Patient and Public Involvement

Help me involve people in improvement

What is PPI?

 

Patient and Public Involvement (PPI) means working with patients, carers and local people to improve healthcare services.

 

Why do we do it?

 

We listen to people's views and experiences so we can make services better and meet the needs of our community.

 

How do we do it?

 

There are many ways to get patients and the local public involved in developing our healthcare services, from sharing feedback of their experiences to being involved from the start to work together to co-design improvements.

 

Please see the Co-Production Framework, Ladder of Involvement and PPI Request Form for support on how to involve patients and the local public.

 

For support, please contact Madeleine.Roche@uhnm.nhs.uk

What is Co-production?

Co-production in healthcare is an equal partnership between patients, carers, communities and health professionals. Together, they design, deliver and evaluate services.

It moves away from a traditional provider-led approach and recognises that lived experience is as valuable as professional expertise.

Our Co-production Commitment

Nothing about us without us

NHS services should be planned, designed, delivered and evaluated in partnership with the people who use them. This ensures lived experience helps drive meaningful and sustainable improvements.

What Good Co-production Looks Like

Good co-production means:

  • People are involved from the beginning, not consulted only at the end.
  • Diverse communities are represented and heard.
  • Power is shared between professionals and the public.
  • Participation is accessible and inclusive.
  • Involvement leads to meaningful change.
  • Contributors understand the impact of their involvement.
  • Relationships are built on trust, respect and mutual benefit.

Core Principles of Patient and Public Involvement and Co-production

1. Build Trust and Long-Term Relationships

  • Develop and maintain long-term relationships with communities.
  • Engage consistently, not only when feedback is needed.
  • Work alongside trusted community leaders, organisations and networks.
  • Build trust through openness, honesty and ongoing dialogue.

2. Equality, Partnership and Power Sharing

  • Patients, carers, communities and professionals work together as equal partners.
  • Make decisions collaboratively wherever possible.
  • Value lived experience alongside clinical, professional and organisational expertise.
  • Create opportunities for patient-led and community-led initiatives.

3. Inclusivity, Diversity and Accessibility

  • Proactively seek and include under-represented voices and communities.
  • Recognise the unique experiences, skills and perspectives of different people.
  • Ensure participation reflects the diversity of the population served.
  • Remove barriers to involvement and make participation accessible for everyone.
  • Adapt opportunities and communications to meet individual needs and preferences.

Consider:

  • Language and translation requirements.
  • Health literacy needs.
  • Disabilities and reasonable adjustments.
  • Digital access and digital exclusion.
  • Large-print and high-contrast materials.
  • British Sign Language (BSL) support.
  • Location, transport and timing of activities.

4. Early and Meaningful Involvement

  • Involve people as early as possible in planning and decision-making.
  • Make involvement an ongoing process rather than a one-off consultation.
  • Engage patients and communities throughout planning, design, delivery and evaluation.
  • Avoid tokenism by ensuring contributions genuinely influence decisions and outcomes.
  • Be clear about the purpose, scope and objectives of involvement.
  • Explain what can and cannot be influenced, including any limitations or constraints.

5. Flexible and Inclusive Engagement

  • Offer a range of ways for people to participate.
  • Provide both formal and informal opportunities for involvement.
  • Use a mix of face-to-face and online methods.
  • Offer sessions at different times and locations, including outside standard working hours where appropriate.
  • Enable people to participate in ways that work best for them.

6. Clear and Accessible Communication

  • Use plain English and avoid jargon, acronyms and technical language.
  • Communicate openly, honestly and transparently.
  • Use visual aids and accessible formats where appropriate.
  • Maintain regular communication throughout the process.

7. Building Capability and Confidence

  • Provide training, support and resources for all participants.
  • Build knowledge, confidence and skills among staff and public contributors.
  • Create a safe, welcoming and inclusive environment.
  • Support people to participate effectively and confidently.

8. Recognition, Reciprocity and Mutual Benefit

  • Recognise and value people's time, expertise and lived experience.
  • Treat all contributors with respect and appreciation.
  • Reimburse expenses and offer payment, incentives or other recognition where appropriate.
  • Ensure involvement benefits participants, communities and organisations.

9. Transparency, Accountability and Feedback

  • Be transparent about how decisions are made.
  • Demonstrate how feedback and involvement have influenced outcomes.
  • Share learning, actions and results with those who have taken part.
  • Close the feedback loop by showing participants the difference their contributions have made.

10. Collaboration and Shared Learning

  • Work in partnership with NHS organisations, local authorities, VCSE organisations, community groups and other stakeholders.
  • Share learning, resources and good practice.
  • Promote joined-up working across organisations.
  • Reduce duplication and engagement fatigue.
  • Make the best use of community insight and experience.

The Co-production Cycle

Stage 1: Planning and Engagement

Establish the Partnership

Bring together staff, patients, carers, communities and voluntary sector partners from the outset.

Build Relationships

  • Develop trust through existing community networks and VCSE organisations.
  • Meet people where they feel comfortable, safe and able to participate.

Define the Vision

  • Agree the purpose, priorities and desired outcomes together.
  • Be clear about what can and cannot be influenced.

Remove Barriers

Ensure meetings and activities are accessible by providing:

  • Training and support.
  • Information in accessible formats.
  • Interpreters and translators, including BSL support where required.
  • Reimbursement of expenses where appropriate.

Stage 2: Co-design and Delivery

Understand Experiences

  • Listen to patients, carers and communities.
  • Gather insight into current experiences and opportunities for improvement.

Design Together

  • Develop solutions collaboratively.
  • Ensure all voices are heard and valued equally.
  • Avoid traditional hierarchies and tokenistic involvement.

Implement Together

  • Share ownership of delivery.
  • Work as equal partners throughout implementation.
  • Maintain regular communication and opportunities for feedback.

Stage 3: Evaluation and Improvement

Measure Impact

Agree measures of success together, including:

  • Clinical outcomes.
  • Patient and public experience measures.

Review and Learn

  • Evaluate what worked well.
  • Identify opportunities for improvement.
  • Use feedback to support ongoing development.

Close the Loop

  • Demonstrate how involvement has influenced decisions.
  • Share outcomes with participants and communities.
  • Celebrate successes and share learning across UHNM and partner organisations.