The participation of adult service users, including older people, in developing social care
Structure - Institutional and political barriers
Institutional and political barriers
Many organisations have an understanding of participation that positions service users as external consultants rather than partners in the development process (Carr, 2004). Since the majority of service users involvement takes place at the consultation level, where policymakers, officials and professionals generally outnumber service users considerably, this explains why some systems for participation may actually reinforce, rather than alter, existing power relations (Hodge, 2005).
Three of the most commonly used ways of preventing these problems include:
- Appointing service users onto management boards or as trustees or as co-chairs on Partnership Boards. To work well this requires careful planning and provision of appropriate training and support. Service user co-chairs can be especially effective as they help ensure that service users are at the heart of decision-making and demonstrate that an organisation is committed to participation (Fyson & Simons, 2003).
- Setting out standards for service user involvement through a compact or charter for service users.
- Changing the style of meetings by dividing into small groups, using more inclusive language by avoiding jargon, abbreviations or technical terms, making sure that there are support workers who can go through meeting papers and documents in advance with service users, and sticking to agreed timetables.
See Practice Examples for Bromley Health, Social Care and Housing Partnership Board, Rochdale Metropolitan Borough, Southern Health and Social Services Board, Surrey Users Network, and Values into Action.
Not sticking to times is also an access issue. They say the meeting is going to end at 3.30 so you organise all sorts of things to enable you to travel at that time, a taxi is waiting, assistance with rail travel is booked and you have to give them 24 hours notice and if you turn up half an hour late, you miss your train, but then the booked assistance isn’t there to meet you on arrival, or your prearranged transport. But if you leave the meeting early because it is running late not only do you miss some of the meeting but you are made to feel that you are being the awkward disabled person by insisting that you leave 'early’. (Service user)