Debate on whether service users are consulted too much

We asked people:- Are service users consulted too much,
or should consultations be more selective?

These are the comments we received:

“From where we sit as workers or managers
within social services departments, one can be forgiven in thinking
that service users are overburdened by consultation.

In recent years, service users have increasingly been offered
the opportunity to become involved with decision-making, either by
taking part in major consultation exercises or  by being part of a
steering group or panel. In addition, there are rafts of
questionnaires and face-to-face surveys to take part in. Add to
that the quality initiatives, and it does paint a picture of the
service user drowning in consultation.

However, from my experience in talking to service users, most,
but not all, welcome every opportunity they are offered to tell
their stories. They hope that they can influence decision making
and  improve services. Indeed, for some of our more vulnerable
service users , the researcher may be the only contact they have
with another human being for hours or even days on end.

The message from service users is not to stop the volume of
consultation, but do something with what they are saying. Make the
consultation meaningful. Don’t keep asking the same questions but
show them how things have changed as a result of their
involvement.

A degree of co-ordination in consultation exercises is of course
to be welcomed. After all, pooled information and resources can
save money. But please don’t go down the one questionnaire will
suit all route. I know what I would do if faced with a huge and
boring questionnaire, bin it, and so too would many service users.
Consultation must take account of diversity and the individual’s
communication needs. We have to collaborate wisely to ensure that
no-one is excluded from having a voice.”

Gay Leggett
Research  Manager
Essex Learning and Social Care 
Essex

“I feel that consulting service users is
purely tokenistic in many authorities, and a large number of the
high-ranking, non-involved professional staff see the user/carer
representatives as a threat to their job.

They don’t open their minds to the real benefit and job
satisfaction that involvement and inclusion can and does bring to
their own profession and personal development. Rather than reduce
the involvement and inclusion of service users with proper
pre-decision consultations on policy and service delivery, social
work staff need to tap into the very substantial and experienced
knowledge that users and carers bring to the table in the planning,
design and delivery of social services.

When the penny drops that user/carer involvement will not go away,
and that to resist it will create a huge barrier of resentment and
distrust, such people should bear in mind that those who pay the
fiddler have the right to call the tune, and if they are unable to
play the tune then they should seek employment elsewhere.

I am a retired RMN who has for many years campaigned for the
inclusion and consultation with users and this has proved immensely
worthwhile as over the last five years it has grown throughout the
country.

Those who don’t want such practice to continue might need
to get out and about within those areas where such involvement and
inclusiveness has shown a marked increase to service delivery and
then they might want to change their excluded
views.”

Francis Fallan
Service User Representative

“It is good that service users are asked
for their opinions and thoughts on the services they receive or
improvements that can be made, as long as what they are asking for
is not unreasonable and can be done without bankrupting the service
provider.

I think that the user and the provider have to be sensible and
work together, with both sides appreciating and understanding every
aspect of the ‘whats and wherefores’ of any changes to
the service.

It is with this in mind that the introduction of supporting
people, and their monitoring of services can help us all give a
good and valued service.”

Di Stokes
Project Manager

“Service users become increasingly
irritated by consultation when they rarely see any tangible results
from previous consultations. 

Often the same questions are asked over and over again by
different agencies.  We need better, more efficient communication
and service users need to see more results.  Otherwise why do
it?“

Lynn Davies
Community Development Manager
Western Sussex PCT

“There is definitely a feeling from
service users that they are consulted too much.  However, I think
the problem is more about not seeing any real change or outcome of
the consultations that causes users to feel demoralised and
apathetic.

We have a long history of not being heard, it can feel like ‘
here we go again ‘ – nothing has changed.

The next stage from consultation should be ‘power sharing’. You
can consult users until the cows come home, but unless you
acknowledge the unequal power base, user consultation and
partnership becomes a myth.  We do have allies and dedicated
workers in our local trust who want and promote user involvement,
but they struggle to do so because they are still the exception and
not the rule.

The complexity of the benefits system is a big problem when it
comes to paying users. Payment should reflect the skills and
experience of users although, in my experience, this rarely
happens.  I had to come off benefits and become self-employed to
work as a service user trainer/consultant, which is risky for
anyone, but more so if you have a mental health
problem.“

Jeannette Harding
Service User Trainer/Consultant
South Cambs User Forum   

“At The Service User and Carer Forum for
Participation in Community Care Services we have, over the years,
built an excellent relationship with County Durham social services
department.  We take part in many consultation and participation
exercises, as well as being involved in a number of training
programmes delivered by the department to their personnel.

The forum, which has around 350 volunteer members, is able to
work as a “go-between” for social services and service
users and carers. The department will inform us in advance of any
consultation exercise and we can then invite any of our interested
members. Training involvement is developed as a joint
implementation. Even though we are involved in numerous exercises
we feel that, as we have such a wide membership to select from, we
can always offer the most useful and valuable views available.

However, we still have some hurdles to overcome: –

·   Occasionally meetings will be organised for a time and
date to suit the professionals, with the service user or carer
being expected to “fit in”.

·    Sometimes carers and service users will feel that
their involvement is tokenistic even though they have a very
important message to offer and have most probably been a useful
professional themselves before their circumstances changed due to
disability.

·    Most of those involved would agree that they could be
most useful if they were to be involved collaboratively from the
start of any process rather than be brought in “once the deed
is done”.

In the meantime, if anyone living in County Durham would like to
find out more about The Forum, please telephone 0191 384 5522 and
speak to either Alison, Bev or Sarah.