Royal Berkshire NHS Foundation Trust's "Meet PEET" (Patient Experience Engagement Team)

The Royal Berkshire NHS Foundation Trust’s Meet PEET (Patient Experience Engagement Team) initiative focuses on engaging and listening to seldom heard groups in our community, for example, those in deprivation index 1 and 2 (the highest level of deprivation) or those who have challenges accessing our healthcare services or a disproportionately poorer patient experience. This might be because of language difficulties or other accessibility needs. We know, for example, that those in deprivation index 1 and 2, are more likely to come to the Emergency Department; more likely to be admitted as an inpatient; more likely to have longer waits for outpatient appointments and are more likely to not attend the appointments they do have.

We are committed to improving access and patient experience for all and know that we need to listen to more diverse patient groups to fully understand their needs and how we can improve our services. We draw in specialities from across the Trust to give them opportunities to engage with our local community and our Meet PEET team is culturally sensitive, i.e. is comprised of nurses from diverse backgrounds, which helps build trust with community groups.

We aim to:

1) build relationships and trust

2) understand and respond to different communities’ varying healthcare needs

3) break down myths and barriers and improve equity in healthcare.

Meet PEET includes the following flexible programme of activity:

• Mini health checks in the local community, to start conversations about health.
• Large engagement events with particular community groups, e.g. Gurkhas, Sikhs and Pakistani communities.
• Junior Carers programme – engaging primary school children in our less affluent areas of Reading to become School Health Ambassadors and learn more about health topics and NHS careers.
• Youth Forums – Engaging with 16-24 year olds, so that we can listen to, and involve, young people in Trust decisions that can improve services for current young patients and future generations.
• Specialist groups/focused work – working with diverse groups of the community with particular needs (e.g. carers, deaf and hearing impaired, etc.), or, for example, working with particular faith groups.

So far our various engagement activities have resulted in numerous benefits for different community groups. For example, our large scale events working with the Gurkha community have included sessions on cancer red flags, benefits of exercise, palliative care services etc. We have also worked with them to develop interventions to improve their experience, like creating a National best practice guide on ‘visiting hospital’ written in Nepalese.

Our mini health checks are recognised locally as a shining example of how to engage the local community in health care. Over 22-23 we conducted over 700 mini checks which identified over 35% of those individuals had high blood pressure, 20% had high blood sugar and nearly 50% had high BMI. All those were signposted to further support for those issues. However, more importantly, often those individuals used it as an opportunity to share concerns they had about other health problems or the challenges they had faced accessing, for example, GP services or attending hospital appointments. Our nurses were able to help individuals with specific challenges, for example, calling the GP and requesting translators to be available for appointments, or connecting individuals with pharmacists who could check medications. However, the Trust was also able to make other interventions, for example, developing a social media campaign to highlight to those on benefits that they can claim travel expenses to their appointments – this was one of the key reasons those on low incomes were not attending appointments.

Our young people initiatives have given children of all ages opportunities to engage with our health services. Our Junior Carers programme provides primary school children in the lower deprivation indexes with opportunities which they wouldn’t normally be able to access. We have shared health information with them that they can pass on to family and friends, as well as inspiring careers in the health sector. They have also undertaken a 15 steps observational assessment in our Children’s wards to provide a valuable alternative perspective, on improvements which could be made. For older children, we have provided Health4youth tours around the hospital to help influence their career choices and show the diversity of opportunities available in healthcare, and our Youth Forum gives young people a voice to influence our strategy and service designs for the benefit of all young people now and in the future.

Engaging with the community has provided huge benefits for us as a Trust but also for the individuals and groups we work with in the community. Our Gurkha community leader said: “It was so important and very helpful to the communities and as an individual to give awareness, advice and very basic knowledge, to prevent from all possible health problems. We are so honoured and privileged to be part of the programme.”

Our Community partner in Whitley, one of the areas we do regular mini health checks at, said: “It’s a real inspiration seeing partnership really working to the benefit of the community”.

Our voluntary sector community partner (Reading Voluntary Action) said following one of our events: “Another successful day, where visitors, staff and volunteers spoke about how important it was to have someone who listened, took care and was so approachable and friendly. Some people who visited the team shared their negative experiences with healthcare professionals in the past”.

One of the individuals we supported at an asylum hotel said: he was extremely grateful for the time, dedication and interest we took in his health. He also felt empowered when given the blood glucose monitor. He felt in control and understood what he needed to do.

The key to making this approach successful is working with community leaders who know their community well. These individuals can help shape our engagement activities from best times and locations, types of engagement which would work best, promotion and encouragement to attend and topics they would like to focus on. We are very flexible in our approach, listen carefully to what people tell us and then make changes depending on their needs. Being out in the community rather than expecting people to come to us and attending places regularly really helps build trust.

Moving forward we are looking to grow our engagement activities and work with more areas of our community. We are working closely with our Integrated Care Board to build a sustainable programme of events and to enable us to link the work we do with individuals into primary health care, i.e. ensure information from our mini health checks is added to patient records and triggers further interventions if needed. We are also focusing on key topics which will have the biggest health improvement outcomes in our area, for example Cardiovascular Disease, as well as still encouraging specialities across the Trust to use our engagement events as an opportunity to learn from their community.