Service users help to shape better care on inpatient wards
As part of the NHS-wide Culture of Care programme, Northamptonshire Healthcare NHS Foundation Trust has been embedding co-production to improve the culture of adult inpatient mental health wards for patients and staff.
The Culture of Care framework, including its 12 principles of care, is underpinned by three key foundations for inpatient care and care environments: ensuring those who have experienced trauma are not re-traumatised (trauma informed), understanding and adapting environments for people who are neurodivergent, and being actively anti-racist. All of this is undertaken with an overarching theme of true co-production.
Four inpatient NHFT wards were selected to take part:
- Harbour Ward, Berrywood Hospital - Adult inpatient ward
- Kingfisher Ward, St Mary's Hospital - Adult inpatient ward
- Riverside Ward, Berrywood Hospital - Older adult's inpatient ward
- Spinney Ward, St Mary's Hospital - Older adult's inpatient ward
The aim was to make wards safer, kinder, fairer and better places to both receive care and work.
The initiative was co-produced, co-designed and co-owned by people with lived experience alongside healthcare professionals.
Who was involved and how was co-production put in action?
Each ward had a dedicated multidisciplinary improvement team which included:
- Lived Experience Advisors (patients and carers)
- Carer Peer Support Workers
- Healthcare Assistants
- Nurses
- Ward Matrons
- Psychiatrists
- Occupational Therapists
- Psychologists
Co-production was truly at the heart of this project, everyone's voice mattered equally. Feedback from inpatients on the Kingfisher Ward suggested that ward culture needed to be improved - weekends and evenings often felt boring and ward rounds could feel overwhelming. The Culture of Care programme gave improvement teams a structure to turn feedback into meaningful action for the people using the services.
Throughout the project, feedback surveys and ward dashboards helped teams to check how well new ideas and actions were working. A dedicated Quality Improvement Coach also played a key supportive role, helping the team stay focused, this made a significant difference to the project's success.
What changed on the Kingfisher Ward?
A number of improvements were made thanks to co-production, including:
Weekly community meetings - these have given everyone a chance to raise issues and suggest improvements that are acted on.
- Trained Lived Experience Volunteers - new training opportunities have meant that Lived Experience Volunteers can now run groups and activities on the wards.
- Improvements to ward rounds - better planning, calmer spaces and support available before and after rounds to make ward rounds less overwhelming. Patients can now raise topics in advance.
- Easier access to the Multidisciplinary Team - helping patients and carers speak to the right staff when they need support.
- More activities - additional fun activities being co-delivered by nursing staff and Lived Experience Volunteers.
What's the feedback?
The impact of the project is very visible. There is a feeling of collaboration and being in it together . Patients feel listened to and staff feel supported. Most importantly, ideas raised in meetings are being turned into real action.
Adam Richards, Kingfisher Ward Matron, said:
"Culture of Care gave us a vessel to truly embrace co production on a ward-based level. Our weekly community meetings have become the epicentre of weekly positive change on the ward. There has been a feeling of empowerment as inpatients witness the suggestions they make turn into action on the ward."
Rachel Roche, Lived Experience Advisor, said:
"The change idea that was implemented regarding the ward rounds I feel has had the biggest positive impact for patients, carers and even staff. Changing the room, limiting the number of staff in the room and bullet pointing the post ward round information for patients are some of the change ideas that we made."
Andy Willis, Lived Experience Lead, said:
"At its best, the Culture of Care initiative promoted genuine co-production between staff and those with lived experience, informed by the voice of current service users, to explore change ideas that fostered a ward culture of continuous improvement, consistently supporting recovery and improvements to both patient and carer experience."
Co production has had a positive impact on these wards, and the influence will continue to grow as teams keep listening, learning and improving together. The ambition now is to secure sustainability of the Culture of Care values and embed continuous improvement across all inpatient wards and the wider service.