1. A volunteer’s guide to PPI
Patient and Public Involvement
A volunteer’s guide to PPI
For more information please contact
The PPI team
Nottingham University Hospitals NHS Trust
Trust Headquarters
City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB
phone ext 76029
© 2013 Nottingham University Hospitals NHS Trust
This information can be provided in different languages and formats. To request this or for more information please contact the PPI team on ext / 76029
Designed by April Strategy LLP
Version 3, March 2013

2. Contents Foreword What is Patient & Public Involvement (PPI)? p4
Why carry out PPI? p5
Getting involved in PPI activities p6
The PPI cycle: four types of activity p8
A. Patients’ needs and views p10
B. Participation and co-design p11
C. Partnership in running services p12
D. Planning and monitoring p13
Involving seldom heard people and p14 diverse minority groups
Our commitment to our patients is to provide caring, safe, thoughtful and effective care. We have made a promise to patients that ‘we are here for you’.
In making this a reality every day, for every one of our patients it is essential that patient and public opinion is heard, feedback is acted on, and lessons are learned.
This guide has been introduced to help volunteers and other members of the public to support us in our Patient and Public Involvement activities. If you would like get involved please do get in touch with the PPI team.
Chief Executive,
Nottingham University Hospitals NHS Trust
In this document the term ‘patients and public’ encompasses patients, carers, service users, individuals, groups and communities. Depending on what we want to achieve we may involve different people or groups at different times. 2 3

3. Why involve patients and the public?
What is Patient and Public Involvement?
PPI means putting patients and the public at the centre of all that we do, so they can:
Let us know about their needs and experiences
Identify what they want from services
Share their ideas and get involved in service design
Have a say on how services and plans are delivered
Understand why services need to change
Tell us how we are doing delivering our promises
Involve people in decisions about their treatment
Understand what’s going well.
PPI helps us to be ‘here for you’
Our promise to our patients at Nottingham University Hospitals NHS Trust (NUH) is that ‘we are here for you’. Through our Values and Behaviors project we have promised patients that they will feel cared for, feel safe, feel confident in their treatment and feel that our services are getting better.
PPI is about listening to and involving patients and the public, so we can understand how we can best serve their needs as individuals. It helps us to be ‘here for you’ in ways they want.
Why is PPI important?
PPI is about understanding and valuing the benefits of involving patients, visitors, carers and other members of the public in the planning, development, day-to-day delivery and evaluation of health services. Effective PPI can improve patient care, and it’s a legal requirement too.
What benefits are we looking for?
By listening to patients’ views: we can learn about their needs and experiences and identify specific areas for improvement
By involving patients and the public in service design: we can ensure that our services are designed and adapted to respond better to the needs of individual patients and patient groups
By running services in partnership with patients: we keep patients’ needs at the forefront of every decision we make, and allow alternative proposals to be developed
By measuring how we are doing: we can see how our improvement plans and activities are progressing. 4 5

4. Getting involved in PPI activities
PPI activities you can get involved in
We have a regular programme of events for our 10,000 Foundation Trust public members
Our Readers’ Panel advises us on patient information leaflets and other publications
Our Patient Partnership Group meets monthly to comment on services and advise on PPI activities
We have a Young People’s Forum
We work closely with LINks (local involvement networks) and patient support groups
We attend local community events and forums.
Listening to patients’ experiences
We measure the views of inpatients and users of other services through annual national surveys and monthly Trust-wide surveys
We use handheld ‘patient opinion trackers’ to understand patients’ experience of our services, and train volunteers to carry out these surveys and to undertake ‘observations of care’
We have processes to manage and learn from patient complaints, concerns and compliments.
The PPI cycle
All these activities form part of our PPI cycle and the next pages describe how you can help us by getting involved…
At NUH PPI is everybody’s job
Everybody at NUH is committed to improving the health and wellbeing of the people we care for. Involving patients in improving services is an important part of our professional roles. Our Trust- wide values and behaviours state that:
Improving services is everybody’s role
We can start by listening to patients.
Getting involved
This guide has been introduced to help volunteers and other members of the public to support us in our PPI activities. If you are interested in getting involved please get in touch with the PPI team on
ext 76029 6 7

5. The PPI cycle A. Patient needs and views Four types of PPI activity
Getting new insight into the needs, views and experiences of the people we serve, listening to:
Patient stories
Focus groups and discussions
One-to-one interviews
B. Participation and co-design
Involving patients in designing improvements and making strategic decisions, through:
‘In your shoes’ workshops
Experience-based design
Informal consultation meetings
C. Partnership in running services
Giving people a say in running our services, via:
User and community groups
Patient champions
Carer groups
D. Planning and monitoring
Checking how we are doing and where to focus improvement efforts, using tools including:
Surveys
Observations during care and treatment
Recording and action planning.
Four types of PPI activity
At NUH we use PPI across the life-cycle of service delivery and improvement, from listening to patients’ views, involving them in designing improvements, acting as partners in oversight of service delivery, and measuring how we are doing to identify new areas for improvement.
A. Patient needs and views
Types of PPI
D. Planning and monitoring
B. Participation and co-design
C. Partnership in running services 8 9

6. A. Patient needs and views B. Participation and co-design
This includes approaches that staff and services use to gain insight into the needs, views and experiences of the people we provide a service to. This helps us to understand where we need to focus our improvement efforts and identify what works well to give positive feedback to our teams.
Patient stories to inspire and motivate change
Focus groups to explore an issue in detail
One-to-one interviews to gain insight from a broader cross-section of the population.
How can you get involved?
The experience of every single patient or carer is important to us, and is an opportunity to learn and improve. Let us know if you or a family member of friend has had an experience at NUH from which we can learn
To support our frontline teams in their efforts to hear about patients’ experiences we can offer you training to listen to patients’ stories on the wards or to facilitate focus groups.
This includes approaches that can help us involve patients and the public in designing service improvements and making strategic decisions:
In your shoes: setting priorities with patients and building staff ownership for delivering them
Experience-based design: staff and patients working together to design service improvements
Informal consultation meetings: getting public feedback to proposals, and listening to alternative approaches.
How can you get involved?
By registering your interest in supporting a specific service or group of services, we can let you know about the improvement events and workshops that will most interest you
You could support the services you are interested in by offering to help with ‘recruitment’ of patients and the public to attend events, for example by handing out leaflets. 10 11

7. C. Partnership in running services D. Planning and monitoring
This includes approaches that give our communities and service users a say in how our services are run and help us to stay patient-focused in our day-to-day management and decision-making:
User and community groups: regular meetings of people who are interested in specific services to provide insight into experiences and feedback on developments
Patient champions: involving patients as observers at regular management meetings to ensure decision-making is patient-centred
Carer groups: support networks for carers to understand their needs and experiences, and gain feedback on proposals.
How can you get involved?
You could join an existing user or carer group. Contact the PPI team for a list of current groups
Where a user or carer group doesn’t currently exist we can support you to set up and run one
We are actively looking for ‘patient champions’, so if you would like to attend key meetings to help us stay patient-focused please let the PPI team know.
Approaches to check how we are doing in delivering our promises to ensure patients feel cared for, feel safe and feel confident in their treatment, and in delivering improvement plans:
Surveys: can help determine priorities and track if services are improving over time
Observations during care and treatment: are helpful in providing immediate feedback to clinicians on the care they are providing and supporting behaviour change
Recording and action planning: after each PPI activity teams develop an action plan.
How can you get involved?
Learning how to undertake ‘observations of care’ is a simple way to help us ensure we are delivering our promises and procedures. It’s a lot easier than it sounds, so please get in touch with the PPI team
Help us to get feedback from patients in real time through our ‘patient opinion tracker’ programme. 12 13

8. Involving seldom heard and diverse minority groups
There are many people in our community whose views we have not heard as much as we could. Often it is these groups who do not access services they are entitled to and often need.
There are many reasons why these groups are heard less than others, and so we need to work harder to ensure we do listen to their experiences and points of view. If you can help us to hear more about the needs and experiences of these groups and individuals, please get in touch with the PPI team.
People who find it more difficult to have their views heard can include, but are not limited to:
Anyone with a bad experience of the service
Ethnic minorities or people who don’t speak English as a first language
People with mental health issues
People with learning difficulties
Disabled people
Children and young people
Older people
Lesbian, gay, bisexual and trans people
Victims of domestic abuse
Refugees and asylum seekers
Homeless people
Travellers
Single parents
Sex workers
People who work
Carers
Drug users. 14 15