Wider Patient Engagement (WPE) in the Nursing programme - a year on Kim Young Associate Professor (SL: Adult Nursing) Lead: Wider Patient Engagement Adult Nursing Field Lead (Cornwall)

Wider Patient Engagement Wider Patient Engagement Activity currently not mandatory but is recommended for all nursing students Mental Health Field Students already have this integrated within their Programme: Service User Involvement

2015: Establishing Links with Patient Representation Organisations MAKING IT HAPPEN

Enhancing Student Nurses’ Experiences of Working with Patients & Carers

Considerations for WPE Activity During Placements… Wider Patient Engagement Activity = non-clinical hours across theory and practice periods WPE activities relate to specific clinical practice Domains (OAR Document) WPE activity should be integrated but should not impact on the student’s preparation for formative and summative assessment in clinical practice WPE activity (such as patient group meetings attendance) to be negotiated with the student’s personal tutor / clinical mentor

Wider Patient Engagement Activity Integrated within the nursing programme The focus is on: Learning about peoples’ experiences of ill-health Learning about what matters to patients Understanding the impact that ill-health has on patients’ lives (and that of their families / carers) Developing knowledge of issues that affect patients / carers when accessing health care services Volunteering with patient support groups, patient participation groups Collaborating and participating with patient representation organisations during the nursing Programme Understanding the importance of raising patient concerns and learning how these are /should be addressed by health care service organisations including their reporting structures

Wider Patient Engagement: Pre-Registration Nursing Programme – National Interest Early collaboration with the Patients Association & Patient Opinion Health Education England visit – highly commended by the national team (Shape of Caring Review: Lord Willis) NHS England – collaboration with regional Patient Experience Team The PPG work with the Patients Association is a ‘national first’ Working with Health Education England to develop a national Toolkit for Patient / Public Involvement in Nurse Education Student nurses WPE activity and national recognition Presentations and awards at conferences

WPE Resources for Student Nurses On the Nursing Programme Moodle Sites WPE Information Sheet year 1 WPE Information Sheet year 2 / 3 Information Resources (what students need to know: WPE) Letter for the mentor Examples of other students’ WPE activity Examples of Plymouth University WPE innovations WPE innovation work is still evolving

Wider Patient Engagement Activities Current Examples Activities with national patient representation groups; Patient Opinion and the Patients Association Volunteering activity: local patient and service user support groups NHS Trust specific ‘Patient Involvement’ opportunities Volunteering with health charities within the local community Working with local Patient Participation Groups in GP Practices Contributing to the WPE Student Nurse Led Forum (Plymouth University) Providing evidence of learning from patient feedback: Patient, Service User and Carer Reports (written feedback) for OAR Domains / E Portfolio reflective evidence

Wider Patient Engagement & NMC Revalidation Practice Related Feedback - 1 of the 7 NMC requirements 5 Pieces of practice – related feedback over 3 years From a variety of sources / forms Written / verbal / formal / informal The feedback may come from: Patients Service users Carers Colleagues Management http://revalidation.nmc.org.uk/what-you-need-to-do/practice-related-feedback/

Undertaking WPE Activity: Adult and Child Health Field Student discusses WPE with the Personal Tutor and Mentor How much WPE activity is undertaken during each academic year? Not specified by total hours but students can take a maximum of 5 days (37.5 hours) per year for extra-curricular activities Reasonable to request /negotiate attendance to a meeting during placement time (with mentor / personal tutor) Student provides mentor with WPE activity Example Could be a monthly / bi or 3 monthly patient group meeting attendance, Statement from Others, WPE Log Sheet

Some examples of students’ Wider Patient Engagement Activities 2016 Some examples of students’ Wider Patient Engagement Activities

Example A Student A in year 1 used her unique log in details with Patient Opinion (PO) organisation to find out more about patient stories. She attended the PO Webinar in her first module to learn more about patient experiences. During the two placements in year 1, she logged in and accessed PO resources related to specific care specialities locally, regionally and nationally. This provided student A with a greater understanding of the type of experiences patients and their families have. The student learned how varied patient experiences are and also diverse types of responses that were provided to these individuals. Student A began to understand some of changes which were made by health care organisations when responding to patient feedback. Student A was able to undertake her virtual WPE at different periods throughout the academic year. She produced some reflective accounts for her E Portfolio throughout the year as evidence of ‘responding to the patient voice’ which she linked to recommendations from the Francis Report (2103). This was discussed with her personal tutor after the each placement and at the end of the academic year.

Example B Student B undertook preparatory reading about Patient Participation Groups (PPGs) in his local area during year 1. At the start of year 2, he decided to contact his own GP surgery to request joining the PPG. This involved attending PPG meetings (2 hour duration) every 3 months (6.00 – 8.00 PM). Student B negotiated with his personal tutor and nurse mentors during the clinical placement periods to attend the 4 meetings throughout the year. He attended 2 meetings on theory days which did not require negotiation. 2 meetings occurred during the placement periods which her negotiated leaving his shift at 5.00PM on the long days. His nurse mentors were supportive and understood how Student B was planning to link these experiences to his OAR Domains and provided evidence of his WPE for his E-Portfolio. Student B saved the PPG Agenda and Minutes to his E Portfolio (consent from the Practice). This included evidence of his contribution and discussion at the PPG meetings. Student B also contributed to a patient survey activity with other PPG members. This resulted in changes being made to improve to the patient experience of accessing GP Practice appointments.

Example C •Student C wanted to find out more about patient experiences and ongoing support after experiencing bowel cancer surgery in the county. This was during her surgical placement at the beginning of year 2. She had read a few ‘patient stories’ online by patients and their family members who had felt isolated and unsupported after hospital discharge. Student C contacted the colorectal specialist nurse in the local NHS Trust and arranged to meet to discuss finding out more about the patient and carer experience following discharge from hospital. The specialist nurse recommended to Student C that she might find it useful to request attending the local Bowel Cancer Support Group as a student nurse volunteer. The specialist nurses are part of this support group. This group has meetings every 2 months but also has virtual meetings.

Example C (cont) Becoming active with this group enabled Student C to develop a very good understanding of how patients and their families cope with the disabling effects of having cancer, the treatment regimes, challenges of role changes, and how these individuals cope with living with cancer after surgery. The group also takes part in health promotion activities to raise awareness of bowel cancer. Student C was able to collate evidence of her WPE contribution to designing awareness posters for local GP Practice waiting rooms. She linked these activities to the Domains in her OAR document and these were discussed as examples of WPE activity with her nurse mentor and personal tutor.

Example D Student D attended a local meeting to find out how health and social care organisations were communicating with the local population regarding the NHS Sustainability and Transformation Plan (STP). He contributed to some of the discussions with representatives from the Clinical Commissioning Group to find out more about potential proposals to save millions of pounds by 2020-21. Student D summarised the main issues raised by public and patients at the meeting and the responses made in his E Portfolio. He was able to reflect on this experience of gaining greater insight in to how patients and the public voice is communicated and how health and social care organisations response to their concerns.

My Year 1 WPE Preparation Mapping: Bethanie Woosnam I created a WPE Folder in PebblePad (E Portfolio) I used PUNC Twitter account to follow Patient Opinion and explored patient stories in detail I saved screenshots as evidence I used the recommendations in the year 1 Student Guidance for WPE (3303X Adult Field Programme site) I visited NAPP website to find out more about PPGs I researched PPGs in my area I found out about my own GP Practice PPG I researched local charities / Memory Cafes in my area I researched 5 local charities in my area that I my be interested in linking to my WPE I attended a public consultation meeting in my area regarding the future of local health services

Social Media WPE – Julie Woolman Via Twitter and the @PUNC14 project I have connected with other students and registered nurses to share information to better inform my practice I became the first student leader for the Twitter nursing community @WeNurses I host Tweetchats every month on nursing related topics. The Tweetchats often have patients and carers chatting with a variety of healthcare professionals enabling them to connect I have also connected with patient groups such as the 'Purple Angel Dementia Group' and their founder, a gentleman living with dementia from the age of 50, has been a source of endless information enabling me to understand what it is like to live with this disease Connecting with patients, carers and other healthcare professionals through Twitter enhances my professional practice

Recent Publication of our WPE Innovation Work: Young, K. , H Recent Publication of our WPE Innovation Work: Young, K., H. Eardley, and R. Jones (2016) Linking students to patient participation groups. Nursing Times, 2016. 112: p. 29-31.