“It felt really good to have people from the NHS taking what I was saying seriously. I could tell they really cared and wanted to help people in custody and people on probation. It really made me feel valued by them.” – Malvinder, Service User

Last month, User Voice brought together service users and representatives from the NHS to an Open Space event to answer the question:

“How can we collaboratively use Lived Experience to design and evaluate the healthcare services across the Criminal Justice System?”

Open Space is a method that User Voice uses to facilitate conversation between service users and service providers/ decision makers. There is no pre-set agenda in Open Space, the discussion revolves around what the people attending want to speak about. They create the agenda together.

The event was part of the London Patient and Public Voice project. As part of this project, User Voice has been commissioned to recruit, train, and support Patient and Public Representatives to engage within health and justice commissioning systems by providing a range of support services. Representatives with lived experience engage with service users using NHS services to gain insight into their experience and any ideas they support for positive changes.

We asked all in attendance to decide what they wanted to discuss at the event. The most common themes, where service users and service providers felt conversations and collaboration are needed were:

• Mental Health support across the system (particular emphasis on police custody)
• Support for pregnant women in custody
• Disability Support in prison
• Self-harm
• Access to Services and Communication

After an initial discussion, the group was broken into smaller breakout groups with a mix of service providers and service users to allow for more detailed conversations to take place with the aim of creating solutions to the issues raised which can then be presented as recommendations (not actions) to healthcare providers.

The event was a great mix of professional and service user, different nationalities and races, different age groups, different genders and religions and different experiences of the system – which is what the event is about!

The event provided a platform for in depth and personal conversations which otherwise would never have happened. Never again will that group of people be in the same room discussing the same question again, and that was felt across those who attend, there was a real emphasis on the importance of these conversations and finding solutions which are realistic.

One service user commented “it felt really good to have my story and experience listened to by people that actually have influence. I feel like I have been able to influence some good happening and that’s all I really want to do.”

For so many service users they go through life being rejected or their opinions ignored, but at this event it was all about what they had to say and how it can be used. It was truly a demonstration of why User Voice matters.

The breakout groups created a total of 18 recommendations which use lived experience to design and evaluate healthcare services and to overall improve healthcare within the criminal justice system.
Those recommendations not only highlight the need for change within healthcare in the system but also the need for lived experience as many of the service users highlighted issues and raised concerns that healthcare staff were not aware of.

From these solutions 5 were democratically chosen to be taken forward and turned into proposals/recommendations which can be presented to healthcare services.

The next steps are for the service users who attended the event, and for any other service users who wish to be involved, to work together to answer the following questions about the 5 chosen solutions and turn them into proposals:

• Why is there a need for this?
• How would it realistically work?
• What would be needed?
• What are the benefits for the prisoners, the prisons, the healthcare teams and the NHS H&J Team

Once this has been completed a member of the UV Staff will type up the proposals and share them, via email, with NHs H&J Commissioners. Then, in the next month service users will meet with the Heads of Healthcare from secure estates across London and relevant Liaison and Diversion staff to present the recommendations and have further conversation around implementation and the gaps currently in the service.

Next steps around implementation will then be agreed and User Voice will be able to create timelines to hold the healthcare system to account in applying lasting change.

By Sophie