Citizen Engagement and Involvement
A key responsibility of NHS organisations is to design and deliver services which meet the needs of their populations and are patient-centred.
Many boards have concentrated on informing the public and they now need to concentrate on how to take account of the public’s views and on making themselves more answerable. NHS organisations need to find opportunities to hear the community’s views, which is unlikely to be achieved through attendance at public meetings alone. Other consultation methods can facilitate public and patient involvement.
The Assembly Government’s Citizen Centred Governance principles embody what the Assembly Government wants public services to be, focused on the needs of citizens, with citizens who are engaged and involved in the development of services and who receive services which are efficient, effective and innovative in their design and implementation.
The following material provides summaries and links to various papers that discuss citizen engagement.
Communication with the press
Responsibility for communication sits with your chair and chief executive and developing relationships with the local press is a key element of this. Training may be needed in this crucial role.
The importance of communications
The Welsh NHS Confederation’s publication More than just a press release Communications in today’s NHS: what it means, how to do it, and why bother? asserts that most modern organisations, whatever their sector, would recognise that building a committed workforce, strengthening the organisation’s reputation and credibility, and raising awareness of what it does and what it can offer, is critical to success. Yet achieving these goals, and many others besides, depends on one crucial ingredient: a comprehensive and effective approach to communications.
This point applies as much to the NHS as to any other organisation, arguably even more so. Our report is based on three main foundations. First, we have tried to distill the experience of the Confederation in the field of communications. Second, we pull together relevant research from elsewhere, on issues as diverse as corporate reputation and public and patient perceptions.
Third, we draw on the good work in communications already being carried out across Wales by NHS organisations; one of the aims of our report is to showcase some of this work, in the hope that it provides inspiration for others.
The Joseph Rowntree report, Community engagement and community cohesion (2008), provides an exploration of the challenges to be addressed if government policies to promote community engagement are to be genuinely inclusive of newcomers as well as more established communities.
Community engagement and community cohesion are both current public policy priorities. But there have been gaps in our understanding about how to promote community representation in ways that take account of diversity and population change. This research explores:
- whose views were being heard and whose were not;
- what were the barriers to being heard and how they could be overcome;
- how these barriers could be addressed in ways that would promote community cohesion, rather than increasing competition within and between communities.
Through three case studies, the study also identifies ways in which new communities can be involved effectively, together with more established communities, thereby increasing cohesion and mutual solidarity.
The Joseph Rowntree report, Community empowerment in practice: lessons from Communities First (2008), provides an examination of a community-based programme in Wales that aims to increase opportunities for community empowerment and potential influence over service providers.
Community empowerment in local governance and service delivery has become a key component of government policy in the UK. However, there are critical challenges to achieving this in practice. This study examines the Communities First regeneration programme in Wales, an early attempt by the Welsh Assembly Government to promote engagement by community members and which now provides five years of experience of a policy centred on the achievement of community empowerment.
The research presents findings from nine case studies of Communities First partnerships to provide insights into the achievement of community empowerment. It considers:
- how far partnerships have developed and evolved to empower communities;
- the relationships communities have with other representative channels;
- the extent to which communities have influenced other agendas;
- the overall impact of regeneration partnerships.
The Joseph Rowntree round-up paper, Citizen involvement in Local Governance (June 2009), looks at the involvement of citizens in decision-making and governance in their local area. It outlines the challenges and dilemmas that local partners, central government, councillors, staff and communities must resolve if citizens are to have more power and influence over local services and their neighbourhoods. The summary of the study draws on the findings of the Joseph Rowntree Foundation's Governance and Public Services research programme and other related Joseph Rowntree Foundation work; looks at how citizens are involved, how they influence decisions and how diversity and population change affect citizen and community involvement.
Designing citizen-centred governance
In the Joseph Rowntree report, Designing Citizen-Centred Governance (2008), the authors state that citizen-centred governance involves new ways of enabling local people, working with statutory and other agencies, to decide how public services can improve their quality of life. This study examined the relationship between new governance structures and the engagement of citizens, service users and the voluntary and community sectors, with the aim of identifying lessons for policy and practice. The report covers:
- the changing governance of communities,
- understanding the new governance,
- designing citizen-centred governance,
- learning from diversity,
- strengthening citizen-centred governance.
Link: - http://www.jrf.org.uk/sites/files/jrf/2205-governance-citizens-engagement.pdf
Routes and barriers to citizen governance
This Joseph Rowntree Foundation study is an exploration of the influences and barriers that impact on citizen participation in local governance.
The government drive for greater community-based governance requires public bodies to ensure that all communities have the opportunity to participate in local decision-making structures and influence local service delivery. How effectively citizens from different communities and neighbourhoods are able to participate, however, can vary considerably due to structural, environmental, cultural and personal factors.
Drawing on the experiences of people from a range of backgrounds, councillors, Local Strategic Partnership members and representatives from the voluntary, community and faith sectors, this report:
- highlights the factors that encourage different communities to get involved;
- identifies the challenges and barriers that prohibit involvement;
- considers in what contexts disadvantage or affluence influences governance choices and participation;
- explores the importance of leadership within local governance.
Link: - http://www.jrf.org.uk/publications/routes-and-barriers-citizen-governance
Building Social Capital
The 2008 Joseph Rowntree publication Do policies to promote community participation in governance build social capital? provides an exploration of whether policies to involve people in making decisions about their own communities are effective in building strong social networks.
Government has made a significant investment in community participation on the back of evidence suggesting that it builds stronger networks between people who live in the same neighbourhood. However, this report questions the accuracy of this belief and looks at whether community dynamics and relationships can in fact make good governance hard to achieve.
Through detailed case studies in two areas, and a review of other research, the authors:
- investigate the key factors influencing participation in governance,
- argue that community participation tends to be dominated by a small group of people, and
- suggest ways in which formal participation arrangements could more effectively engage with informal every-day social networks.
Link: - http://www.jrf.org.uk/publications/do-policies-promote-community-participation-governance-build-social-capital
Why Community Involvement?
The Joseph Rowntree paper, The value added by community involvement in governance, reviews the experiences of those involved in local strategic partnerships (LSPs) in England.
One of the government’s explicit aims when they introduced LSPs was to enable more and different people to become involved in the development of priorities for local services, as well as in their continuing governance.
The result of in-depth interviews with a range of people currently involved in LSPs (including elected representatives, service providers and community representatives), this report:
- considers how effectively LSPs are meeting these objectives,
- explores the challenges and difficulties encountered in getting involved, and the personal economic and social costs and benefits to participants,
- examines the value of community involvement in partnership working from a range of perspectives,
- offers a number of practical suggestions to policy makers and practitioners on how to maximise the value of community engagement.
Drawing on the words and experiences of participants, the report’s findings have implications not only within LSPs but also more widely in the context of community participation in governance.
Link: - http://www.jrf.org.uk/publications/value-added-community-involvement-governance
Public officials and community involvement
The 2008 Joseph Rowntree report, Public officials and community involvement in local services, provides an examination of community involvement in the governance of local services, with an emphasis on the role of public officials.
The role played by public officials in community engagement has important effects on the extent to which community views can influence local services. This study explores the experiences and views of public officials, comparing a local authority, a police service and a primary care trust in one part of London.
The research examines:
- public officials' perspectives on the purposes of community engagement, the different types of engagement mechanisms used, and the role played by community participants,
- organisational constraints and enablers of community engagement, including senior management support, resources, performance management systems, time frames and organisational culture,
- the informal practices and processes used by public officials to engage with the community and their attitudes and feelings towards it, and
- the extent of community influence and the factors which affected this.
Link: - http://www.jrf.org.uk/publications/public-officials-and-community-involvement-local-services