We will identify which types of patient experience measures and organisational processes facilitate effective translation of these data into service improvement actions. We will search for evidence of service user and carer involvement and evidence of potential impacts in the form of service improvement activity. We will present our findings to a consensus conference of experts (including service users and carers) at which recommendations about best practice will be agreed (Aim 4). We will ensure that our results are anchored in what is acceptable, feasible and sustainable in real-world NHS settings. We will extend this by modelling variation in resources (costs) associated with adopting new ways of collecting and using patient experience data and associated service improvements, the obstacles to this, and the value (i.e. cost) of evidence required to convince NHS commissioners and providers to substantially alter the way they deliver inpatient mental health care (Aim 5). Design We propose 5 work packages: systematic review (WP1, Aim 1); survey of NHS providers of inpatient mental health care in England to populate a sampling frame for WP3 (WP2, Aim 2); in-depth case studies selected using WP2 findings, analysed using a realist approach (WP3, Aim 3); consensus conference to agree recommendations about best practice (WP4, Aim 4); and health economic modelling to estimate resource requirements and barriers to adoption of best practice (WP5, Aim 5). This work will take place across all parts of England and WP3 sites will be chosen to ensure geographic diversity. Benefits and potential impact Outputs will be evidence-based recommendations on the most effective existing ways to collect and use patient experience data to improve the quality of inpatient mental health services. Recommendations will cover content; data collection methods; optimal organisational processes for translating data into action plans; and evidence of (potential) impact. Our results will be grounded in robust consensus about what is happening now, and on the feasibility, acceptability and sustainability of any proposed change.

Lay abstract: What will we be doing? The project is specifically looking at how patient experience and feedback is managed in inpatient mental health care settings. To ensure the patient voice is heard, NHS Trusts are required to collect feedback from patients routinely. We do not know what kinds of feedback are most important or what management processes are needed to translate this into effective action plans, and we do not know if this makes any difference to patients themselves. In order to explore this area, the proposed research has 5 work packages (WPs) that are linked to the 5 study aims: After completing a systematic review to identify patient experience themes relevant to mental health care (Aim 1), we will identify, describe and classify approaches to collecting and using patient experience data to improve inpatient mental health services across England (Aim 2). We will use this information to choose 6 Trusts around the country for in-depth case studies where we will carry out interviews to find out what works for whom, and where (Aim 3). We will look particularly for evidence of meaningful service user and carer involvement, and for service improvement activity. We will present our findings to experts (including service users and carers) at a ‘consensus conference’ to agree on recommendations about best practice (Aim 4). We will ensure that our results are anchored in what is acceptable, feasible and sustainable in real-world NHS settings. Finally, we will use health economics to predict the costs that would arise (and savings that might occur) if ‘best practice’ in collecting and using patient experience data was widely adopted, and we will speak to senior NHS colleagues to explore obstacles to adopting best practice (Aim 5). Why does this research matter? How will it make a difference? Every Trust collects patient feedback data, and in some cases they have spent years setting up local systems for this. We aim to learn what works best from the wide range of current approaches. Our results will provide the first comprehensive overview of current approaches to collecting and using patient experience data to improve inpatient mental health care in England. The research, and our recommendations, will be grounded in the real world NHS. We will review the study findings and agree recommendations based on what is judged feasible, acceptable and sustainable according to commissioners, service providers and service users and carers. We hope that this research will inform the future collection, management and use of patient experience data and thereby improve services. Who is involved in this study? The project is a collaboration between the University of Warwick, the University of Birmingham, Queen Mary University London and the Mental Health Foundation. The project is supported by CRN West Midlands, and is overseen by a Project Oversight Group and an Independent Study Steering Group. In addition we have a Service User and Carer Reference Group which is comprised of people with lived experience of experience of caring for people who have experienced adult inpatient mental health care.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH