The participation of adult service users, including older people, in developing social care

Practice - Working with seldom heard groups

Until recently, little attention has been paid to ensuring that systems for participation take account of the diversity that exists among service users in terms of their ethnicity, sexuality, and life experiences (Beresford, 2002b; Carr, 2004).

Now, there is greater awareness of the need to include 'seldom heard’ or so-called 'hard to reach’ groups.The three main reasons why this should take place are:

  1. All service users have equal rights as citizens to make sure that their views are heard.
  2. Service users comprise an extremely diverse group (Begum, 2005; Beresford & Branfield, 2006) and this should be reflected if participation strategies are to be both inclusive and representative.
  3. Members of seldom heard groups may have separate or differing needs for participation (Begum, 2005).

The lack of more inclusive approaches to participation means that while some groups complain of 'consultation fatigue’ and the lack of action resulting from participation (Butt and O'Neil, 2004), others argue that no attempts are even made to consult with them (Afshar et al., 2002).

There is also a danger that service user participation is seen as applying only to those who are currently receiving services and fails to address groups of people who are under represented or who do not receive a service.

There are some groups of users who are more stigmatised than others and they may feel reluctant to disclose their status as a service user. In these instances, it may be necessary to use methods aimed at providing an individual and collective voice for service users at risk of being excluded from more mainstream traditional types of involvement. For example, separate focus groups for people with a learning disability have been used as part of Best Value consultations (Cambridge & McCarthy, 2001)