We really want some answers

Nine years ago in Tameside, Greater Manchester, about 40 people aged 50 and over gathered with senior managers to thrash out the improvements they wanted to see in adult social services.

So successful was this inaugural Really Important Questions Conference that delegates decided it was time to form a body to
influence social care and health agendas on a regular basis.

The RIQ Network was born.

Martin Garnett, Tameside Council’s head of services for older people and community services, says the work has moved on from
being solely about consultation to actively engaging older people. “It is not tokenistic. It is aiming to put older people at the heart of service development,” he says.

“The biggest thing for me is moving from a small-scale conference to more actively influencing service transformation. We
wouldn’t do anything now without ensuring RIQ members are engaged, and the council probably gets less resistance if people
understand the changes.”

However, inviting frank comment is not always easy listening. “It can be challenging. People can be very clear when some of
the changes are not to their liking, such as consultations on post office closure, but it can and should challenge you as an organisation, you have got to be prepared to be challenged.”

The RIQ work, which is managed by adults’ services, has expanded into all public sector areas, including leisure facilities,
housing and transport. Members are encouraged to contribute their views on service development in several ways.

First, they can attend the annual conference, which is held in October and attracts up to 200 delegates who can question
speakers on a topic chosen in advance. The speakers range from senior council staff to health trust managers, voluntary services and government department officials. Last year’s topic was Putting People First, and included discussions on what personalised budgets will mean for older people.

Each year a Really Important Answers report is produced, which feeds back the questions raised and details progress. It is presented at the following year’s conference.

Four quarterly RIQ forums have been introduced, so that members can have a regular input on service developments. RIQ
members are also called upon by service managers to lend their views on specific work – for example, some representatives
are involved in contract monitoring for the council’s joint planning and commissioning team. Another strand of their work has been to shape early intervention and engagement of older people as part of the national Partnerships for Older People Project, for which Tameside is a pilot site.

Network members have been representatives on the National Service Framework working groups, including falls prevention,
integrated community equipment services and mental health. “Whenever there have been large national consultations we have
used RIQ to respond,” says Garnett.

To support their involvement, RIQ members can take part in a training programme called “How to be a good representative”,
which is provided in fortnightly sessions over a few months. The course covers training in communication and presentation
skills, how to contribute and represent views, and the structures for health, social care and voluntary services.

At Tameside General Hospital, RIQ members are involved in age discrimination training for nurses based on their experiences
of being an older person in hospital.

While the RIQ work has taken off, the user involvement development team has been introducing similar programmes of work across adult social services client groups, including forums for people with learning disabilities and those with physical
and sensory impairments. These too offer training and annual conferences.

The council’s success in engaging service users has earned it a clutch of Beacon awards, including one in 2008 for “Transforming Services; Citizen Engagement & Empowerment”. The RIQ work is also starting to be profiled nationally as a structure to gauge older people’s views.

Members of the Really Important Question Network say their input not only transforms social care and health services, but also can be the catalyst for change in their lives.

James Pinder, 79, has been an avid member since 2003: “It was the name Really Important Questions that interested me. I’d heard about RIQ through several people who had gone. The first time I went I was very impressed. I don’t know many other older people’s groups that attract so many people – there were about 130 at the last one I attended.”

He puts his enthusiasm down to “the fact that we can put questions to people in the highest management positions that we wouldn’t otherwise have contact with in day-to-day life”.

As well as attending a couple of training courses, Pinder has also spoken to a group of carers about the types of services he would like to receive from personalised budgets. “I’m in so many groups, but at least it keeps my brain active,” says Pinder.

He describes the conferences and forums as “incredibly inclusive”, by allowing people to become involved in different aspects of the work early on and drawing people from a large range of cultural backgrounds.

Doris Goodwin, 83, has attended nine conferences and forums. “I’ve benefited enormously from the amount of information I have received at those meetings from every branch of service,” she says.

Participating in the training changed her life, says Goodwin, who has a hearing impairment. “I learned communication skills – I’ve progressed from being an introvert to someone who now finds it hard to be quiet. It has given me the confidence to stand up with the microphone and know how to ask questions so that I get the answers I want.”

Goodwin has a particular interest in disability issues and took part in Tameside General Hospital’s training scheme. She is most proud of a system introduced on her suggestion to signal to people with hearing impairments when to breath in and out during X-rays.

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