Developing a patient-centred physiotherapy leaflet: A co-production journey

Introduction

Developing clear and effective patient information is essential for helping individuals comprehend and actively participate in their healthcare.

This blog provides a brief summary of the process of creating a physiotherapy support leaflet through a co-production approach within the Musculoskeletal (MSK) Hip / Knee pathway. This work was led by Alison Wilkinson (Physiotherapist) and Matt Evans (Senior Change Manager, It’s All About People Personalisation Team).

Understanding the Need

Initial conversations with both members of the public and clinicians, and a review of existing physiotherapy patient information, revealed significant gaps in understanding.

For people on a MSK journey, misconceptions about physiotherapy practices were common. People found that the available information didn’t address these misconceptions, or adequately explain what physiotherapy could offer. 

Among the public we engaged with, anxiety and reluctance to book or attend appointments were prevalent.

People had several pressing questions that impacted on their engagement in the process to access physiotherapy. These included:

• ·       Will physiotherapy worsen my condition?
• ·       Is physiotherapy mandatory?
• ·       Will it cause more pain?
• ·       How effective is physiotherapy?
• ·       What about travel and referral logistics?

Furthermore, referring clinicians were not clear about the services provided by the physiotherapy team.

First Steps

To address these issues, the team identified the need for better promotion of physiotherapy. We needed to review the existing leaflets from the point of view of the receiver. We did this by engagement with a co-production group who had previous MSK and physiotherapy experience.

Our discussions focused on content, layout, and most importantly the purpose for the potential users.

We also used what we had learned during an earlier project we had completed with One You Lincolnshire. This focused on the redesign of an information brochure to support people in pain to move more, lose weight, drink less, and give up smoking. 

Lessons learned

The co-production process highlighted several important lessons:

• The need to simplify language and avoid medical jargon.
• Use a coaching approach tailored to individual needs.
• The emotional state of people receiving the information needs to be considered.
• Focus on how physiotherapy can help people, and how people can help themselves.
• Ensure the leaflet speaks directly to the person, not the commissioner.

Actions

The team made several key changes:

• Revised wording to be more person-friendly.
• Prioritised the information that matters most to people.
• Listed treatment options and choices.
• Provided details on what to expect at the first appointment.
• Included a 'Finding Answers' section to help people to prepare questions to ask during their appointment.

Challenges and feedback

Despite the improvements, United Lincolnshire Teaching Hospitals NHS Trust (ULTH) corporate governance and branding guidelines required that changes had to be made to the proposed leaflet.

This meant that the 'corporate' version of the leaflet was less engaging and personable. Concerns were raised by the co-production group, who felt that this version of the leaflet was not for them, and would not help to encourage attendance.

Print costs also increased as the revised leaflet was a three-page instead of the original two-page document.  

Recommendations

Moving forward, the team recommends:

1. Rethinking the approach, using lessons learned.
2. Establishing a co-production group to revise the ULTH corporate/brand guidelines.
3. Focusing on communication, engagement, governance, and delivery of shared information effectively to positively influence behaviour change.

Conclusion

The journey of developing a person-centred physiotherapy leaflet underscores the importance of co-production and engagement.

By listening to people and addressing their concerns, healthcare providers can create more effective and engaging information that truly meets the needs of those it is intended to serve.

For more information, please see the slide deck in the download panel or contact us to discuss it further via lhnt.itsallaboutpeople@nhs.net