Increased patient, public involvement in locality planning - the use of patient’s narratives to support service design and continuous improvement – An evaluation from the Northwest of England
Authors: Kelly Allison , Marshall Kirsty 
Published: January 2024

People’s narratives on their experience of health and social care can be powerful drivers for change however, Ledema (2012) found that most patients and family members felt that the health service incident disclosure rarely met their needs and expectations (1). For people to feel confident in sharing the experiences they also need to be assured that the sharing of their stories will lead to change (2).

Rochdale is a multi-ethnic (1 in 5 of the population coming from a black or minority background) locality within Greater Manchester. Around a quarter of local people have at least one or more long term conditions and a third of residents live within 10% of the most deprived neighbourhoods nationally (3). As part of the development of a system and place-based approach, Rochdale has developed system wide learning events. These events bring together partners from across NHS, local authorities, voluntary, community and faith sectors and communities. The uniqueness of these events is that they are led by a narrative of experience of services. A person, carer, or family who have had complex experience within services is invited and supported to share their story at a themed event. Then the patient’s story is contextualised within the wider system to provide an understanding of how services can support care, where gaps exist, where there are opportunities for integration, and where there are areas that require improvement. Linking the actualities of people's experience of service to the quality improvement programme is an important feature, as are the resulting action plans which are monitored and reported through the integrated boards.  To ensure agreed on plans progress and as their impact on quality improvement is realised a co-production philosophy is adopted and the events are seen as a journey rather than one off event.

Development of the evaluation approach has been used to grow and advance the events as this has enabled the impact of the events to be monitored and the events themselves to be modified and improved to ensure that they provide a unique and valuable resource in the boroughs journey to meaningful and impactful integration, which is based on peoples experience and centred on reducing the inequalities that people across the system.

1)Piper, D., Iedema, R., Gray, J., Verma, R., Holmes, L., & Manning, N. (2012). Utilizing experience-based co-design to improve the experience of patients accessing emergency departments in New South Wales public hospitals: an evaluation study. Health services management research, 25(4), 162-172.

2)Hanna, E., & Robert, G. (2021). Understanding amputation care in England and Scotland: a qualitative exploration of patient stories posted on an online patient feedback site. Disability and Rehabilitation, 1-9.

3)Rochdale Borough Council (2020) Co-operating for better health and well-being Rochdale Borough -Locality Plan 2020-2024 retrieved  https://www.rochdale.gov.uk/downloads/file/879/rochdale-borough-locality-plan