SCIE Practice guide 11: The participation of adult service users, including older people, in developing social care

Meaning and importance of participation - Legislation and guidance

• The United Kingdom government sees greater participation as a way of increasing the numbers of people who are 'active citizens' (Millward, 2005; Morris, 2005).
• Examples of legislation (www.dh.gov.uk/en/Policyandguidance/index.htm)
• Health and Social Care Act 2001. Its purpose was to:
  • Improve the performance of the NHS.
  • Provide better protection for patients through a faster, more effective and fair system for regulating practitioners.
  • Strengthen the way the public and patients are involved in the way the NHS works.
  • Modernise pharmacy and prescribing services.
  • Extend direct payments for social services users.
  • Provide a fairer system of funding for long term care including measures to reduce the need to sell one's home on entering residential care.
• National Health Service Reform and Health Care Professions Act 2002 which established patient forums and the Commission for Patient and Public Involvement in Health, soon to be replaced by Local Involvement Networks (LINks) (Department of Health, 2006b).
• Guidance where there is an explicit requirement for service user participation includes the White Paper Our Health, Our Care, Our Say (DH, 2006); the Valuing People White Paper for people with a learning disability (Secretary of State for Health, 2001); the National Service Frameworks (NSFs) for older people (DH, 2001); for people with mental health problems (DH, 1999) and for people with long term conditions (DH, 2005), and the requirements for the social work degree (DH, 2002).
• Legislation and guidance documents bring benefits because social care organisations are required to show evidence that they have consulted with service users. This may be used as levers for introducing changes, however there are concerns that legislative and policy pressures have sometimes led to a 'tick box' or tokenistic culture of participation (Newman et al., 2004; Beresford, 2005b).