Looking forward to the NICE Quality Standard on service user experience in mental health

1. Looking forward to the NICE Quality Standard on service user experience in mental health Dr Diana Rose Service User Co-Chair Guideline Development Group

2. Why Mental Health Specifically? • Cinderella service? • Approached by NICE differently? • Can be deprived of our liberty and compulsorily treated without committing a crime.

3. Structure of the GDG • Convened and facilitated by the National Collaborating Centre for Mental Health (NCC MH) • Two chairs: one provider and one service user • Group evenly split between providers and service users

4. Evidence • There are no RCTs • National patient surveys • But also qualitative work • Chapters in previous NICE guidance • Healthtalkonline

5. Framework • Considered Picker Institute and Institute of Medicine • Adapted • Care pathways

6. Examples of domains for quality standards • An environment of optimism • Dignity and respect • User involvement and shared decision-making • Single multi-disciplinary team • Timely access • Full information • Involvement in care planning • Those at risk of crisis have a crisis plan

7. Examples of domains for quality standards: hospital • Daily one to one contact with a professional • Meaningful and culturally appropriate activities including evenings and weekends • CR&RT used competently, safely and as a last resort

8. Overarching themes • Diversity • Parents • Carers • Combating stigma (also specific QS)

9. Shouldn’t these things be happening already? • These things not new – service users have been recommending for quite some time • We know that practice is good in some places • But in others there is a lot to be desired • Members of the GDG had experienced both • Many mental health professionals need to change their whole approach to their patients

10. What is new in this guideline and quality standard? • Rooted in the experience of mental health service users • Admits a broader range of evidence

11. Measures and metrics • Most unlikely that this quality standard could be measured using techniques such as real time experience or dashboards • Mental health service users need time to reflect on their experience of services and treatments • Recommended that service users themselves are involved in assessments of how far QS is being met locally • Yet still room for quantitative metrics

12. Conclusion • This guideline and quality standard is rooted in the experience of service users and practitioners • It was facilitated by the NCC MH and used prior evidence collected by them • It results from careful deliberation on the evidence inflected by the experience of the GDG