The past 10 years have seen more recognition and acceptance of the right of service users to participate in developing social care, especially given the new responsibilities that key government legislative and policy initiatives have placed on organisations to consult service users. As a result, service users are increasingly asked to take part in the planning, provision and evaluation of services. This has created interest in what works in participation and why.
Whole-systems approaches have become a popular way of thinking about the steps that organisations need to take to achieve change. They involve identifying the various components of a system and assessing the nature of the links and relationships between each of them.
To make service user participation work organisations must change at every level, from senior management to front-line staff. It should become part of daily practice, not a one-off activity, and must take place at different levels of the organisation.
Wright and colleagues suggest that the different elements of participation can be brought together in a single framework, like a jigsaw puzzle. The pieces are as follows:
● Culture: The ethos of an organisation, shared by all staff and service users, demonstrating a commitment to participation.
● Practice: The ways of working, methods for involvement, skills and knowledge which enable children and young people to become involved.
● Structure: The planning, development and resourcing of participation evident in organisation’s infrastructures.
● Review: The monitoring and evaluation systems which enable an organisation to evidence change affected by participation.
The pieces, if they fit together well, have significant implications for practitioners.
● Beresford P, Shamash M, Forrest V, Turner M and Branfield F (2005), Developing Social Care: Service Users’ Vision for Adult Support, SCIE
● Carr S (2004), Has Service User Participation Made a Difference to Social Care Services? Social Care Institute for Excellence
● Department of Health/Public Services Productivity Panel (2000), Working in Partnership: Developing a Whole Systems Approach, HM Treasury
● Department of Health (2006), A Stronger Local Voice: A Framework for Creating a Local Voice in the Development of Health and Social Care Services: A Document for Information and Comment, DH
● Wright P, Turner C, Clay D and Mills H (2006), The Participation of Children and Young People in Developing Social Care, Social Care Institute for Excellence.
● Resource guide 07, Participation: Finding out What Difference it Makes
● Nasa Begum, Report 14, Doing it for Themselves: Participation and Black and Minority Ethnic Service Users
● Map the different levels at which participation occurs, from how service users are involved in daily decisions to strategic decision-making. This will help identify participation “champions” and areas that need improvement.
● Plan in advance, use accessible venues and make sure that service users have time to prepare for the meeting.
● Good practice involves making sure that service users feel valued and welcomed.
● Use reviews to assess progress and provide evidence of the changes that have been made as a result of service user participation.