How has this work influenced the way services for disordered eating are delivered at ELFT?  

One example would be that having the service user perspective in staff meetings really helps us to keep conversations honest. If we’re discussing issues around waiting lists or referral pathways, it helps us to stay focused on trying to eliminate some of the bureaucracy around referrals and make them easier – rather than keeping certain processes that aren’t valuable to residents. Hearing people’s stories has also helped us as a team to try to be more open as a service when we’re thinking about treatments. We want as few barriers as possible between somebody realising that they need support for an eating disorder and accessing treatment. For the last few months, we have been really focused on working with service users to develop a mechanism for self-referral; self-referral is huge for us.

How has the co-production work impacted on understanding of eating disorders in the service?  

I’ve actually really noticed the impact EbEs have had on other staff such as GPs, nurses and voluntary organisations. When we’ve co-delivered training to other teams, the feedback we’ve received has really highlighted what they’ve learned from the EbEs and their stories. That has emphasised to me the value of the service user perspective, especially for clinicians who might not ordinarily develop a therapeutic relationship with them. It helps them try to imagine what service users are going through. This training has also reemphasised to me some things I’ve learned from my clinical work, such as the service user perspective on ambivalence – really highlighting that struggle between desperately wanting to recover, while at the same time not wanting to get rid of some of the perceived advantages of an eating disorder.

Is there anything you’ve learned about what can be done outside of specialist services?

One big takeaway for me is that clinicians shouldn’t be afraid to ask people about their experiences with disordered eating. It’s not just a question for specialist services to ask. I think often it can be seen as invasive or potentially triggering or traumatising to ask people about their relationship with food. But I’ve heard about lots of missed opportunities to identify issues and help people and there’s a huge amount of transferrable skills that every clinician will have – as long as it’s done in a sensitive and understanding way.

What would you say to other clinicians or services who are interested the benefits of co-production, but are uncertain of the challenges in practice? 

Honestly, I would say definitely go for it. I think it takes more time to get things to completion because you’re considering more perspectives. But it saves time in the long run because what you end up with is a product or a mechanism or a referral pathway that has been thought out really well and has that service user perspective built in. I think we're trying to do that with the website we’re currently developing for our service. It's been really helpful to collaborate on that with EbEs because there were certain things, like images that we’d used, that weren't useful. There were certain turns of phrase that weren't helpful. We were able to get accurate information about how the content was being received by residents. What we end up with will be a lot more helpful and a lot more attractive to service users – which will hopefully encourage more people to seek support. If we'd done it by ourselves, I don't think we would have had the same standard or quality of product. 

How would you describe your experience of coproduction in a few words?

Enlightening. Valuable. Challenging, in a good way, in that it challenges your own views and ways of working. And finally, energy – there’s a lot of energy behind this work, and it gives a lot of energy too, I think.