Re-engage staff and re-empower patients

The report – and all the evidence behind it – makes clear that any meaningful change in health and care must start with patients, staff and the public. This is not just as a matter of principle and values, but a matter of pragmatic necessity. These are the people whose knowledge, experience and expertise will ultimately enable the NHS to reinvent and renew itself.

What does real, practical engagement and empowerment look like? We at THIS Institute and Thiscovery have spent much of the last five years delivering this kind of work in practice. We’d like to offer a framework that we believe could form the basis for involving patients, staff and the public, at scale, in the significant work that lies ahead. It’s been tried and tested for improvements and innovation including:

• Development and implementation of new technologies
• Creation of new clinical tools, pathways and services
• Development of new policy frameworks, guidelines or best practice

1. Understand the problem

The first stage is listening to truly understand the current experiences and priorities of staff and patients – what works well and what doesn’t, and what matters to whom and why. This can be done at scale by using online approaches that people already find comfortable and familiar – for example as text, audio, and video – to express their views. AI transcription and analysis tools can help to quickly identify the key areas where action is needed.

2. Create a vision for what good looks like

The next critical step is to give people proper, inclusive opportunities to contribute to creating a vision for the product or service. People need to be enabled to suggest ideas and comments based on their own lived and learnt experience, to prioritise options, and to advise on how trade-offs should be handled.  Techniques such as online consensus-building and discrete choice experiments are powerful ways of ensuring this kind of inclusion.

3. Co-design solutions

Using tried and tested design techniques online and at scale can generate practical, actionable solutions. Testing these solutions offline using techniques like simulation ensures solutions are fit for purpose in the real world.

4. Evaluate

Evaluating solutions is critical to ensuring their effectiveness, value for money, and acceptability to staff, patients and carers.  Perhaps running alongside traditional research methods such as trials and economic analyses, real-time evidence can be collected online, and can help to iterate and further improve solutions.

This framework of understanding problems, creating shared visions, co-designing solutions, and testing them offers a highly practical approach to re-engaging staff and empowering patients.

It respects the expertise and experience of staff, giving them the chance to influence their day-to-day work and the strategic decisions that underpin it, and enabling them to feel heard and valued.

For patients, this framework puts their lived experience and practical knowledge of their illness and the health system at the heart of NHS reform. To date, over 7000 people have engaged in this type of improvement and innovation work via the Thiscovery platform. These patients, staff and carers have given their time, expertise and experience willingly to benefit others. The people who work in and use the NHS are a huge asset. Let’s use this framework to release their potential to deliver the reform needed.