Involving service users in every stage of
staff selection not only makes good recruitment sense, it can also
help fine-tune service delivery, writes Peter Beresford. And it
doesn’t have to stop there either.
User involvement in staff selection is a
particularly powerful force for progress in a welfare world where
“paying the piper” means calling the tune. The Durham example,
which is featured on page 32, is interesting for two reasons.
First, because it involves young people – a group which more often
receives brickbats than bouquets – in the care system. And second
because it concerns the appointment of senior staff – and without
things changing at the top, they will be that much harder to change
at the bottom.
As with all things in “user involvement”,
however, the involvement of health and social care service users in
staff selection and recruitment needs to be approached
systematically and coherently – enthusiasm is not enough. Effective
guidelines building on service users’ experience are overdue.
I have spoken to people with learning
difficulties who have sat on appointment panels, expressed clear
preferences and then seen someone else’s (unwelcome) candidate
appointed. Other service users on panels have reported never being
told who was actually appointed. There are also examples of good
practice to build on, but tokenism has been a long-standing problem
in this area.
To overcome this, we need to follow the rules
of good practice for all equal opportunities staff recruitment.
Service users need to be involved from the start in identifying
employment needs and drawing up job and candidate specifications.
Their role should be clearly set out and agreed. And they should
also play an equal part in the shortlisting and final selection of
any support or training they want.
But why stop there? Service users should also
be involved in defining and reviewing performance and, crucially,
in the promotion processes. Furthermore, all groups of service
users should be involved.
Already attention is starting to focus on how
groups who face particular exclusions, such as black and ethnic
minority service users, people without verbal communication, with
dementia or with multiple or “profound” impairments can contribute
to recruiting people with “the right stuff”. All this is likely to
turn on its head traditional understandings of what service users
really want and need from service workers.
This has already happened, of course, in the
best known and most effective example of service users selecting
staff – direct payments schemes – where they recruit and employ
their own personal assistants and support workers.
A growing range of service users are now
starting to gain access to these. We know that direct payments work
best and can be most inclusive where support is available from
service users’ organisations.
But later this year it will be mandatory to
offer many service users the option of direct payments and we can
expect a new phase in the development of service user-led staff
selection. There is another issue to address here. Involving
service users in staff selection has to be a step forward but it
also raises the much bigger issue of ensuring that people with
experience as service users themselves have equal opportunities to
be recruited to and promoted in the workforce.
So far this generally has not been the case in
health and social care services. More often than not, having an
impairment or experience of using mental health services has been
viewed negatively. Service user workers highlight the frequent
failure of their organisations and managers to be supportive of
This must change. Direct experience of social
care services should be valued and should be built into job and
candidate specifications. Service users’ concerns about “glass
ceilings” and their ghettoisation must also be
The Disability Discrimination Act 1995, now
extended to cover education and backed up by the Disability Rights
Commission, could make a real difference here. User-controlled
services are offering examples of good practice in employing and
promoting service users, although their often limited and insecure
funding makes it hard for them to offer an acceptable career
We’ll be getting there in mainstream services
when people with experience as service users – not least experience
of the care system – are not only appointing but are being
recruited as senior managers, as well as playing their full and
equal part in every other kind of role in health and social care.
1 Colin Gell ed,
Valuing Experience, Institute for Applied Health and Social
Policy, King’s College London, 2001
Peter Beresford is professor of social
policy at Brunel University and is active in the psychiatric system