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

Structure - Dealing with barriers to participation

Personal barriers

Service users can be supported in overcoming some of the barriers to individual participation in three main ways. These are through:

Training for service users

Supporting service users through training is an example of capacity building whereby, as service users become more confident, their capacity for activity is increased. This has been a key feature in the development of user-controlled organizations (Postle & Beresford, 2007). However, investment in capacity building has remained low or poorly co-ordinated and this has been identified as a major reason why communities and service users remain excluded from systems for decision-making (Duncan & Thomas, 2000).

The practice survey identified the three following types of training for service users.

1. Campaigning and lobbying skills

Campaigning skills, and being able to put one’s views across effectively, are very important for service users, especially if they are taking part in formal settings, such as being a representative on a local authority strategy group. Although many service users are experienced campaigners, others are not. Training in campaigning and lobbying skills helps those without experience in this area.

See Practice Example for Alzheimer’s Society.

2. Assertiveness training

Assertiveness training can be used to help service users become more confident at expressing their views.

See Practice Examples for Bradford Metropolitan District Council and RNIB.

3. Workplace skills

Training can be used to support service users who would like to become paid workers or volunteers. This includes training in counselling and presentation skills, project management and staff recruitment.

See Practice Examples for Bradford Metropolitan District Council.

Offering training is especially important where service users are involved in specialist roles, such as teaching on social work education programmes (Duffy, 2006) or working as co-researchers (Miller et al., 2006; Smith, 2004; Walmsley, 2004).

Minimising the costs of participation to service users

Service users who can’t work go along to these meetings where everyone else is being paid as part of their salary to be there and we are not paid and we sometimes are not even paid expenses. This is hardly equality. It often isn’t done with any intention to discriminate service users, which is the sad thing. Often they just don’t have a clue about participation so they don’t take into account payment when they are putting the budget together and then it is too late and they don’t have the money. It is ignorance and a lack of thought. (Service user)

Organisations can help overcome barriers to individual participation by developing clear and efficient systems for minimising the costs to service users of participation. This is about more than the actual monetary value because it demonstrates a commitment to equalising relationships between service users and professionals. An important starting point is having a policy for participation that makes things clear from the start and spells out what will be paid and how. This helps to prevent differences in the way that people are treated and reduces the difficulties that might be caused by informal arrangements when there are organisational or staff changes.

See Practice Example for Southern Health and Social Services Board.

Linked with this, is the need to have a policy for paying support workers, and/or personal assistants, and reimbursing the expenses of volunteers if they are needed to help the person participate, or to cover replacement support costs for family carers.

It is vital to make sure that expenses are paid as quickly as possible, either by fast-tracking claims through the organisation or by bringing along cash to reimburse people on the day. Service users should be reminded in advance if they need to bring receipts or provide invoices.


[What’s needed is] changing the benefits system so people can get involved without fear and worry. It is undermining participation and people’s chance to get involved now. (Service user)

Devolving budgets to service user organisations

Power is seen in monetary terms and service user organisations don’t have much money. It’s another reason why service user organisations should be put on a better financial footing. (Service user)

See Practice Examples for The Cedar Foundation and Leonard Cheshire.

Systems that are flexible

This can range from flexible employment policies to providing quiet areas for people to rest or take time out. Similarly, there should also be recognition that service users with conditions which have periods of remission, may have times when they would like to increase their involvement.

See Practice Example for MS Society.