Exploring the impact of Patient, Public and Community Engagement and Involvement in the design and development of the Evaluation of the Recovery Navigator Programme in the North East and North Cumbria
23rd November 2022
Emma-Joy Holland, Newcastle University & Fiona Tasker, public contributor
Background: People who come to emergency departments on a regular basis with alcohol problems have high levels of need, often due to their mental ill-health. However, there is currently limited evidence on how to effectively support the transition from hospital to community-based support for heavy drinkers. This study seeks to evaluate a new role, Recovery Navigators, that will provide enhanced support regarding transition back into the community across the North East and North Cumbria (NENC) Integrated Care System (ICS). Recovery Navigators will offer bespoke support to address what matters to the client, e.g. housing, benefits or welfare, and will guide care within hospitals and, crucially, post-discharge.
Methods: Mixed-methods evaluation based in six Acute Hospital Trusts and their associated community services. The evaluation comprises four work packages (WPs): WP1&2 - analysis of key routinely collected data to quantify the impact of the scheme; WP3 - semi-structured interviews with health and social care professionals, patients and carers from across NENC ICS; WP4 - region-wide staff survey. Three Patient, Public and Community Engagement and Involvement (PPCEI) groups have been established to support to evaluation including people with lived experience of heavy drinking, their carers and members of the public.
Findings: This presentation will focus on the PPCEI work conducted to date as part of WP3, the qualitative evaluation of the Recovery Navigator role. The lead qualitative researcher will discuss the impact of PPCEI discussions on the study design, in particular the recruitment strategy and materials. A PPCEI representative involved in the study will discuss their background to research involvement, their role in the study, and reflect on the changes they have helped shape.
Conclusion: This presentation will provide valuable ideas on how we lay foundations for long-term relationships with communities and public contributors in populations with high levels of need.
Emma-Joy Holland is a research associate at Newcastle University and affiliated to the NIHR School for Primary Care. Emma-Joy, who has previously worked in stroke research, joined the team at Newcastle University to facilitate the qualitative arm of the Recovery Navigator evaluation project. This practitioner-led project is funded through the NIHR Three Research Schools Mental Health Practice Evaluation Scheme and aims to evaluate the newly established Recovery Navigator role in supporting the transition from hospital to community-based support for heavy drinkers, often with co-occurring mental health difficulties.
Fiona Tasker is an Expert by Experience and is passionate about using her poor experiences to make a positive change for others. During her recovery from her last bout of Mental Health Difficulties she accessed ReCoCo (the Recovery College Collective) and now works there, providing a warm welcome to anyone coming to the building and helping those who are feeling anxious into the session they have arrived for.
Seminar series editor commentary and highlights
In their presentation, Emma-Joy and Fiona introduce the Recovery Navigator project and how public involvement has been implemented so far. In the first part of the presentation, Emma-Joy, a researcher on the project begins by introducing the background to the project, an evaluation of an intervention to improve access to services for people with mental ill health and alcohol related harm. In the second part of the presentation, Fiona and Emma-Joy adopt a novel ‘in conversation’ approach, with Fiona reflecting on her contribution to the project as an expert-by-experience in response to prompts from Emma-Joy.
Emma-Joy and Fiona’s presentation illuminates multiple ways in which research can be responsive and flexible to accommodate public contributors’ suggestions and make research more accessible. The evaluation has developed multi-faceted involvement strategy, comprising different groups with different types of expertise by experience performing different roles. Emma-Joy also highlights two areas where the research team made changes upon the recommendations of the public contributors, including producing study information in more accessible language and formats. And they then go on to lead by example by taking a different approach to presenting.
In her reflections, Fiona reminds us that impact goes in both directions, and involvement in research can be mutually beneficial for research and public contributors, particularly the value of having influence. Fiona also draws attention to the importance of being able to share both her experience of public involvement but also her expertise by experience by meeting other people in a similar position to whom she can “pass the baton”.
References and resources
Blackwood (2020) gives some context around patients who are regularly admitted to hospital due to alcohol-related illness: Prevalence and patterns of hospital use for people with frequent alcohol‐related hospital admissions, compared to non‐alcohol and non‐frequent admissions: a cohort study using routine administrative hospital data - Blackwood - 2021 - Addiction - Wiley Online Library
COVID-19 and the Northern Powerhouse -NHSA report - Demonstrates the impact of COVID-19 on various issues across the North East: NP COVID REPORT 101120 (thenhsa.co.uk)
Braun & Clark (2019) – interesting paper around analysis – we are using this approach to begin our analyses: Reflecting on reflexive thematic analysis: Qualitative Research in Sport, Exercise and Health: Vol 11, No 4 (tandfonline.com)
May (2009/2011) around Normalisation Process Theory:
Implementing, Embedding, and Integrating Practices: An Outline of Normalization Process Theory - Carl May, Tracy Finch, 2009 (sagepub.com)
Evaluating complex interventions and health technologies using normalization process theory: development of a simplified approach and web-enabled toolkit | BMC Health Services Research | Full Text (biomedcentral.com)
Recovery College Collective website (ReCoCo) www.recoverycoco.com