This page contains the answers to many common questions about the National Advocacy Unit, 'Your Service Your Say' and service user involvement.
If you cannot find the answer to your question here please contact Rachel McEvoy on (086) 854 3695 or email at rachel.mcevoy@hse.ie.
Click on a FAQ title to view the answer.
What is 'Your Service Your Say'?
The National Advocacy Unit (formerly the National Office of Consumer Affairs) has responsibility for developing and implementing best practice models of customer care within the HSE and promotes service user involvement throughout the organisation through the concept of 'Your Service Your Say'. It is committed to the delivery of a high quality service and has national responsibility for the following functions:
- Comments, Compliments and Complaints
- Freedom of Information
- Data Protection
- Records Management
- Service User Involvement
- Liaison with the office of the Ombudsman
- Liaison with the office of the Ombudsman for Children
- Liaison with the Information Commissioner’s Office.
What is 'service user involvement'?
Service user involvement is not just about structures - it is a cultural change. It is about empowering service users to have a say, and about people in the HSE working differently and listening to and acting upon the views of service users. Service user involvement improves patients' experiences of the HSE. For more information go to the Your Service, Your Say section.
'Service user involvement' - The policy context
People centeredness is one of the key principles of the Irish Health Strategy, 'Quality and Fairness; a health system for you' (2001). The 'people-centred' health-care of the future will have dynamic, integrated services, which can adapt to the diverse and changing health needs of society generally and of individuals within it. These integrated services will empower people to become active participants in decisions relating to their own health, and involved as partners in planning and evaluating services. This principle is echoed in other more recent health planning documents such as the HSE Corporate Plan 2005-08 (objective 4) that states 'We will develop the HSE as a dynamic, effective and learning organisation in partnership with service users, patients, staff, not for profit/voluntary/community sector and other stakeholders. This means that we are committed to listening to and learning from the experience of our service users, partner service providers, staff and other stakeholders. We will actively consult around the planning, delivery and evaluation of our services' (HSE 2005 p.34).
To demonstrate its commitment to objective 4 above, and to build on the recommendations promoting involvement which were outlined in a position paper of the national primary care steering group (DoHC 2004), the HSE has specified in one of the projects under the 13 transformation programmes for 2007-2010 that the organisation will 'develop and implement a framework for involving service users and communities in service development' (HSE 2007b p.13). This provides concrete reality to the commitment made by the HSE and the Irish Government to include service users at all levels in service planning, delivery and evaluation and is the underlying driver for the development of a 'National Strategy for Service User Involvement' (HSE and DoHC 2008) in the design, planning, development and delivery of the health and social services in Ireland.
Why 'service user involvement' is important
Several key outcomes can be expected from increased service user involvement at individual, organisation and community level.
Research suggests that promoting greater involvement at a one-to-one level will result in increased satisfaction, increased sense of dignity and self worth, and the acknowledgement of the credibility and authority of the service users perspectives. It will also lead to an improvement in staff and patient morale and a cultural change in the health system. In addition, service users bring grass roots and community views and preferences to the table to add to the technical skills brought by others.
Increased service user involvement at organisational level has been shown to result in:
- Increased legitimacy and creditability of decision making
- Improved communication and subsequently improved performance and effectiveness and health outcomes
- Improved public perception and confidence
- The increased likelihood of project success and acceptance
- Greater understanding of the links between health and the circumstances in which people live their lives.
High levels of community involvement have shown:
- Improved and more relevant policies to address health inequalities
- The anticipation of problems during planning
- Services that responded better to the needs of the community
- Equitable and inclusive services that helped to address social exclusion and poverty
- Increased resources as services become more cost effective
- Increased ownership of the commitment to health and social services
- Reduced power imbalances and a better response to health inequalities
- Reduced complaints and services becoming more accountable to the communities they serve.
How can one or two people who use services be 'representative' of all the relevant groups?
It is not reasonable to expect one or two people to be representative of all people who use similar services. It might be helpful to think about seeking people's perspectives rather than representativeness. If you want a range of perspectives, involve a range of people, and give the people you do involve the time and resources to network with other people.
How can trained or professional members of the public reflect the views of 'typical' patients?
It is important to think about your reasons for involving people who use services when answering this question. If you want two people who use services to sit on a project steering group, they will need to be willing and able to participate in meetings, and able to put their views across to a variety of individuals with a range of professional expertise. These 'representatives' may not be 'typical', but they will be able to contribute important insights from a patient/user/public perspective and will also be able to access and present a range of people's views.
To what extent should service users be involved?
We describe three different levels of involving people who use services - consultation,collaboration and user control.Whilst there is a role for each of these levels of involvement within health and social care, it is important that service users are clear as to which level of involvement is being sought.
Consultation: When you consult people who use services, you ask them for their views and use these views to inform your decision-making. For example, you might hold one-off meetings with people who use services to ask them for their views on a research proposal. You will not necessarily adopt those people's views, but you may be influenced by them.
Collaboration involves active, on-going partnership with members of the public in the overall process. For example, people who user services might take part in a steering committee for a research project, or collaborate with researchers to design, undertake and/or disseminate the results of a research project.
User control might be broadly interpreted as where the focus of power, initiative and subsequent decision making is with service users rather than with the healthcare professional. It does not mean that service users undertake every stage of the process, or that 'professional' researchers are necessarily excluded from the process.
Which level of involvement is best?
There is no definitive answer to this question. Different types of involvement will be most appropriate for different projects. This will depend on the project co-ordinators, the people you wish to involve, the project topic and method and the requirements of the funding body. In any single project, you might consult and collaborate with people who use services, or they might lead at different stages of the project.
Who do I contact if I have any questions in terms of how to best involve service users?
Related Link: Contact Us
If you wish to speak to someone in relation to involving service users please feel free to contact the Consumer Affairs area manager within your respective area. Contact details are available through the related link above.
What should I do if I have a comment or complaint about some of the content on this site?
If you wish to comment on any of the content on this site please contact Rachel McEvoy on (086) 854 3695 or email rachel.mcevoy@hse.ie
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Last updated on: 05 / 10 / 2011