User Involvement in ‘Clinical What’?
| Date | 01 September 2004 |
| Pages | 21-23 |
| DOI | https://doi.org/10.1108/13619322200400027 |
| Published date | 01 September 2004 |
| Author | Richard Brook,Moira Fraser |
| Subject Matter | Health & social care |
Focus on…
The Mental Health Review Volume 9 Issue 3 September 2004 ©Pavilion Publishing (Brighton) 2004 21
User Involvement in
’Clinical What’?
Richard Brook
Chief Executive, Mind
Moira Fraser
Policy Officer, Mind
he triumph of the service user and
survivor movement over the last 20 years is that it
would be unthinkable now to write a policy or set up a
working group on clinical governance without placing
the issue of user involvement very firmly on the list of
‘must haves’. This right to involvement has been
enshrined in the Health and Social Care Act 2001,
which states that it is the duty of trusts to ensure that
persons to whom services are being provided are
involved in and consulted on the planning and
provision of those services.
This has been a battle long fought, and it is
testament to the tenacity of users and survivors that so
much has been achieved. And there are undoubtedly
many examples of service users playing a full,
influential role in the planning, delivery and
monitoring of services across the country –
unthinkable in the thankfully dim and distant past
where the ‘patient’ was expected to be grateful and
know his or her place.
Involving service users, survivors and also carers is
now seen as an ethical and democratic requirement.
The assumption that someone who has never been in
the position of using a service can know what it is like
to be in that position, or the ways in which services
can best help, has been challenged successfully. A
much more partnership-based approach is promised
between service users and professionals, and between
the voluntary and statutory sectors, with a view to
providing services that are designed around what suits
those who use them.
So perhaps we should permit ourselves a small pat
on the back for whatever part any of us might have
played in supporting the colossal change which has
been achieved, albeit slowly and with many
frustrations along the way.
We must not get too carried away, however. We are
a long way from the involvement nirvana where users
Tand survivors are universally treated as equals, as
people who are experts, who play a fundamental role
in making sure services are responsive to the needs of
those who use them. Because despite the ostensible
move towards the democratisation of our health and
social care, experience from the front line tells us that
much more is still to be fought for. In many cases
users are not so much in the driving seat of clinical
governance as passengers somewhere up the back of
the bus without a map and no idea where it is going
anyway. Or worse, frustrated hitch-hikers who are only
allowed on board if they happen to be going in the
same direction and promise not to cause trouble.
But it is all too difficult, the cry goes up. It’s hard to
recruit service users, and then they don’t turn up to
meetings, or they’re not representative, or they
haven’t read the papers or they don’t understand
what’s going on so can’t take part in the discussion. Or
it takes too much time or it’s too expensive. And it can
be just as confusing, frustrating, boring, demoralising,
stressful and too expensive in time and money for
service users, too. Nobody ever said it would be easy.
Instead of saying it’s too hard and settling for a token
effort, we need to address the barriers and make sure
it works.
Many examples of good practice exist where
service users are more than token attendees at stuffy
boardroom meetings. The March 2004 issue of Mental
Health Review showcased several examples of
meaningful, innovative, outreaching involvement
strategies where users play key roles in planning,
delivering and evaluating services in a range of ways
that are accessible to all. The next step forward will be
to make these the rule rather than the exception.
Getting the language right
‘Clinical governance’ is just about as high up the list of
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