This study by Age Concern London, funded by the Joseph Rowntree Foundation, brought commissioners and service users together to discuss how service users can be involved in shaping local services.

The researchers
Samantha Mauger and Gordon Deuchars from Age Concern London, with independent consultants Stephanie Sexton and Silvia Schehrer

Please click here for the full paper

Overview

The project reflected on what's happening at the moment and how user involvement in commissioning could work in practice. It found that:

• The involvement of service users in shaping local services is still in its infancy.
• The definition of 'user involvement' varies from one-off consultations to equal partnerships.
• There are more good practice examples of user involvement in Social Care than in Health.
• Key Points

• The involvement of service users in shaping and commissioning services is at an early stage. We are a long way from credible user involvement in World Class Commissioning.
• ‘User involvement’ can mean different things. It can represent a valued process with users as equal partners in reshaping services or be a manipulative one-off consultation, when users gradually realise they are being given bad news.
• Commissioners and their partners were frequently poorly placed to engage with user involvement in commissioning. Their skills, knowledge and practice of effective involvement were often limited. Even where they had knowledge, there were few drivers which pointed them towards service users and away from simply responding to organisational necessities.
• In most cases the facilitation of user involvement was handed down to voluntary organisations without acknowledging tensions between their provider and advocacy roles or taking into account variable user involvement within voluntary organisations themselves.
• There seemed to be two ideas within the same system. Individual service users were to have choice and control in line with Personalisation. Commissioners retained control over block contracts. It was difficult to see how one influenced the other.
• There were examples of better practice where service users were involved in shaping solutions, more often in Social Care rather than in Health.
• Even where good practice did not yet exist, there was often an honest acknowledgment of poor practice and a desire to improve.
• Change was not simply about shifting a few structures. Some of this was about trying out different approaches. But some of it was about believing it is possible.