Jaqui talks about her experience of coproducing in relation to orthopeadics. 

My name is Jackie. I'm a patient at the Royal National Orthopaedic Hospital and as part of I think it must have been one of my appointments or something they sent through, Um, you know, various information and on there it said, Do you want to be part of being a volunteer but involved in various patient experiences? And I said yes, because I'd been involved and worked for the NHS. Previously, I was just very curious, really, to get a look behind the scenes, and they had several projects. I think, that were very in the early stages of trying to get co-production going

And one of those projects was around, which is what I was just in was around developing I m e statements with a group of both staff and patients looking at what we would like as patients, what we expect from the hospital, what we'd like to have from the hospital and trying to thrash those out into statements that were understandable and sort of translatable. And then afterwards, the staff sat down and looked at our statements, made sure they were comfortable with them, and that they made sense to them and came back with any questions they had, but then sat down and we statements So how they would look at our statements and how they would be working to try and meet those statements. And then the reverse came through

So all of a sudden they would come back to us for us to say yes, you've understood us. And yes, that's the sort of thing we would look for. So it was a two way conversation all of the time, which for me was really enlightening because I'd worked for the NHS in orthopaedics 30 years previously

Back when it was very much a case of consultants weren't interested with anything apart from somebody's picture, and everything else was, you know, their their their x-ray. They didn't actually want to know who the patient was. They definitely weren't interested in it

If you've had an opinion or whether you wanted any input into any of your treatment or anything at all like that, so it was really quite refreshing. So all of a sudden somebody was interested in wanting to work with you to try and make the experience so much more beneficial to both parties. So yeah, I I thought it was

Yeah, a brilliant experience from my perspective. That Yeah, I Gosh, you said something then about the, um, how the eye and the week statements were were developed. So you, as patients, wrote the eye statements and presented them

We we Yeah, we had staff members. We had some various staff members sitting in with us so they would look and we sort of we'd split into various groups and things so we could all sort of discuss things and try and do some brainstorming and sort of trying to make sure that they made sense and then the we did then the reverse for the we statements where it was predominantly staff with some patients making sure that we could say yes, that's what we meant and talk through our statements. So it just the ratio of staff to patients depended on which way around the statements were whether they were I or we

I I love that two way dialogue that you've had in that, um, it was we couldn't have done it without it because it was no point in us sitting down just as a group of patients demanding something of a service that had no input or weren't able to express how realistic or unrealistic we were being with things. So it was Yeah. No, it was really good

What? What do you think the impact of doing that with the staff was Was Did did that Did you notice anything about, you know, Did they? How did they respond to that? I think it was really good. I think the staff, especially some of the more sort of senior staff, were actually sort of quite interested in making sure that they had people involved. And, um, I think it it it was different

It was different because I think the staff appreciated actually hearing from a patient's perspective without being in a clinical setting and being able to question OK, what is it you want from that? What is it? You know, sort of. It was not impression, You know, you can't ask somebody those questions in the clinical setting. It was completely off the books, if you like

So we were very much all sitting around the table without necessarily I'm a patient. You're a member of staff. You know, we were We were having a very much a a collective conversation, which is what I think was quite useful for both of us

Yeah, and? And what happened? What happened to the statements after that, um, you know, have have they actually made a difference. They they've all they all went up to the board. They all had to be signed off by the board

So they all got signed off by the board. They then come back. We've actually done some graphics, and we they had a budget come through to make it so that it was sort of something that could be made into posters and leaflets and spread around the around the hospital

And they they literally just got to that point now where by some of the staff members are aware because they by word of mouth or because they were involved in some of the working groups. But they're only just rolling and rolling those things out now and starting to, you know, sort of starting to produce the the various bits of artwork it it takes so long to do any of these things, doesn't it with, you know, with workshops on both sides and sign off from the board and that sort of thing. So it's when I know when I was just literally just recently an inpatient at Stanmore and speaking to some staff members, they were obviously aware of the whole project and the initiative, whereas other staff were were, were unaware because it wasn't something they'd been involved in and the posters hadn't gone out

And the, you know, the various leaflets and things like that. So it's very much the early stages. Yeah, And when we were chatting earlier, you you talked as well about, um was it the ward accreditation and how they're going to be used in relation to that as well? Yeah, The ward accreditation is another project that they're doing, which is all about trying to make the world better, to make sure that they reach a certain standard and part of that project

I was then asked to be involved based on my experience with the i o. E. Statements to have a look through and see whether or not the various all of the I statements were actually met by this by the checks that they were going to do as part of the world accreditation

So it was nice to think that even though at that point they hadn't been completely signed off. People were were aware of the fact that those statements weren't just something they were going to be as opposed to on the wall. They were actually being embedded in what they were planning on doing

Moving forward, um, with progress. Yeah, yeah, and that's That's a really nice link from it. It does show that it's not just a paper exercise

It's absolutely not just about having a set of statements, but it's looking at. Are those statements actually gonna make a difference? Is it very much, Yeah. So is the word accreditation, then, as is a bigger piece of work then or another piece of work

That's another project they have going on, obviously, like within any organisation, there are so many different projects at any one time. And this was just another project that happened to be going on that I was asked to to look at um and I think I mean, there will be multiple projects moving forward, and I'd like to think that a lot of them will consider, actually, do we need to look at the I E statements? Can we have somebody or people that have been involved with those to make sure they are sort of rolling down into any other new processes and new things we do within the within the organisation. Yeah

And do you think, um then obviously, from your perspective, as a patient, um, you've been back into that environment and you, you can see that people are aware of. Do you think it's making a difference for people? Um, having So I think so. And I know, as I say, not everybody is aware of it yet

It's too new and it hasn't properly rolled out. But I think they were quite keen. Those people that had been involved in some shape or form were quite pleased

The fact that it was now being written down the fact that the patients had an opinion were being in were going to be encouraged in sort of, especially as things move forward, they were going to be encouraged to divo that opinion. I know. For instance, I went to one department who were absolutely awful, making sure the patients that too many patients didn't realise they had a voice that was valuable and they were really excited about the fact that the patients had had asked for that voice and that it was going to be encouraged moving forward

So it was really strange to go somewhere where actually it was. They were more interested in the ice statements almost than the statements, because it was too important for them that the patients felt, which was really nice. Actually, I thought that was that was quite nice

The fact that actually staff felt that what I wanted to do as it was a patient was actually going to really help their case as well and make them work more efficiently with other departments within the organisation. So no, it was really good, Yeah. Do you think, Do you think it was a bit of a It sounded like it was a bit of a relief for them to I think it was, I think it was

And I think it was probably a case of like like any organisation or any department. Some departments are far more willing to sit down and discuss things and sort of be open and transparent and all those sorts of things than other departments, and I think it was just a case of actually, that's really good, because that means to say that we don't have to fight the battle alone as a department. We actually we will have the wider patient community potentially on our side as well

And it will help encourage that that transparency and openness throughout the whole organisation, which was good, do you think that's improved? The relationships then between the professionals and I think it will do, Yeah, I definitely think it will help sort of the internal challenges that they have as well as the external ones they do, you know that they have with with patients. And I think that's one of the things, isn't it from an external per sort of perspective? If you can go in and look with fresh eyes and say, Actually I think these improvements could be made, then there's always going to be somebody inside that says, I've been thinking that for months and years, and I was just waiting for somebody else to point it out so that so that somebody would listen to me because they weren't listening to me. So yeah, I think it's been really quite useful

Yeah, and that that was that was another sort of thing that was going through my mind was, you know, were there any surprises for people? Or was a lot of what was talked about, You know, actually, yeah, we really should have been doing this or thinking I I think it was a case of there was no real great surprises. I think it was. It was what they were expecting

I just think it was very useful for them to have a fresh perspective on it and to realise we only had. I think it was eight statements we had to have. So it was very, very much a case of having to make sure, OK, that these are the most eight most important things to us and why they are so important

And as I say, I think to some extent it's what, what they what they knew there was no surprise is it was just good for them to understand why, as a patient, it was important to us and to hear the as I say the narrative behind it a little bit and and you know, obviously it's hard to remember specifics in terms of what some of the statements are and and things. But do Do you think that in terms of the actual statements and being able to, um, implement those, are there things in there that could potentially cost the organisation a lot of money or is a lot of it around, You know, changes in the way you interact with people or there were a couple that would would cost the organisation money in terms of the fact that we were saying we would want more communication from the hospital. So we would want to be informed slightly more, Uh, and when departments already stretched the fact that they may then have to make you know an extra, you know, I don't know how many phone calls it would be, you know, if I thinking

But personally, I would like a phone call in a month, and I'm only one patient you know exponentially. How many more that would be. It would be more than the departments could cope with

And that was one of the things that some of the staff were feeding back on is like, that's an absolutely brilliant idea. I haven't got time to do that. Are we going to get the backing to do it, so they they will need to to look at how they're going to be able to fulfil some of those things back end

So yes, so I think probably a lot of it may may be. A little bit of extra work may not be a huge amount of extra work, and actually longer term may end up not looking quite as bad as what it is because, actually, if you're giving out information, maybe you don't have as many phone calls and people ringing in to find out the information. So it's it's very difficult to say, but I think, yeah, definitely some of them would have would actually have made things, at least initially, Slightly more expensive, I think

Yeah, but potential there to really make a difference? Um, yes, definitely to make it. And I think one of the things that I quite like is the fact that they were and having worked on it, definitely So it was. I was sort of privy to something that was coming down the line

The fact that they were saying to the fact that a patient has a voice that needs to be listened to when I was in hospital. I was very much aware, obviously, that several patients, especially sort of like those which are sort of slightly quieter shire, more sort of elderly. And things didn't necessarily question things openly with with staff, but then would question things almost afterwards with other patients

And it's like actually, it will be so nice when you really feel the confidence to have a voice and to to know that you have the right to question various things and not be judged for it. And, you know, and and I just thought it was it definitely gave me the confidence to to question and say no, a little bit more than I would have done previously. So I think the fact that that's gonna be a something that's almost down as a poster that you have the right to say no to something

Although we may argue with you about the you know, we will explain to you the reasons behind it. It's nice to be told that you can say no. Yeah, you know, and that you have the right to to challenge or question and things like that

So I think that would be really useful for lots of patients. Yeah, And that. And again, that's not necessarily about a a financial value

There's no monetary value on that. But there is a value for people in that they feel like you feel like you. You listen to You've got more confidence

The experience that you have now and then is overall better. Yes. Have you lost? I definitely think it will

A lot of a lot of the statements will be around making people and you've frozen. I can still hear you. You just I'm just gonna see if it will switch

Switch over. I thought something was was going going awry. Um oh, I can still hear you

Oh, you've moved again. All right, OK. I think a lot of the statements are just around making patients feel a bit more valued, which is all to and a lot of it is all to do with just in in sort of improving the patient experience and actually making them feel as if hospital is slightly less daunting

And it is a collaborative thing and that your admission and any of your treatments are being you're not They're not being done to you. They're being done with you, which Yeah, definitely makes it better. Yeah, it it

Yeah, it does. Is there anything else you'd like to add, Jackie, before I stop the recording? No, no, no. That's good

Thank you. That's brilliant. Thank you

I'll stop it..

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