4Pi Involvement Standards

4Pi is a framework for the involvement of service users and carers – in our own care, in our communities, in service delivery and evaluation and in organisational governance and strategy.

4Pi is a simple framework on which to base standards for good practice, and to monitor and evaluate involvement.

The framework builds on the work on many people: mental health service users and carers and others who have lived and breathed involvement and shared their experiences in various ways, both written and unwritten.

Meaningful involvement means making a difference: it should improve services and improve the mental health, wellbeing and recovery of everyone experiencing mental distress.

Background

Developed by people with lived experience as part of the National Involvement Partnership (NIP) project, the 4Pi National Standards ensure effective co-production, thus improving experiences of services and support. They were formally launched at the NSUN AGM on the 29th January 2013.

4Pi was the result of an NSUN hosted project, the National Involvement Partnership (NIP), which was funded by the Department of Health (Innovation, Excellence, Strategic Development) voluntary sector funding. The aim of the three year project was to strengthen and ‘hard-wire’ involvement in to the planning, delivery and evaluation of the services and support we use for our mental health and wellbeing needs.

This framework established some basic principles to encourage people to think of involvement in terms of principles, purpose, presence, process and impact (4Pi).

The 4Pi National Involvement Standards continue to influence people beyond the boundaries of NSUN. We have a long list of articles, newsletters, resources and websites where 4Pi has received a mention or recommendation – even receiving international acclaim. Our Reality and Impact report a couple of years ago showed that the standards are well-used.

The Five Year Forward View for Mental Health describes 4Pi as a framework that ‘…will help ensure services and interventions are accessible and appropriate for people of all backgrounds, ages and experience’ and should support CQC inspection of ‘the quality of co-production in individual care planning, carer involvement and in partnership with communities to develop and improve mental health services.’

Please note: funding for the 4Pi project has now ceased, and we are unable to offer consultancy and training around the usage of the 4Pi Involvement Standards. However, we still encourage organisations and services to make use of the resources (which you can find below) about understanding and using the 4Pi framework. If you are an organisation looking to do involvement and co-production, and are looking for help in setting this up, running it, or evaluating it, we recommend the services of user-led organisation Shaping Our Lives.

The 4Pi framework

Statement of intent:

Our vision is of ‘nothing about us without us’. Meaningful involvement for us means involvement that makes a difference: it should improve services and improve the mental health, wellbeing and recovery of everyone experiencing mental distress. 

PRINCIPLES

Meaningful and inclusive involvement depends on a commitment to shared principles and values. This includes valuing the contribution of service users and carers equally to those of professionals.

PURPOSE

The purpose of involvement should be clear and clearly communicated to everyone involved in the activity as well as the wider organisation.

PRESENCE

A diversity of service users and carers should be involved at all levels and all stages of an organisation or project. The people who are involved should reflect the nature and purpose of the involvement. Service users and carers should have the opportunity to be involved separately as they may have different priorities.

PROCESS

The process of involvement needs to be carefully planned in terms of issues like recruitment, communications, being offered appropriate support and training and payment, so that service users and carers, including those from marginalised communities, can get involved easily and make the best possible contribution.

IMPACT

For involvement to be meaningful, it needs to make a difference to the lives or the experiences of service users and carers. This means we will be clear about the purpose of involvement, the individuals and groups who will be present and their role in the process. That process and the desired impact of involvement will be explained from beginning to end. When a particular piece of work is complete we will feed-back on what has been achieved to those involved. By working to the 4Pi Framework we will make the best of working together which should improve outcomes for all.

Resources

Pdfs:

4Pi report: executive summary
4Pi report: involvement for influence full version 
Companion report: the language of mental wellbeing
Companion report: Service User Involvement in Health and Social Care Policy and Legislation

You can also Download the 4Pi poster here

Word versions of the report and executive summary:

4Pi report: executive summary
4Pi report: involvement for influence full version

Signatories

Please note: funding for the 4Pi project has now ceased, so we are unable to offer consultancy and training around the usage of the 4Pi Involvement Standards, and we are no longer actively adding organisations to the list of signatories below. However, we still encourage organisations and services to make use of the resources (which you can find above) to understand and apply the 4Pi Standards to involvement work. If you are an organisation looking to do involvement and co-production, and are looking for help in setting this up, running it, or evaluating it, we recommend the services of user-led organisation Shaping Our Lives.

Other resources and publications on involvement and co-production

• The Ladder of Co-Production by Think Local Act Personal and NCAG
• Co-Production guidance by SCIE
• UK Standards for Public Involvement (for research) by NIHR and others
• Co-Production Model by the Coalition for Personalised Care
• Resources by The Co-Production Collective, including their 2022 resource “What is the value of co-production?” and their Co-Production Library
• “Tickboxes and Tokenism? Service User Involvement Report” and “My Voice Matters” (a guide for people wanting to take part in involvement) by Shaping Our Lives
• Involving people with lived experience in suicide prevention FAQs by the National Suicide Prevention Alliance
• Influence and Participation Toolkit by Mind
• For more, visit our Service Involvement & Influencing page