Background

Barry Welsh (left), after graduating with a degree in agriculture, led a successful farming career and bred prize-winning Ayrshire cattle. In the late 1990s, he was consumer representative for the then Southern Regional Health Authority. Now, he is principal advisor at the Ministry of Health and in November 2011 was awarded a PhD for his evaluation of the KPP programme in a number of District Health Boards across New Zealand.

David King led the first closure programme of the old mental hospitals when he was an NHS chief executive in Exeter, England in the 1980. Following a visit to Exeter by the first Mason review team, he was recruited in 1989 as chief executive of the Auckland Area Health Board to lead the de-institutionalisation work in New Zealand.

In 1992, he returned to London to chair the Ministry of Health’s Mental Health Task Force: the task was to close England’s last 54 hospitals and develop community services. He also co-chaired a review of London’s mental health services. Talking to consumers in every acute unit and among the homeless on the streets, made him aware that even in that great city, the numbers weren’t teeming and multiplying as everyone then believed, and, more importantly, that the people were all well-known service users.

He returned to live in New Zealand in 1995 working as a consultant, now with Te Pou.

The partnership

We first met in 1999, and teamed-up soon after.

Our experience makes a rare combination and we also found that our interests in the field were complementary. Barry’s experience of mental health services motivated him to seek improvements in their delivery with a view that, as he knew from farming, information is crucial to their achievement: it was difficult to understand how such a large industry could manage without more performance information. David’s interest was to define the qualities of a ‘good’ mental health service and make it happen everywhere.

Factors for success

From its onset, people have realised how the principles of the first KPP application can be applied to client groups in many fields.

We think that three things in particular are important in KPP.

Firstly, the data collected must relate to a particular question: what is the purpose of the service, is it delivering and having the intended effect? Our interest is data collection to inform action, not as an end in itself.

Secondly, that a selective – keeping it simple - rather than exhaustive inquiry stands the best chance of survival: if that turns up something of great interest, you can always explore one aspect in greater depth.

Thirdly, and the most important, that the best way to evaluate services is to look at the experience of consumers. We have found it possible to do this cheaply, without invading privacy, and to the potential benefit of each and every consumer.