This Toolkit has been developed as a result of the findings of a funded project (2019-2020) that aimed to improve the uptake of peer support in kidney care in the UK
The project aims to:
- extend and update a 2012 survey of peer support in kidney care across the UK
- examine the reasons for poor participation levels in peer support in two NHS Trusts by interviewing staff and patients
- use the findings of the survey and interviews to inform the development of a Toolkit to overcome the barriers and drivers to poor uptake of peer support in kidney care
The Toolkit was developed by a project team led by Nicola Thomas, Professor of Kidney Care at London South Bank University and Eleri Wood, Renal Nurse Consultant at Kings College Hospital NHS Trust in collaboration with a patient group at Barts Health NHS Trust and Kings College Hospital NHS Trust. The team would particularly like to acknowledge the support of Andrew Trasolini, the project assistant. The work was very kindly funded by Kidney Care UK.
This toolkit has been created to help your unit establish and maintain a peer support programme to provide informational, emotional and appraisal support for people with kidney disease.
How to use
Staff or supporters interested in implementing or improving their peer support service are encouraged to read through this toolkit and consider the questions posed and the resources provided. The information presented is a suggestion and can be adapted to fit the needs of your unit.
Understanding peer support
- Read about peer support projects (not just kidney care) in the UK
- Learn about the benefits and positive outcomes of peer support in kidney care (PDF)
- Read more about someone’s experience of receiving peer support
- Read more about volunteers' experiences of giving peer support
- Read a review of facilitators and barriers to peer support programmes in kidney care in the UK (Trasolini A., Wood, E. and Thomas, N (in press) A Narrative Review of Peer Support Barriers and Facilitators in Kidney Care. Journal of Renal Care)
Before setting up peer support
Some questions to ask before setting up peer support include:
Has there been peer support on your unit before?
Check to see if any sort of programme (informal or formal) was previously offered (check records, ask people involved, etc). If so, what worked and what didn’t?
Who can take the lead?
Once established, the service may not need a person solely responsible however it is helpful to have someone passionate as a leader with a peer supporter as a co-lead
Is there interest from senior unit leaders?
Was/is there funding in place or could it become available?
Have you consulted patients?
Involving patients in the design of the service will ensure it is tailored to their needs
Have you consulted your Trust’s volunteer office?
They can help with background checks. Your volunteers may have to enroll as Trust volunteers to work as volunteer peer supporters – this varies between Trusts
Determining how peer support will be offered is needed so it is inclusive and flexible for all.
- Buddying? Peer support? Peer education?
- Will support be in-person (if so, where)? Over the telephone? Based on preference?
- Will the interaction be one-to-one or in groups?
- Virtual peer support should be considered (E.g Skype, WhatsApp, Zoom, etc)
- Where will the sessions be offered? At the hospital? In an informal setting? Regardless of setting, privacy is essential
- How often will sessions be offered and can the recipient determine this? E.g one off meetings or long term support?
- How long should the duration be between interactions?
- Will a drop-in service be considered
Increased awareness for both clinicians and potential recipients is key to a programme’s success. See Peer support: increasing participation through clinician engagement (PDF)
Consider factors such as:
- Communicate reminders to staff about the programme in a timely and effective manner. Keep track of who has been referred.
- Download a staff information leaflet template (Word doc.)
- Find out the best methods to reach patients.
- Download a service promotion poster template (Word doc.)
- Download a recipient information leaflet (Word doc.)
Recruiting/Training peer supporters
Having an ongoing pool of volunteer peer supporters is important to ensure the programme maintains momentum. Some elements to consider include:
- What is important in the job description for peer supporters to be made aware of?
- E.g. What is the scope of the supporter role? How will you ensure supporters follow-through?
- Download a supporter handbook template (Word doc.)
- Download a supporter registration and preference form (Word doc.)
How will you create awareness to ask potential volunteers?
How do you encourage volunteers from specifically BAME backgrounds? How do you ensure there is a range of treatment experiences, ages, etc within your supporter pool?
- Download a recruitment poster template (Word doc.)
- Download a social media recruitment template (Word doc.)
Supporter training – supporter training is recommended due to the benefits for both the supporters and the overall service
What will supporter training look like? Who will deliver it?
- Will supporters have contact with each other/opportunities to support each other?
- Will supporters have formal support? E.g counsellor led group supervision sessions
When/how to refer
A clear/simple referral process is crucial so that clinicians can easily access peer support for their patients. The referral process should be communicated to all clinicians.
How to refer
- Can technology be used to improve the referral process? E.g referrals integrated into the patient record system or electronic reminders to refer on patient charts
- How are referrals tracked – through a team? An individual? A database?
- Will it be clinician referrals or self-referrals? A combination?
- If clinician referrals, how can their awareness be increased? And will clinicians be trained on this referral process?
- Download a sample referral form (Word doc.)
- Download a sample referral tracker spreadsheet (Excel doc.)
When to refer
- Support should be offered along the entire care journey, regardless of how long they have been a patient
Who to refer
Note that all patients should be offered peer support - just because a patient is not visibly in need/vocal about their interest, does not mean they would not benefit. Questions to consider include:
- Is there scope for identifying patients at risk who may need the service more urgently? Could risk factors be identified that help referrers make a decision? E.g current anxiety levels, existing coping strategies and carer support, complexity of disease/treatment
- Who will the service be targeted towards? All patients? Just transplant? Just those making treatment decisions? Carers? Kidney donors? This impacts on the number and type of peer supporters you’ll need to recruit
- Will you prioritise certain times of offering support? E.g when changing modalities?
The Matching Process
Matching supporters with recipients based on mutual characteristics can improve the overall experience for both.
When matching, consider:
Who is responsible for matching?
Matching can be time consuming and a set process should be in place such as a team or a database to assist so it does not fall on one person.
- Patients should be given an option to specify what preferences they would like in a supporter.
- Matching can be based on numerous characteristics and may require flexibility given the diversity of the support pool – some examples:
- Treatment experiences, age, gender, ethnicity, occupation, interests, first language, religion
- Matching based on treatment experience, condition and age has been shown to be favourable among recipients
Evaluation and feedback
Hearing feedback about the service will allow you to adapt the programme to better fit the needs of those involved. When looking for feedback, consider:
The Toolkit was developed by a project team led by Nicola Thomas, Professor of Kidney Care at London South Bank University and Eleri Wood, Renal Nurse Consultant at Kings College Hospital NHS Trust in collaboration with a patient group at Barts Health NHS Trust and Kings College Hospital NHS Trust. The work was very kindly funded by Kidney Care UK