NSUN network for mental health is an independent, service-user-led charity that connects people with experience of mental health issues to give us a stronger voice in shaping policy and services.
4Pi - Framework for Involvement
4PI stands for 'Principles; Purpose; Presence; Process; Impact'; it is a framework to help create meaningful involvement with service users and carers. The 4PI national involvement standards have been developed over the last couple of years by a partnership of organisations hosted by NSUN (the National Survivor User Network). Developed within a mental health context, these standards are universally relevant to involvement and co-production in all areas of health and social care.
The idea behind the project was to ‘hard wire’ the service user and carer voice and experience into the planning, delivery and evaluation of mental health and social care services. The project shares good practice and resources, and strengthens existing networks to build an infrastructure to support strong and meaningful involvement.
The 4PI framework stands on the shoulders of giants. It builds on the work of many people: service users and carers and others who have lived and breathed involvement and shared their experiences in various ways, both written and unwritten. We carried out consultations around the country to ensure that the framework made sense to people and we made amendments as a result.
The framework helps people to think through why they are involving people, what is the purpose for involvement, where and how people will be involved and what difference they want the involvement to make. The following gives a brief summary of the standards.
Principles: Meaningful and inclusive involvement starts with a commitment to shared principles and values.
Tips: Start by sharing your principles and values together: what is important to each of you about involvement? See where there are similarities and differences: talk about them.
Purpose:People need a reason to get involved. The purpose of involvement needs to be clear and clearly communicated to everyone involved in the activity as well as the wider organisation.
Tips: At the start of an involvement activity, discuss and agree both the purpose and the outcomes you are aiming for. Record them so that the success of the involvement exercise can be evaluated later.
Presence: We would like to see a diversity of service users and carers involved at all levels and at all stages of a project or organisation. The people who are involved need to reflect the nature and purpose of the involvement.
Tips: Start by looking at the population relevant to the involvement activity, and use this as a guide to who needs to be involved. Set up monitoring procedures from the start so that you can assess the success of your recruitment (and retention) procedures.
Process: The process of involvement needs to be carefully planned to make sure that service users and carers can make the best possible contribution.
Tips: Process needs to be considered in four areas: engagement, communication, support and training, and practical issues.
Impact: For involvement to be meaningful, it needs to make a difference to the lives or the experiences of service users and carers.
Tips: The following questions can help in thinking about the impact of involvement:
What were the intended outcomes of the involvement activity?
What difference(s) have service users and carers made to the project, activity or organisation?
How did everyone feel about the process of involvement?
Did the involvement of service users and carers make a difference to the end result of the activity/project?
Did the involvement of service users and carers make a difference beyond the activity itself – to the delivery of services or the understanding of mental health, to the recovery or wellbeing of individuals?