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

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

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

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

Framework  Considered Picker Institute and Institute of Medicine  Adapted  Care pathways

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

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

Overarching themes  Diversity  Parents  Carers  Combating stigma (also specific QS)

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

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

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

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