northern ireland nhs confed national conference april 16 th 2015 michael ryan director advancing...

Northern Ireland NHS Confed national conference

April 16th 2015Michael Ryan

Director Advancing Recovery Ireland

Service user partnership working togetherA new way

• Michael Ryan, project lead Advancing Recovery Ireland

• Special Needs Teacher, Social Care Worker• Farmer ,Computer salesman• Spouse, Father, Sibling• Community council, Football coach • Mental health Service user


• Lived experience• Debilitating force• Hospitalization• Self harm • Homelessness• Fear• Confusion• Despair


• Personal Recovery• Social Integration• Independent Living• Meaningful Roles/ Employment• Full Citizenship• A regular Joe Bloggs!


• Someone to love

• Somewhere to live

• Something to do

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Service user partnership working together

A new way ‘Recovery is a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness’. (Anthony, 2003)

Service user partnership working together

A new way PERSONAL RECOVERY: 3 essential features (Repper & Perkins 2000)

1)HOPE – believing that one can still pursue one’s own hopes and dreams, even with the continuing presence of illness. Not ‘settling for

less’, i.e. the reduced expectations of others

2) ‘AGENCY’ – (re)establishing a sense of control over one’s life and one’s illness. Finding personal meaning – an identity which incorporates illness, while retaining a positive sense of self

3) OPPORTUNITY – to build a ‘life beyond illness’. Using personal strengths and resources, non-mental health agencies, friends and

informal supports to achieve real integration in the community


• Why partner with Patients• Life style illnesses- By 2020, it is predicted that

Non communicable diseases, cancer, diabetes, chronic pulmonary and mental health problems will be causing seven out of every ten deaths in developing countries. – (International Journal for Equity in Health Research January 2005)

• Current model unsustainable – • Medically, Economically, Politically, socially, Ethically


• Why partner with Patients• Service users want partnership-

• ‘people want to play a part in making decisions about their own health care and that people living with a long-term

illness develop an ‘expertise and wisdom’ about the condition ‘(Brophy 2006)

• The increased interest in service user involvement is linked to the recognition that many of the health problems faced by the community are complex, and go beyond the capacity or jurisdiction of any single organisation to change or control

(Lasker and Weiss 2003)


• Benefits of Partnership• Better patient experience – increased satisfaction• Increased sense of dignity & self worth• Validation of patient experience• Improved communication• Improved problem solving• Improved service planning• Better recovery outcomes• Economic benefits• Culture change• (Brophy 2006, Nielsen et al 2004, Gregory 2007)


• Policy on Partnership• WHO -patients can play an important role in understanding

the causes of illness, protecting their health and taking appropriate action, choosing appropriate treatments for acute episodes of ill health, and managing chronic illness. These roles must be recognized and supported. - Where are the patients in

decision-making about their own care? (2008)

• NHS- Ensure that every person with a long-term condition or disability has a personalised care plan supporting them to develop the knowledge, skills and confidence to manage their own health. TRANSFORMING PARTICIPATION IN HEALTH AND CARE 2013


• Policy on Partnership

• HSE- The service user should be central to their own care and to the design and delivery of health and personal social services. This will result in more appropriate services of a higher quality with increased service user compliance and satisfaction. National Strategy for Service User Involvement in the Irish Health Service 2008-2013

• HSE mental health-“Involvement of service users and their carers should be a feature of every aspect of service development and delivery”. (vision for change 2006)


• A practical applicationTokenism!- it is possible to be engaged in numerous involvement activities without really involving people particularly if professionals continue to drive the agenda and make decisions about services and treatments without taking service users views into account . (Coney 2004)

Human level-‘the most significant forms of involvement are those that become part of the day-to-day practice of health care delivery and planning, whether at the level of the individual encounter or at a more collective level, yet these are often the least visible. (Ridley and Jones 2002)•


• Partnership in Practice• HSE structures -National advocacy unit- Director of

Advocacy• Irish Advocacy network ( Independent mental health voice)• National directorate for mental health - 2014• National head of service user, family & carer engagement –

2014• 9 Regional heads of service user, family & carer engagement-

2015


• Partnership in Practice• Engagement- listening meetings, surveys,

forums, focus groups , reference groups, reps on committees, consumer panels

• Professional roles - Peer support working ,Hse 2015 NI 2018

• Su & family using their own lived experience to empower others to recover.


• Partnership in Practice• Recovery education (Recovery Colleges 1 Mayo 1 NI,

32 UK , world wide)• Recognises the equal expertise of Su & other

stakeholders as co creators of recovery. • Su assume new identity as students• Everything is co produced by equals (Su, Family,

professional• Community wellness Colleges (not just mental health)


• Multiple Partnerships• Service User• Family & Supporters• Clinicians• Voluntary Sector-Education - Housing- Employment support- Wider community


• What do we bring to our roles?

• Professional experience

• Lived experience• Skills & talents • Human experience


• Expert Patient• Lived experience of mental health issue• Empathy and understanding • Understanding of condition -triggers• Experience of Personal Recovery• Holder of hope• Professional Peer support worker


• Family Member/Supporter• Experience of living with someone with

mental health issue• Understanding of condition –triggers• Understanding of personal recovery• Holder of hope• Collaborative working• Professional family advocate


• Service provider/ Clinician• Clinical & professional experience• Lived experience• Human experience• Holder of hope• Clinical recovery- reframing the

treatment…the issue is what role treatment plays in recovery (Davidson 2006)

Coproduction• Cubism

A Partnership and Collaborative working approachRecognising , respecting & utilising mutual expertise & perspectiveMoving to a new place together……RECOVERY


• Organisational change ImROC methodology• Senior management commitment - national

policy – A vision for change• Recovery principals – different types of

expertise• Real collaborative working between all

stakeholders• Audit services & identify key areas to address


ImROC 10 Key Organisational Challenges

1) Changing the nature of day to day interactions and the quality of experience

2) Delivering comprehensive user-led / family member / carer training and information programmes

3) Establishing a Recovery education unit to drive the programmes forward4) Ensuring organisational commitment, creating the ‘culture’. The

importance of leadership5) Increasing ‘personalisation’ and choice6) Changing the way we approach risk assessment and management.7) Redefining service user / family member / carer involvement.8) Transforming the workforce.9) Supporting staff in their recovery journey10) Increasing opportunities for building a life ‘beyond illness’


• Challenges to Partnership• Power Imbalance• Remuneration issues• Structural issues• Language & bureaucracy issues• Constituency capacity deficits• Cultural challenges


• Thank God for the foolishness to think that you can make a difference- Benedictine blessing

• Patient Partnership is possible is possible…


• Thank You

• Michael Ryan • [email protected]• 00353872497617

mailto:[email protected]

northern ireland nhs confed national conference april 16 th 2015 michael ryan director advancing...

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