Using patient experience data to support improvements in inpatient mental health care: the EURIPIDES multimethod study

Scott Weich, Sarah-jane Fenton, Sophie Staniszewska, Alastair Canaway, David Crepaz-keay, Michael Larkin, Jason Madan, Carole Mockford, Kamaldeep Bhui, Elizabeth Newton, Charlotte Croft, Una Foye, Aimee Cairns, Emma Ormerod, Stephen Jeffreys, Frances Griffiths

Research output: Contribution to journalArticlepeer-review


All NHS providers collect data on patient experience, although there is limited evidence about what to measure or how to collect and use data to improve services. We studied inpatient mental health services, as these are important, costly and often unpopular services within which serious incidents occur.

To identify which approaches to collecting and using patient experience data are most useful for supporting improvements in inpatient mental health care.

The study comprised five work packages: a systematic review to identify evidence-based patient experience themes relevant to inpatient mental health care (work package 1); a survey of patient experience leads in NHS mental health trusts in England to describe current approaches to collecting and using patient experience data in inpatient mental health services, and to populate the sampling frame for work package 3 (work package 2); in-depth case studies at sites selected using the work package 2 findings, analysed using a realist approach (work package 3); a consensus conference to agree on recommendations about best practice (work package 4); and health economic modelling to estimate resource requirements and potential benefits arising from the adoption of best practice (work package 5). Using a realist methodology, we analysed and presented our findings using a framework based on four stages of the patient experience data pathway, for which we coined the term CRAICh (collecting and giving, receiving and listening, analysing, and quality improvement and change). The project was supported by a patient and public involvement team that contributed to work package 1 and the development of programme theories (work package 3). Two employed survivor researchers worked on work packages 2, 3 and 4.

The study was conducted in 57 NHS providers of inpatient mental health care in England.

In work package 2, 47 NHS patient experience leads took part and, in work package 3, 62 service users, 19 carers and 101 NHS staff participated, across six trusts. Forty-four individuals attended the work package 4 consensus conference.

The patient experience feedback cycle was rarely completed and, even when improvements were implemented, these tended to be environmental rather than cultural. There were few examples of triangulation with patient safety or outcomes data. We identified 18 rules for best practice in collecting and using inpatient mental health experience data, and 154 realist context–mechanism–outcome configurations that underpin and explain these.

The study was cross-sectional in design and we relied on examples of historical service improvement. Our health economic models (in work package 5) were therefore limited in the estimation and modelling of prospective benefits associated with the collection and use of patient experience data.

Patient experience work is insufficiently embedded in most mental health trusts. More attention to analysis and interpretation of patient experience data is needed, particularly to ways of triangulating these with outcomes and safety data.

Future work
Further evaluative research is needed to develop and evaluate a locally adapted intervention based on the 18 rules for best practice.

Study registration
The systematic review (work package 1) is registered as PROSPERO CRD42016033556.
Original languageEnglish
Pages (from-to)1-338
JournalHealth Services and Delivery Research
Issue number21
Early online date1 Apr 2020
Publication statusPublished - May 2020

Bibliographical note

© Queen’s Printer and Controller of HMSO 2020. This work was produced by Weich et al. under the terms of a commissioning
contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of
private research and study and extracts (or indeed, the full report) may be included in professional journals provided that
suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for
commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation,
Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Funding:The research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as
project number 14/156/20.


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