Experience Based Co-Design of Psychosis Centred Integrated Care Services for Ethnically Diverse People with Multimorbidity (CoPICS)

Research Question: How can health and social services improve the care of people from diverse ethnic groups, living with psychosis and multiple long-term conditions? Background People living with psychosis experience more long-term physical conditions (multimorbidity, MM) and a shorter life expectancy by 15-20 years. Black and minority ethnic groups more often experience psychosis, social disadvantages, and poorer access to effective care. Patient experiences can inform better design of primary, specialist hospital, and social care. Aims To improve the care and outcomes of ethnically diverse people, living with psychosis and MM. Objectives • Gather in-depth experiences of health and social care using photovoice and biographical interviews, from diverse ethnic groups living with psychosis and MM • Use this knowledge to co-design resources for clinical practice, training, supporting carers, commissioning, policy-making, and design of integrated services • Evaluate acceptability, feasibility, and readiness for implementation • Assess cost implications • Share the findings in participating areas and Integrated Care Systems. Methods Participants: 80 people from ethnically diverse groups with psychosis and MM will be recruited from three urban and four rural regions of England. They will participate in three photovoice workshops using photographs taken to represent their care experiences with reflective narratives of these experiences. Twenty carers and 20 professionals will also undertake the photovoice workshops. A subset of 20 patient participants will give biographical narrative interviews about how care and life experiences, social contexts, relationships, and disadvantages affect their care. Peer researchers will be involved in data collection and analysis. Patient, carer, and professional experiences will be summarised to identify touch points. Using these, alongside published literature, we will develop an overall programme theory for how to improve their experiences living with psychosis and MM. The programme theory, touch points, pictures and narratives will feed into an experienced based co- design involving health and social care professionals, commissioners, policy makers, patients, and carers. The participants will pool their knowledge and experiences over 12 months and co-design a photo-gallery and narrative library, and additional resources, being sensitive to the items of normalisation process theory. The co-designed resources will address clinical practice, training, carer support, commissioning, and the design of integrated services. A PPI group will advise on all aspects of the study. We will assess readiness for implementation by a survey of practitioners, and a process evaluation (staff, patients, carers), and the cost implications of innovations. Timelines for Delivery This 39 month project includes 18 months for gathering experiences, 15 months for co-design, and six months for a process evaluation. Dissemination & Impact We will share the resources in participating regions. Future impact is expected on training, practice, commissioning, carer and patient experiences and outcomes, service design, and policies. Dissemination We will share the findings by: • Curated displays (digital/physical) of pictures, narratives, and evidence summaries. • Public knowledge festivals. • Social media, lay, and academic publications. • Involving policy and practice partners throughout.