Case Study

Me first is the first healthcare communication model designed specifically for and with children and young people; it has the potential to make a significant difference to children and young people’s experience and health outcomes. Children and young people’s involvement in designing, developing, and delivering all aspects of Me first has been the single most important driver for the success of the project.

Me first is an innovative education package to improve communication between children, young people (CYP) and healthcare professionals. Me first aims to improve health outcomes for CYP by enhancing the knowledge, skills and confidence of healthcare professionals (HCP) in communicating with CYP. Crucially, all of the resources have been co-developed with CYP and have a strong evidence base in research. The centrepiece of the project is the Me first CYP centred communication model – the first designed specifically for and with CYP. The Me first masterclasses and mefirst.org.uk help HCPs to build on their existing expertise and apply the Me first communication model to their clinical practice. Co-delivered with young people, the masterclasses use quality improvement techniques to ensure the learning makes a lasting impact on practice. The emerging findings from our independent evaluation are showing a lasting impact on the communication skills of participants. A core aim of Me first is to ensure that the model, resources and learning apply to and can be adopted by all healthcare areas and services. We are determined to transcend organisational boundaries and develop education resources that make a difference to professional practice and to the experience of children and young people across the UK.

‘I should be the one involved in decisions because it’s my body’

‘When they talk to my parents, it feels like they’re the one with the condition, not me.’

Improving communication and decision making in healthcare is an issue consistently highlighted by CYP as a priority. 43% 12-15 years olds said they were not involved in decisions about their care, with CYP with long term conditions more likely to have poor experiences of communication, including not feeling listened too. The HEE mandate is clear that improved training in communicating and involving children and young people in decisions about their care has a significant part to play in improving their health. Me first seeks to improve health outcomes for children and young people through the delivery of an education programme and resources designed to enhance the knowledge, skills and confidence of healthcare professionals in relation to communicating with children and young people. The primary audience for Me first is healthcare professionals and healthcare support workers working in predominantly adult settings, who will come into contact with children and young people in the course of their work. However, we have learnt from the pilot phase that members of the children’s healthcare workforce have also found the resources useful in their own practice, in addition to supporting the development of good communication practice with trainee healthcare professionals or non-paediatric colleagues.

Partnership working has been the foundation of Me first. Funded by Health Education North Central and East London (HENCEL), Me first has been developed by Common Room and Great Ormond Street Hospital with the support of Birmingham Children�s Hospital Young Peoples Advisory Group (YPAG), East & North Hertfordshire NHS Trust, Dr Cathy Street & Associates, Evidence Based Practice Unit (UCL and the Anna Freud Centre), and Nutshell Communications. Following a review of the research, we held a national stakeholder event and also undertook extensive interviews with professionals experienced at working with CYP from a range of backgrounds, and with CYP with experience of healthcare, in order to gather evidence and top tips for use in practice and to ensure the project was informed by and worked across disciplines.

We worked with a team of young advisors to synthesize this and co-develop the full range of resources, including:

-The Me first communication model, which provides a practical framework to support children and young people-centred conversations in healthcare. We believe this is the first healthcare communication model of its kind, designed for and with children and young people.

-The Me first website (mefirst.org.uk) contains an interactive communication model to enable healthcare professionals to build their own conversations and apply the model to their practice; a resource hub, which enables users to share tools, projects, and ideas from throughout the UK; and practical advice and tips from children, young people, and healthcare professionals about how to put the model into practice.

-The Me first masterclasses, which are co-delivered with young people and support healthcare professionals to apply the Me first communication model to their practice. The training builds on attendees existing skills and expertise, and utilises quality improvement techniques to enable healthcare staff to embed learning in their clinical practice. The resources were developed and piloted, before being rolled out nationally in 2015.

The Me first project has been hugely successful. In 10 months we have trained over 200 healthcare professionals, with 100% of participants rating the training and resources as good or excellent. The Me first masterclasses have been independently evaluated by the Evidence Based Practice Unit (Anna Freud Centre and UCL), with emerging findings showing improvements in professionals exploratory listening, consensus-oriented listening and receptive listening after the masterclass. All of the professionals interviewed are now using what they learnt in their practice to make care more collaborative and young person centred.

Attendees of the masterclass have said:

‘The training has inspired me to make changes to my own practice and the department I work in.’

‘Excellent course. Very useful having all different professionals present to get a variety of perspectives and ideas.’

‘The day was engaging and creative, with a mix of different activities and time for reflection. We not only learnt the principles of CYP centred communication but how to apply them within our own specialities and practices. A rare and much needed course, I would highly recommend this to any professional working with CYP.’

Comments on our twitter #CYPMefirst include:

‘It really is excellent, I am genuinely very excited and feel this is part of the solution to so many common themes raised by our young people. Top work! It is up to us to now get using it locally.’ Karen Higgins, Young Health Champions Project Manager, Shropshire CCG

‘Just wanted to say I love everything about Me First it’s exactly what we need!. Go team Me first!’ Young Person

Improving communication and decision-making with children and young people has significant benefits across healthcare, including reducing fear, anxiety, and resistance, increasing adherence to treatment, and improving health outcomes. Thus, from the outset, the aim has been to develop a model and resources that can support CYP-centred communication across the full range of healthcare roles, professions, and services.

To achieve this we have:

-Developed the communication model, training, and resources based on extensive interviews with practitioners across a wide range of healthcare professions and services to ensure applicability and acceptability.

-Resource section and website are free and promoted nationally to ensure they are widely accessible to healthcare professionals across England. Submitting funding bids for two impact studies in partnership with other organisations to explore and evidence the impact of Me first.

-Seeking endorsement from Royal Colleges to increase the perceived relevance of Me first for specific professional groups.

Watch the Presentation Here!