Case Study

The University of Greater Manchester is a growing higher education institution located in the North West of England (Main Campus based in Bolton), dedicated to excellence in teaching, research, and community impact. With a diverse academic community and over 900 staff members, the university supports a wide range of undergraduate and postgraduate programmes across health and social care disciplines. These include Nursing, Midwifery, Operating Department Practitioner, Paramedic Science, Physiotherapy, Sports Rehabilitation, Sports Medicine, Public Health, Social Work, Allied Health Professions, Dental Technology, Health and Social Care, and Medical Education.

The university plays a key role in preparing the future health and care workforce through innovative, interprofessional learning, active involvement of people with lived experience, and strong partnerships with NHS, local authorities, and the voluntary sector.

The Patient as Coach Team (PaCT) initiative represents a transformative step forward in nurse education. Led by service users and carers, PaCT reimagines how student nurses learn about, connect with, and practise person-centred, compassionate care. By placing lived experience at the heart of its design, the initiative offers a powerful model of learning that supports the development of emotional intelligence, ethical awareness, and the values that underpin professional nursing practice.

In an era where healthcare systems are under increasing pressure to maintain dignity, empathy, and humanity in care delivery, PaCT stands out as a pioneering and innovative educational response. It is firmly rooted in the 6Cs of Nursing—

1. Compassion and Empathy

2. Dignity and Confidentiality

3. Trust and Honesty

4. Collaboration and Communication

5. Courage and Commitment

6. Competence and Expressing Emotion

It offers students an opportunity to engage in co-produced education shaped by people with direct experience of care. Rather than being passive recipients of care, service users and carers become educators in their own right, and are influencing the next generation of practitioners.

The PaCT initiative offers a bold and sustainable way to bridge the gap between theory and real-world practice. It humanises the learning experience, embeds lived experience as a vital source of knowledge, and helps to shape a workforce that is not only clinically competent but also grounded in empathy, dignity, and ethical care.

Recognising the value of PaCT is a recognition of what the future of nurse education must look like: one where compassion is not only taught, but genuinely understood, deeply felt, and consistently practised.

The PaCT (Patient as Coach Team) initiative was developed in response to a growing recognition within nurse education that technical proficiency alone is not sufficient for delivering high-quality, person-centred care. There was a clear need to create structured, sustained opportunities for student nurses to meaningfully engage with the lived experiences of those receiving care, that is beyond simulated scenarios or abstract case studies.

Emerging from a desire to embed values-based practice at the heart of nurse training, PaCT was designed to humanise the learning process and challenge students to critically consider the real-world impact of their communication, attitudes, and behaviours. The initiative arose from shared efforts to co-produce education with service users and carers, ensuring their voices not only inform curriculum content but actively shape professional identity formation.

The development and delivery of the PaCT (Patient as Coach Team) initiative was rooted in co-production, bringing together academic staff, service users, carers, and clinical education partners to collaboratively design and implement a meaningful learning experience for student nurses.

Planning Phase-PaCT was initiated by Lead for service user and carer involvement and academic staff within the School of Nursing and Midwifery, to embed lived experience more centrally within the curriculum. A planning group was formed, comprising Programme and Module Leads, service users and carers with experience of health and care services, NHS Practice Education Facilitators. This group co-designed the thematic framework based on the 6Cs of Nursing and created workshop formats that prioritised psychological safety, accessibility, and relevance. Crucially, service users and carers were involved from the outset as equal partners, not just as contributors but as co-educators and designers.

Delivery Phase-Each session is delivered in small groups to promote open dialogue, reflection, and a safe learning space. Sessions are facilitated by trained service user and carer educators, supported by academic staff who provide logistical coordination, safeguarding, and reflective guidance.

• Service users and carers lead Stage 1 workshops, sharing personal narratives linked to the six core themes and encouraging open dialogue with students.
• Students engage in active listening, questioning, and reflection during the sessions, followed by Stage 2, where they complete a structured Reflective Learning Worksheet aligned to the themes discussed.
• Academic staff arrange the sessions, ensure alignment with curriculum learning outcomes, and support facilitators before, during, and after the workshops.
• Feedback loops are integrated into each cycle—students, facilitators, and staff provide input that informs future session refinement and planning.

The whole process is underpinned by a commitment to valuing lived experience as expertise, with service users and carers compensated for their time, contributions and offered opportunities for training and development. This collaborative model has created a culture of mutual respect and continuous improvement, enabling the PaCT initiative to thrive as a sustainable and impactful part of nurse education.

The impact of PaCT was formally evaluated and published in Kuti and Houghton (2019), which explored student nurse perspectives on service user involvement in teaching. The study used a qualitative methodology, including focus groups and reflective narrative analysis, to assess the impact of the PaCT sessions. The article below details the measure, data fathered and results of evaluation of the PaCT session.

Kuti, B. and Houghton, T. (2019) Service user involvement in teaching and learning: student nurse perspectives. Journal of Research in Nursing.23(3-4) pp. 183 – 194

Key findings from the evaluation highlighted:

• Increased awareness among students of the real-world impact of their behaviour and communication on patients and families.
• Improved confidence in navigating complex situations and responding to service users with greater sensitivity and care.
• A stronger sense of accountability and professional values, with students reporting that the sessions challenged their assumptions and influenced their practice placements.
• Evidence of long-term impact, with students integrating learning from PaCT into their ongoing reflections captured within their Personal Development Portfolios.

The continued success and sustainability of the PaCT (Patient as Coach Team) initiative is underpinned by its strong institutional integration, co-production ethos, and commitment to continuous improvement. PaCT is firmly embedded across all three years of the adult nursing degree programme, ensuring its longevity as a core component of students’ educational journey. Its alignment with professional standards and values (such as the 6Cs of Nursing and NMC expectations) further reinforces its relevance and necessity in pre-registration nurse education.

A key feature of the initiative’s sustainability is the ongoing feedback mechanism built into its delivery. After each session, students, service user facilitators, and academic staff contribute to structured feedback forms and reflective discussions. This real-time input drives iterative refinements to workshop content, delivery methods, and support structures—ensuring the model remains responsive to changing needs and experiences.

To support future growth, we are actively recruiting more diverse service user and carer volunteers from the local community through our public and community engagement work, to further build facilitator capacity and confidence. We are also exploring interdisciplinary expansion, adapting the PaCT model for wider application across midwifery, social work, allied health, and medical education programmes—several of which are already piloting values-based, co-produced sessions inspired by the PaCT framework.

The initiative continues to benefit from institutional backing, with academic leads, curriculum planners, and quality assurance teams recognising its value. We have been highly commended by the NMC, during programme validation about the PaCT initiative. Its reputation as a model of excellence in co-produced education positions it well for future investment, partnership, and dissemination across the wider health and social care education sector.

Ultimately, the enduring strength of PaCT lies in its ability to evolve while staying true to its founding principle: that those with lived experience are not just voices in the room—they are educators who shape the professionals of tomorrow.

What makes the PaCT (Patient as Coach Team) initiative stand out is its deeply embedded, co-produced design that elevates the role of service users and carers from contributors to educators and facilitators. Unlike traditional approaches that feature lived experience as occasional input, PaCT is longitudinal, embedded across all three years of the adult nursing programme, and directly aligned with professional values and regulatory expectations.

Its success lies in several key elements:

• Authentic Co-Production: Service users and carers co-design, lead, and shape the learning, ensuring their voices are central, not tokenistic.

• Structured, Reflective Learning: The two-stage model—immersive workshops followed by reflective worksheets—balances emotional engagement with critical thinking, encouraging personal and professional growth.

• Safe, Small-Group Format: Sessions are delivered in intimate settings that foster open dialogue, psychological safety, and meaningful exchange.

• Tangible Impact on Practice: Student feedback consistently highlights improved confidence, empathy, communication, and preparedness for compassionate, person-centred care.

• Cross-Disciplinary Potential: Its structure is flexible, enabling successful adaptation across other programmes such as Social Work and CBT. These are just two examples.

PaCT is more than a teaching tool. This ethos of dignity, partnership, and emotional intelligence makes PaCT an exceptional and inspiring model that we can confidently share with others why it is critical to how we train future health and social care workforce.

These lessons below are vital for seeking to introduce co-produced, values-based learning that genuinely transforms both educational practice and student professional identity.

1. Co-Production from the Start and all the way through: Involve service users and carers as equal partners from the outset—not just as participants, but as co-designers and facilitators. Their insight is essential to shaping meaningful, authentic learning, that inhects reality in ways that an abstract case study cannot.

2. Embed: Make the initiative a sustained, integrated part of the curriculum rather than a one-off or supplementary session. Embedding ensures continuity, impact, and cultural shift in professional development.

3. Create Safe, Reflective Spaces: Use small-group formats to foster open dialogue and psychological safety. Pair storytelling with structured reflection to deepen learning and personal growth.

4. Support and Train Lived Experience Facilitators: The sustainability of this initiative has been, the ability and passion to invest in ongoing training, support, and remuneration for service user and carer educators. This ensures quality, sustainability, and mutual respect.

5. Use Feedback to Evolve: Build in continuous feedback mechanisms from students, staff, and facilitators to inform iterative improvements and keep the model responsive to changing needs.

6. Ensure Cross-Programme Relevance: Design the structure with adaptability in mind so it can be applied across disciplines like social work, psychology, and allied health professions.

7. Institutional Backing Matters: Secure leadership support to embed the model in quality assurance processes and ensure long-term commitment.