Older People’s involvement

This research aimed to find out how older people in London are being involved in the development of council policies and services. It asked about the outcomes of investment in older people’s groups that have received funding to promote engagement with public services. The research addressed the engagement of older people in improving local services, whether a wide range of older people are included in such processes and the usefulness of any support. The specific aims of the survey and case studies were to find out about older people’s participation and partnership with council services and from this to identify any gaps. The study also sought to find out what helped in working together and what hindered this approach. Finally, the study aimed to distinguish any models of participation and to highlight examples that seemed innovative and effective.

The survey found that most now have a corporate strategy or policy for engaging with local citizens, and one third of these have a specific policy applying to older people. More than half the councils who responded to the survey (22 in number) said that they provided training and support to older people to encourage and enable participation.

The councils listed a variety of ways in which older people participate, notably: through older people’s forums, newsletters, surveys and representation on groups and committees. Methods less frequently cited were involvement of older people in delivering services, as mentors or inspectors, or in reciprocal exchanges. According to the council respondents, most of whom were in social services and health units, the main barriers relate to lack of funding, time or staff to do more in this area.

Each of the three case study sites had developed a different way of engaging with local older people. One had established an independent older people’s forum, the second contracts with and supports a group to “do” participation. The third has an older citizens’ panel, a pool of older people who can be involved as and when. Innovations identified included older people  undertaking evaluations of services, provision of training and opportunities for older people from underrepresented groups to develop skills and confidence, and social activities to help build trust between older people and staff providing services. These attract older people who may not ordinarily take part in public engagement activities. Some of these developments were proving to be a source of participants for other consultations.

The qualitative part of this study involved interviews with council staff and older people. They advised local councils to communicate thoughtfully with older people, to be aware of possible disabilities and communication impairments, for instance. They recommended that older people should be thanked for their input and compensated for their time and trouble. Councils were advised to maintain traditional engagement routes and structures, but also to make use of venues that older people  frequently visit, such as doctors’ surgeries and shopping malls, to get in touch with a diverse range of older citizens. Some called for senior staff to show their support for participation efforts within their organisation and to feed back the results of consultation and resulting plans for any change.

Older people interviewed spoke of the value of personal contacts in getting involved initially. They recommended that people with experiences of meetings and familiarity with systems and services should be able to mentor those without such knowledge in order to provide support.

Government’s role in providing resources for participation was highlighted, since much of the imperative for citizen involvement has been linked to government policy (DWP 2005). Some of those interviewed believed that government could do more to help share good practice and to build up networks of experience and expertise.

Both the survey and the case studies revealed that despite citizen participation in public services being a cross-department responsibility, social services often take the lead in this (a point confirmed by the Healthcare Commission’s evaluation in 2006). This means that many older people participating in public services debates are users of social care services or are carers and, not surprisingly, have interests in this field. Other council departments appear to be content with social services taking this role and so they do not have so much input from older people (Manthorpe et al 2007).

Despite the innovations, mentioned briefly above, much participation is still pretty traditional in format: and the study authors argue that different approaches are needed. Although councils do not always see how they can spare the time and resources for this, most agreed that the broader the approaches to participation, then the greater the diversity of older people reached. Likewise, older people may have different interests or be dedicated to one single issue: and so participation approaches need to embrace all such groups.

Experiences in increasing participation among older people from ethnic minorities suggest the value of linking up to existing community groups and also providing tailored support to individuals (see also a recent study of Chinese older people, Chau 2007). For many people, informality is also an attractive element of participation.

The researchers summarise their work as revealing that how engagement is managed determines who gets involved. Some of the most common activities tend to exclude people who do not like formal methods. Many practitioners are aware that there are groups who are not regularly consulted, but they also know that there are different motivations and experiences among those who are regularly involved.

These include prior work roles, the impact of bereavement and experiences (good or bad) of using services. Improvements to participation may lie in making participation more of a corporate council activity; enhancing trust with older people, developing a menu of approaches and having resources to sustain the work.

Enlisting Senior Support: Practitioners in this study spoke of the value of having managerial support and of their managers being “visible”. This finding may encourage practitioners to ask for such engagement (“buy-in”) from senior staff with a clear idea about why this should be a priority.

Valuing Current Activity: While it is easy to say more can be done, social services should take some pride in being the leading light in many areas concerned with older people’s participation. Practitioners have much expertise that could be shared.

Practising Contact: Social workers may be used to thinking about overcoming barriers to communication on a one-to-one level with service users. This study suggests the importance of drawing on this experience to think about ways of addressing such difficulties in public settings and in the workplace.