Service user involvement goes to the very heart of service provision as those who are involved in planning services or attempting to involve service users in the new social work degree are discovering.
The main questions are: what is this service trying to achieve, who is it for, and how do we know it is hitting the target? The standard answers to these questions usually bring us to service user involvement. As a general principle, it is widely accepted but it is putting the principle into practice that is contentious.
A recent Joseph Rowntree report1 explores the involvement of service users and highlights ways to help voluntary organisations make better progress.
The researchers at the Centre for Institutional Studies at the University of East London worked with users, carers, staff, volunteers and trustees in four voluntary organisations, which were not already run by and for service users, to implement specific plans. By evaluating processes of change, the study drew out lessons that could be useful for other voluntary organisations.
The project looked at two providers of services to disabled people, one national and one regional; a local advice and support agency for people facing problems with drugs, housing, unemployment and offending; and a local community organisation for a group of women from ethnic minorities. The interviewers included one disabled and one non-disabled researcher together with a service user.
The findings raised the tricky issue of what is meant by user involvement, something with a wide range of interpretations. A distinction was made, however, between “management-centred user involvement” where users participated in a mainly pre-determined agenda defined by the organisation; and “user-centred user involvement” where it was the users who set the agenda. The report suggests that anything short of the “user-centred involvement” smacks of tokenism.
The report highlights factors promoting user involvement, including a focus on users’ priorities, good communication, and the important role of leaders with a strong sense of direction and vision while “allowing sufficient opportunity for change”. A key dimension to vision and commitment was “clarity about who the organisation was for, and therefore who it was trying to involve”.
All four projects found that policies from central and local government and the various funding bodies had provided the lever for change, but that the level of commitment to implementation had varied. The report’s usefulness therefore may be found not least in the section which highlights the “barriers to implementing change”.
Progress towards change was often slower than had been hoped, and was affected by such things as a fragmented structures or approaches, leadership styles which did not easily encourage user involvement, a “glass ceiling” that prevented users from reaching the real centres of power in the organisations, and the problems with staff turnover leading to loss of momentum and continuity.
In many ways this report contains no surprises. But to have these familiar issues, barriers and problems so clearly stated arising from organisations struggling with implementing user involvement makes the report compelling reading. It might even help many more projects to get it right.
1 Paul Robson, Nasa Begum and Michael Lock, Developing User Involvement: Working Towards User-Centred Practice in Voluntary Organisations, The Policy Press, 2003
Bernard Moss is principal lecturer in social work and applied social studies, and a learning and teachingfellow at Staffordshire University.