A case study to explore how a national organisation works in partnership with people who have lived experience in a national mental health improvement programme

Abstract

Working with people who have lived and living experience (PWLE) is acknowledged as a key component of healthcare improvement; however, there is limited understanding of how this happens in practice. The need to improve quality in mental health care is widely recognised and to address issues, there has been a significant effort to utilise Quality Improvement within healthcare as a means of delivering evidence-based care and improving mechanisms of care and clinical outcomes. Healthcare Improvement Scotland (HIS) is a national healthcare organisation whose purpose is to lead national improvement programmes, focused on supporting services to deliver improved health and wellbeing outcomes for the people of Scotland. National improvement programmes use a range of approaches to understand the system and to design, implement and evaluate changes – with PWLE central to this work. There has been limited research within national organisations, and findings from this case study have brought together existing evidence to explore partnership with PWLE within a national context. A case study approach was used to understand how HIS worked in partnership with PWLE in a mental health improvement programme. This research explored how partnership working was described and demonstrated in practice in the Personality Disorder (PD) Improvement Programme, considering factors which influenced partnerships. Qualitative data was gathered from documents, participant observations, and semi-structured interviews. Thematic analysis was used to organise, find patterns, and elicit themes in the data. This improvement programme commissioned third-sector organisations to lead direct work with PWLE, and representation of PWLE through other organisations was discussed. Partnership working in the improvement programme was characterised by conflicting perspectives of power, different social processes, and high levels of conflict. A concept map is presented to articulate how key themes of mechanisms, identity and power were demonstrated in practice and how they influenced partnership working within a national context.