This report published by the Joseph Rowntree Foundation is based on discussions with service users and commissioners from six London boroughs.
Key points from the document include:
· Service users identified three varying approaches towards user involvement, namely: both willing and open; ‘ostensibly open’ but not willing and not open. However some also felt that their local authorities actually assume all three of these approaches simultaneously.
· Service users also emphasized the importance of action and feedback in response to their involvement to ensure that their contribution to decision making was acknowledged and valued.
· The service users interviewed for the research were invariably willing to be involved in the commissioning of services. However they highlighted a range of issues that prevented this such as: “officers working to a service-centred model rather than a user-defined agenda”; involvement being merely a ‘tick-box’ task for commissioners and insufficient information around the aims and objectives of events.
· The impact of support workers within this process was perceived to be mixed. While in some cases it was felt that they could act as a bridge between staff and users, concerns were raised about potential conflicts of interest.
· Four of the six commissioning teams worked in local authorities, with the remaining two based jointly across the PCT and council. Many of those interviewed accepted “that there was a lack of capacity, knowledge and skills around user involvement.”
· The consensus from the commissioners was that user involvement within the NHS “lagged behind” the processes employed in social care.
· The authors highlight concerns about the willingness of commissioners to share power with their service users. They note that this is the result of a mixture of technical issues and the decision-making culture.
· Service users and commissioners did agree on a range of necessary measures to ensure user involvement is realised in practice. These include: sufficient resources; clarity about the different stages involved; valuing the experience of front line staff and service users and ownership of the process by all concerned.
For more information visit the Joseph Rowntree Foundation website.