Leading and Learning: A study to explore how patients can educate healthcare staff for better leadership and safer healthcare.
By drawing on the experience of others, an appreciative inquiry was undertaken to discover where exemplar practice involving patients in the education of health professions was occurring in order to inform and extend the involvement of patients in the work of the NHS Leadership Academy.
Visits were made to two sites in British Colombia, Canada; The Division of Health Care Communication within The University of British Colombia and Island Health on Vancouver Island – over 17 days in April 2104. Interviews and focus groups were held with health mentors, students, members of faculty, community groups and health professionals. Using a stem approach with core questions put to all, and bespoke questions for different groups, the inquiry centred on exploring the role of patients as teachers, and in particular the Health Mentors programme at UBC where the patient is the primary educator for 200 multi-professional students taking that module over a period of 15 months. Additionally insight was sought from almost all 50 mentors and 200 students during the 3rd Annual Health mentors Symposium on 23rd April 2104.
Information gained pertained to what it takes to be a successful educator and also the experience of students who were taught by patients as part of their academic study. A small number of additional visits were made within the UK on return.
Results show that patients can provide a unique dimension to healthcare education. There can be disagreement between what patients and academic staff feel is the most appropriate input. Patient educators feel that not all patients are suitable to be educators and not every part of a programme is appropriate to have patients involved. Patients feel there should be an application process similar to applying for a job and an acceptance of themselves and their condition in order to be an effective educator – involvement is about shaping the behaviour of the next generation it is not therapy for themselves.
Students who are educated by patients feel they have greater understanding of the patient as a person. They report greater curiosity to know about then beyond their condition and pay greater attention to the social effects of chronic illness.
Two strands have subsequently informed the work of the NHS Leadership Academy. These are: ‘Person first, patient second’ and for true involvement and participation individuals need Elevation – an equal presence with the programme facilitators, Dignity – that professionals see beyond the condition to the individual person, Reward – material or in kind but true recognition for their expertise. Different parts of the Academy have worked together to implement a number of developments. The NHS Leadership Academy has appointed People Champions who sit on the strategic advisory board, re-developed the curriculum to have a greater emphasis on power, diversity and inclusion, expanded roles for patients to include assessment of participants and involving patients in the governance structures of the Academy programmes.
Whilst it is still early days, patients have reported a positive experience of being involved. However, once involved, they cannot be ‘left to their own devices’. Patients need thorough preparation, ongoing support and contact. Dedicated resource has to be sought and this must in place at the outset. Patients also value continuity with a named contact. This project is just the beginning and further work is being undertaken to expand the number of patients involved in the Academy work and the roles in which they will be involved.