Service User Involvement: Little i  - Big I 

Our approach to QI stresses the importance of hearing all the voices involved in the area of work that you want to improve.  Different people have different perspectives, and these can open up new ways of thinking about the ways we work and deliver services. 

Service Users and Carers (also called Experts by Experience) have a unique view on our services, and their views should help shape your improvement work, from as early as possible.  Evidence suggests that the QI projects which involve patients and carers achieve more lasting improvements than the QI projects that do not.

There are different ways of working with Service users and carers to ensure that their involvement is meaningful.  We often refer to involvement as Little i and Big I.

Involvement with a little i means asking the people who use your service for ideas, what needs improving and have they noticed the improvements (after a project is completed) This can be done through a survey, focus groups etc. It is a periodic partnership.

Involvement with a Big I means involving service users and carers directly in your project and QI development and delivery. It is a full and continuous partnership. 

In practice, you may find that you work across both Little i and Big I in your work.  

The Patient Involvement Team has developed a short and simple guide to help you work effectively with service users as part of your improvement work. They can also help you find service users and carers to join your project and advise you on all aspects of involvement.   

They have also co-produced a short guidance document for service users and carers who are getting started in QI, which should be given to them as part of their induction to the project.

Please mark the level of service user involvement in your project Life QI.  You will find the ‘Service user involvement’ drop down box and a notes window on the right hand side of the General tab in your Life QI project.  Please use the notes window to briefly record what you are doing to achieve either Big I or little i.