National Service User Executive

Conference
24 January 2009
“Capturing the Customer Voice”

Patricia Gilheaney

Director Standards and Quality

Assurance

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Presentation Overview

 Mental Health Commission (brief overview)

 Consumer Involvement in Healthcare (brief

Overview)
 “Capturing the Customer Voice”
– Best practice guidelines
– Mental Health Commission
 2004 – 2007
 2008

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 Mental Health Commission
 Established in accordance with law (S.32 MHA 2001)

 13 members [Section 35, MHA 2001]

– “3 shall be representative of voluntary bodies promoting the interest of
persons suffering from mental illness (at least 2 of whom shall be a
person who is suffering from or has suffered from mental illness)”

 Legal mandate [Section 33, MHA 2001]

– “To promote, encourage and foster the establishment and maintenance
of high standards and good practices in the delivery of mental health
services and to take all reasonable steps to protect the interests of
persons detained in approved centres under this Act.”

 Remit extends across all mental health services

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Mental Health Commission
[contd.]
 C.E.O.
 Inspector of Mental Health Services
 Mental Health Tribunals
 Training and Development
 Corporate Services
 Standards and Quality Assurance

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Consumer Involvement in
Healthcare
 Social Role of Consumer

– Rights
 Patient Rights
 All consumers rights whether or not they are patients

– Values
 Self-determination

 Self-governance

 Responsibility

 Self-development

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 Consumer Involvement in
Healthcare (cont’d.)
 Social Role of Consumer
– Empowerment
 “… a social process of recognising, promoting
and enhancing people’s abilities to meet their
own needs, solve their own problems and
mobilize the necessary resources in order to
feel in control of their own lives”
[Gibson, 1991]
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 Empowerment

Exit “Voice”

Leave and go Refers to the ability of

elsewhere consumers to exert
influence over a
service, if they wish the
service to be changed
[Hirschman, (1970)] in some way
Emergence of “Consumer” in
Healthcare
 Not a new phenomenon [Hamilton, 1982]
 400 AD - “Sick chest”
 1800’s (U.K.) – “Friendly societies”
 1867 (U.S.A.) – 24,000 benevolent societies
– By the end of 19th Century medical societies
penalised participating member [Falk, 1974]
 Early
20th Century – “Twilight sleep
movement”
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Capturing the Customer Voice
 “Voice of the Customer” (VOC) process used
– to capture requirements/feedback from the customer
(internal and external)
– to provide the customer with the best in class
service/product quality
 Process
– Being proactive and constantly innovative to
capture the changing requirements of
customers with time.

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Reaching Out - Guidelines on
Consultation for Public Sector Bodies
[Department of An Taoiseach]

 Consultation Process
– Planning

– Execution

– Analysis and Evaluation

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Consultation Process -
Planning
Subject and purpose of •What is the consultation about?
consultation •What will the consultation achieve?

Identification of timescales and •What is the scope of the consultation?

question for consultation •How long will it last?
•What questions need to be answered?

•Who should be consulted?

Identification of stakeholders •What is the best way of reaching them?
and methods •Will you chosen methods reach
everybody?

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Consultation Process -
Execution
Decision to proceed
Publication and distribution of
material
Consultation period
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•Will the chosen channels reach
everybody?
•Is the material accessible?
•Have you considered legal
obligations?
•Have you chosen channels that will
reach everybody?
•Is the material accessible?
•Do stakeholders have enough time
to respond?
Consultation Process –
Analysis & Evaluation
Analysis of responses and
dissemination of results
Review of consultation process
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•Will the submissions be published?
•Will the analysis draw out key
message and themes?
•How will feedback be given?
•Will you need help to do analysis?
•Will another consultation round be
required?
•What worked and did not work in
the consultation?
•How will lessons be disseminated?
•Did the consultation make a
difference?
Consultation methods
 Written Consultation  Community Fora
 Comment/Suggestion  Citizen Panels
Schemes & Complaint
Mechanisms  Citizen Inquiries
 Mystery shopping  Customer Surveys –
 Piloting Proposals Questionnaire Based
 Public Meetings Surveys
 Open Days/ Road Shows/  Foresight/ Market
Exhibitions
 Focus Groups Observatory
 Customer/ User Panels  Ballots/ Referrals/
 Advisory Committees Deliberative Polling
 Face-to-face Interviews  Information
 National Fora Technology
 Inquiry by Design

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National Strategy for Service
User Involvement in the Irish
Health Service 2008 - 2013
Department of Health and Children

Health Service Executive

in consultation with

Health Services National Partnership

Forum

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National Strategy for Service
User Involvement in the Irish
Health Service 2008 – 2013
(cont’d.)

Goals:
2. Commitment and leadership
3. Systematic approach
4. Patient involvement in their own care
5. A Patient’s Charter
6. A specific work with children, young people and
socially excluded groups
7. Develop existing service user structures
8. Performance and development

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National Strategy for Service
User Involvement in the Irish
Health Service 2008 – 2013
(cont’d.)
Levels of involvement:
 As individuals involved in their own care
 At a community level involved in local
service delivery and development
 At a national level whereby strategic policy
is informed through the involvement of
service user organisation in partnership
with health professionals

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Strategies for Service User
Involvement in Regulation
 Involvement in the Governance of Regulatory Bodies

 Involvement on Regulatory Advisory Groups

 Participation in the development and review of strategies

 Involvement on Inspection Teams

 Consulting with service users and the public

during inspection and review activities

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Mental Health Commission
Service User Consultation
and Involvement

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Quality Framework Mental
Health Services in Ireland

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Rules

 Rules Governing the Use of Electro-Convulsive

Therapy . Brought into effect on: 1st November 2006

 Rules Governing the Use of Seclusion and

Mechanical Means of Bodily Restraint .
Brought into effect on: 1st November 2006

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 Codes of Practice [Section 33(3)(e),
MHA 2001]
 “…the Commission shall…prepare and review periodically, after
consultation with such bodies as it considers appropriate, a code
or codes of practice for the guidance of persons working in the
mental health services.”

 Code of Practice Relating to Admission of Children under the

Mental Health Act 2001.
 Code of Practice on the Use of Physical Restraint in
Approved Centres .
 Code of Practice governing the Use of
Electro-Convulsive Therapy for Voluntary Patients.

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Relevant Mental Health
Commission Research
Examples include:
 Service Users Perspectives on Home Care
Services [Fell, M., Sweeney, L. (2006)]
 The Views of Adult Users of the Public
Sector Mental Health Services [Dunne, E.
(2006)]
 Happy Living Here… A Survey and
Evaluation of Community Residential Mental
Health Services in Ireland
[Tedstone Doherty, D., Walsh, D.,
Moran,Working
R. (2007)]
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A Recovery Approach within the
Irish Mental Health Services :
Translating Principles into Practice
Discussion paper (2006):
 A Vision for a Recovery Model in Irish Mental Health
Services
Objectives:
 To review different perspectives on and definitions of
recovery
 To review models of best practice in recovery oriented
services
 To define the process of recovery
 To consider how mental health services in

Ireland could incorporate the concept of

recovery into service delivery
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 the Irish Mental Health
Services : Translating
Principles into Practice
(cont’d.)
Outcomes

Recovery Pack:
“The Recovery Journey – A Recovery Approach Within
The Irish Mental Health Services”, Position Paper,
MHC (2008)
“A Recovery Approach within the Irish Mental Health
Services – A Framework for Development” MHC (2008)
“A Vision for a Recovery Model in Irish Mental
Health Services – A Qualitative Analysis of
Submissions to the Mental Health Commission”
MHC (2007)
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 the Irish Mental Health
Services : Translating
Principles into Practice
(cont’d.)
Recovery Pack (cont’d):
– “A Common Purpose: Recovery in Future Mental Health
Services” Social Care Institute for Excellence, Royal College
of Psychiatrists, Care Services Improvement Partnership
(2007).
– “Making Recovery a Reality”, Sainsbury Centre for Mental
Health (2008).

Conference:
– “A Recovery Approach within the Irish Mental Health
Services – Translating Principles into Practice”
– 233 attendees

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 Next Steps & Challenges
Ahead
 Continue to build on active service user involvement
including “Hearing the Customer Voice”
“There is no one monolithic voice of the customer. Customer voices are
diverse. These diverse voices must be considered, reconciled and
balanced to develop a truly successful service.” [Crow, 2002]

 Continue to “learn from” service user involvement to ensure that we

continue to strive to “get it right”.
 Most powerful mechanism for “Hearing the Customer
Voice” is active involvement in one’s own care and
treatment based on the recovery approach.

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“When I am listened to I feel important and what I have shared counts.

When I’m heard I feel someone has offered me their hospitality of heart and
mind.

When I’m accepted I feel affirmed and comforted.

When my pain is acknowledged I no longer feel a fraud.

When the shattered fragments of my life are handled with compassion and
respect, I can believe in their place in re-building my life.

When I am understood I feel my burden has been shared

and the journey of healing can begin.

When I am met at my point of need, I know I have a

travelling companion for the journey ahead.”

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 Thank You

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