Evaluating Patient and Public Involvement (PPI) in NHS Talking Therapies for Anxiety and Depression: A Framework Analysis of PPI Experience and Development of Good Practice Guidelines

Abstract

Abstract Background Patient and public involvement (PPI) in research is increasingly growing. Despite the potential benefits of receiving service-user feedback within healthcare services, PPI remains limited in the context of psychological therapies services. Six PPI meetings, aiming to improve treatment engagement, were held in an NHS Talking Therapies service in Northwest England. The aim of the study is to evaluate the PPI experience and to develop good practice guidelines, hoping to encourage PPI activity within Talking Therapies services. Methods The study adopted a qualitative focus group design using a semi-structured topic guide. Five participants were recruited from the PPI meetings, all of whom were ex-service users. Framework analysis, incorporating both inductive and deductive coding, was applied to the transcript. The National Institute of Health Research (NIHR) INVOLVE standards were used as the predetermined themes, namely, respect, support, transparency, responsiveness, fairness of opportunity and accountability. Results The members reported an overall positive PPI experience. Acknowledgement of PPI contribution, receiving adequate guidance and flexibility, and acquiring new knowledge increased members’ feelings of empowerment. It was also emphasised that being provided with detailed information about the process and role expectations, as well as enabling inclusivity, encouraged engagement and active participation. The members also offered some suggestions for future involvement, such as ensuring diverse recruitment and discretion. In addition, a new standard was added, “Safe Space”, underscoring the importance of creating a welcoming environment when involving people with past or present mental health difficulties. Conclusions To the best of our knowledge, this is the first study presenting good practice guidelines to facilitate the recruitment, engagement, empowerment, and impact of PPI activity in Talking Therapies services. By providing this guidance, we hope that researchers and clinical staff will be encouraged to involve service users in the decision-making of Talking Therapies service improvement.