The challenge
NHS Hammersmith and Fulham was clear that its user group needed to be representative of people living with diabetes in the borough. The group’s role was to influence a service redesign process that would influence all of diabetes care across the borough. Hammersmith and Fulham is a diverse inner city borough. The challenge was to make sure that seldom-heard groups were also included. Some local ethnic groups have a significantly higher incidence of diabetes and are at greater risk of complications.
What happened?
NHS Hammersmith and Fulham worked with Diabetes UK as part of the User Involvement in Local Diabetes Care project to identify the range of people that should be represented in the group. It decided on a group of 25 to ensure there were enough people.
The following profile was identified for the group:
- people with Type 1 and Type 2
- equal balance of men and women
- members from areas of deprivation/social housing
- balance of age groups (over 18)
- geographical spread across the borough (North, Central & South)
- variety in time from diagnosis, including newly diagnosed
- people from the significant local ethnic communities, including African-Caribbean, Somali/Arabic, South Asian and Chinese
- carers
- parents of under-18s using paediatric services
- people with other health needs or disabilities (eg mental health issues, visual or physical impairments, etc).
The recruitment approach was based on this profile. They designed an A4 colour flyer with simple, clear information and photos (see sample in Resources) and used it to advertise through the following groups and people:
- graduates of the Expert Patient programme (88 people)
- graduates of diabetes structured education programmes
- healthcare champions
- diabetes specialist nurse (DSN) contacts
- local Diabetes UK group contacts
- sheltered housing
- GP surgeries
- local voluntary sector
- faith communities
- community groups
- health trainers
- LINk
- CTAS (interpreters group)
- texts from one GP surgery to people with diabetes.
It also used the following communication channels:
- coverage of the project in local papers and Local Authority newspapers
- free adverts in events section of local newspapers
- Diabetes UK Facebook page
- NHS Hammersmith and Fulham website
- other internet diabetes forums
- advert posted on Gumtree London (a website community).
In Hammersmith and Fulham, the most successful method of recruitment was a mailing sent to graduates of the Expert Patient Programme. This is how the 42 initial enquirers heard about the group:
15 Expert Patient Programme mailing
5 newspaper article
3 local Diabetes UK groups
2 health awareness open day
3 local Diabetes UK groups
1 health champion
1 already involved user
1 text from GP surgery to all diabetes patients
2 Diabetes UK Facebook
9 not known.
The outcome
49 people expressed an interest in joining the group having seen a flyer or advert, and 24 people applied to be part of the group. Of those, 22 who applied were selected to be members of the group. The group was diverse in terms of age, ethnicity and where people lived in the borough. While some of the members had previous experience of user involvement, many had no experience but were eager to use their experience to influence diabetes services.