W2D-005 Social services-0.txt
Developing a Policy for Public Participation

Introduction

All of us have used, are using or might in the future use our health and personal social services.

These services often have an important effect on the health and wellbeing of those of us who use them. So, if you live within our area you will want us to provide an efficient service which meets you needs as closely as possible, with the resources we have available. Generally, people who get help from health and social services make much better progress when these services take account of their hopes and needs.

In the past, we did not always realise the importance of giving: - you, the public in general; - service users (those of you who use our services); - carers (people who look after their relatives or friends); a say in the development of our health and social services. However, the recent reforms in health and personal social services were based on the belief that involving the three groups mentioned above in decisions about the planning, sharing out and delivering of our services is vital in developing really effective services. One government after another has said how important this involvement is.
In his introduction to 'Involving Users: Improving the Delivery of Local Public Services', the Minister for Public Service said:
"This government is committed to modernising our public services: to improving their quality and making them more responsive to users....public services should consult and involve the public. That is because we believe in finding out direct from people what their experiences of public services are, and how they could be improved." (National Consumer Council, Consumer Congress and First Unit in the Cabinet Office, 1999.)

In Northern Ireland, the 'Code of Practice on Openness in the Health and Personal Social Services' (DHSS, 1996) makes a clear commitment to 'providing ways to make it easier for the public to be involved in making decision about their health and personal social services care'. The 'Well into 2000' document says 'the full participation of individuals and local communities is essential in planning and implementing strategies to enhance their own health and wellbeing'. (Well into 2000 and the Regional Strategy; DHSS, 1998.) The Equality Commission says that discussion with appropriate individuals and groups should be a central part of the policy process. (Equality Commission for Northern Ireland: Consultation Paper; Guidelines, Public Authority Schemes, 1999.)

The Social Services Inspectorate (Northern Ireland) has published 'Standards for Consumer Involvement in Community Care Service, (Social Services Inspectorate, DHSS, 1999.) This was based on work with disabled people and other involved organisations, and it included field testing (market research) of the standards in one community trust in each board's area. The field testing found evidence that people who used their services also got involved in planning their own care, and got partly involved in planning services at a practical level. They found little evidence of the public being involved, at planning and policy levels, in health boards or trusts. Also, there weren't any clearly-defined policies for the public (particularly those who use these services to get involved. (Consumer Involvement: Changing Attitudes; DHSS, 1997.) This is likely to be the situation across nearly all health and personal social services.

We recognise the interest that the public have shown when we make changes to our health and personal social services. Recent public involvement in discussions about the future role of local hospitals shows how much interest the public have and how much they want to be involved in decisions affecting these hospitals. Some of you who use our services (services users) and your carers want more of a way in your own treatment and care, and in the development and delivery of our services generally.

The introduction of community-care services gives individual service users and carers the chance to be more fully involved in the decisions we make about their own care and support services. A group of users and carers, who worked with our officers on issues about public involvement, asked to be continually involved in our decision making through formal processes. (The Voice of Users and Carers; EHSSB, 1995.) For our service reviews, like those on day services for people with physical disabilities, and services for people with eyesight problems, w have had contributions from those of you using our services and your carers.

More professionals (like doctors) are beginning to understand how important it is to listen to their patients or clients. This is because professionals do not always 'know best'. The patient or client and their carers understand their own situation best, and the professionals should remember this when they plan the treatment or care.

Aims of our policy

The following are the aims of our policy to involve you in our decision making. They are to: - show our commitment to making sure that you have an important effect on our policy and the way we develop and deliver our services; - make sure that we set up effective and appropriate procedures to involve you, including members of ethnic and other minority groups, in a real and ongoing discussion about health and personal social services; - make sure that we keep you informed about the resources (like money and staff) that we have available for health and social services, and the issues that we need to consider when we decide how to share out these resources; - encourage and help you to get more involved in our decision making; - decide how much you need to be involved for us to make sure that our services respond to your needs; - make sure that if you want it, you can get involved in developing our policies, services and delivery in ways that meet your needs and circumstances; and - make sure that we regularly monitor and measure how well our public-involvement policy works.

Principles

- We and HPSS Trusts in our area (providers of health and personal social services) will encourage public involvement at all levels.

- We and HPSS Trusts in our area will encourage two-way involvement, so that you can ask questions and reply to the questions that we ask.

- The way we involve you will depend on each situation.

- We will try to make sure that we listen to different views, including those of minority groups.

- The way we involve you will be real, important and ongoing.

- We will have systems in place (for example, a website for giving your views) that allow you to contribute to our policies effectively.

- We will respond to any worries that you have, where we can.

- We will keep any promises that we made to you about involving you in our decision making.

- We will try to make sure that we take account of all your interests and groups when we make decision which affect you.

- Your involvement will have clear results which we will monitor and share fully with everyone involved.

- We will use clear, jargon-free language in all our communication with the general public.

Who are the public?

All of you who live within the area that we cover make up our 'public'. This means individuals, families, groups, organisations and communities who use our services now, or might do in the future, and who have an interest in how we provide and develop our services. When we talk about 'the public' in this paper, we mean those of you who live in our area, including those of you who use our services and your carers. We want to make sure that our public involvement process is open to all of you who want to contribute your views, including those of you from ethnic and other minority groups.

We realise that as well as individuals giving us their views, the public make their views known in a number of ways, including through their elected representatives, voluntary organisations and community groups. Our policy is not to interfere with the well-established role of public representatives, voluntary organisations and groups in the way they represent their members. Instead, our policy is to give you extra ways to strengthen your involvement, and public involvement in general, by building on existing methods.

What do we mean by involvement?

Public involvement is about involving the people who make decisions and provide our services with the ordinary person, in matters that affect and interest them all. The 'Well into 2000' document (see page 2 for details) makes it clear that involvement means the full participation (taking part) of individuals and local communities in planning services policies and putting them into practice.

We believe that the following main points are vital if we are to have full public involvement.

1 Information

If we are to get the public involved, we need to provide clear and relevant information in a range of appropriate formats, for example, on audio tape. The DHSS's 'Code of Practice on Openness in the Health and Personal Social Services' gives details about the information that you, the public need. This includes information about: - the services we provide, the targets and standards we set, the results we achieve, the costs and how good our services are; - our important policy suggestions or proposed changes in the way we deliver our services; - how we and our trusts communicate with the public; - how we and our trusts are managed and funded; and - how you can contact the Eastern Health and Social Services Council, and the Northern Ireland Commissioner for Complaints (the Ombudsman).

We have a policy for producing information in a way that suits those of you with specific needs, for example, on audio tape and translated into other languages, if you ask for it.

2 Consultation (discussion)

This means that we listen to: - you (the public); - people using our services (service users); and - your carers; to find out and answer their questions. The Equality Commission identified four main reasons for consultation (in their 'Consultation Paper: Guidelines, Public Authority Schemes, 1999).

These four main reasons are to: - work out current policies, services, functions or laws; - get your vies on proposed policy, service and law developments; - explore new ideas and issues, and how they affect the public; and - develop policies on questions that affect everyone.

Our consultation policy will include discussions through our existing systems and processes, such as the work of our policy-planning teams and our links with public-representative groups. It will also include 'one-off' arrangements such as public meetings, work groups and a citizens'jury. This whole process will need a flexible approach that considers the needs of the individuals, groups or communities that we are consulting.
Citizens'juries are made up of between 12 and 16 members of the public, who are chosen at random from the electoral register. They hear evidence from a range of specialist witnesses on a particular topic over several days and make a report which is usually purblished. The jury members then reach their own conclusions. They do not have to be experts in the topic they are considering or belong to any interest group.
3 Participation (taking part)

In its widest sense, participation means that the public, service users and carers will have a lot of influence over our decision making. We will keep them all fully informed before, while and after we make our decisions. Their views, experiences, needs and understanding will be central to our decision making.
