A new self-reported questionnaire to help measure the experience of service users and carers in conducting involvement activities has been developed by a team of researchers and two patient and public involvement (PPI) coordinators at King’s Improvement Science.(KIS).
The KIS team worked with South London and Maudsley (SLaM) NHS Foundation Trust, and PPI representatives to develop the questionnaire.
The questionnaire can be used by health service providers and any organisations that carry out PPI activities, who would like to assess the experiences of service users and carers who take part in those activities.
How the questionnaire was developed
The questionnaire is theoretically drawn on the 4PI National Involvement Standards (which encourage people to think of involvement in terms of: principles, purpose, presence, process and impact), and its development was informed by review of the literature, and feedback from experts in the field.
The questionnaire includes a brief Introduction, and a total of 31 questions (i.e., 22 about the ‘experience of involvement’, and nine about ‘demographic background’) which would take approximately 20-25 minutes to complete.
The identification of the experience of involvement questions (went through an intense iterative process within the research team. Clarity and pertinence of the items were explored in a focus group with service users and carers as research participants. Also, the accessibility review was tested in a small pilot.
In addition to the questionnaire, the team developed an accompanying Guide which provides information about the development of the questionnaire, and offers recommendations for how it could be used, and suggestions for improving its accessibility.
Dr Barbara Grey, Director Improvement Service (QI, SLaM Partners, Improvement Analytics, Improvement programme management) South London and Maudsley (SLaM) NHS Foundation Trust says:
“We're very excited that the 4Pi Questionnaire is available to use. Information gathered through the 4Pi Questionnaire will be immensely helpful in our continued efforts to meaningfully involve service users in quality improvement (QI). We know from our experience and our evaluation that when service users are involved from the start of QI that the results are better for all”
Richard Morton, service user and carer involvement lead at South London and Maudsley (SLaM) NHS Foundation Trust says:
“Evaluation of patient and public involvement is important to ensure that such involvement activities are conducted with a good degree of quality and in a meaningful way. We created this guide to provide a robust and standardised method to evaluate PPI, which also involves patients, service users, carers and the public as part of the design process allowing us to understand their experiences and if required have the information in regard to which area our organisation should focus improvement efforts..”
Araya Gautam, a PPI representative who helped to develop the questionnaire says:
“The 4Pi Questionnaire should be used by staff members in charge of managing patient and public engagement as part of an organised strategy to track and enhance involvement procedures. It provides insights into how individuals felt about their role and influence within a project, going beyond basic indicators (like attendance). By acting on the feedback and feeding back to involvement members on how their input led to change, staff help close the loop—making involvement feel authentic and impactful.”
Manuela Russo and Bernadette Khoshaba, Research Fellows, King’s Improvement Science.
“The 4Pi questionnaire offers a valuable snapshot of service user and carer involvement experiences. The questionnaire could offer valuable insights into how PPI is embedded across the organisation. Used alongside feedback from staff and other relevant stakeholders, it would support the development of a more comprehensive understanding of how PPI is conducted.”
