Are we really listening to the people who rely on and deliver care? Putting service users at the centre is widely accepted—but is it truly happening in practice? Professor Martin Green, Chief Executive at Care England, explores the gap between rhetoric and reality, and what must change to deliver genuinely person-centred care.
Over the years, there has been a growing recognition of the importance of putting people who use services at the centre of health and social care planning and delivery. Engaging people not only enhances their experiences but also significantly improves outcomes.
When service users are actively involved in their care plans, the quality of care improves. Individuals can share their preferences, needs, and expectations, ensuring that services are tailored to meet their requirements. This personalisation fosters a sense of ownership and responsibility for people’s own health, leading to better acceptance of treatment and care recommendations.
Engaging people in the decision-making process increases their satisfaction with the services they receive. When people feel listened to and valued, they are more likely to report positive experiences, which is crucial for the reputation and credibility of care providers.
Research consistently shows that when service users are included in their care planning, health outcomes improve. This is particularly evident in support for people with long-term conditions, where personalised care plans can lead to better symptom control and overall well-being.
Service users provide invaluable insights that can shape policies and practices in health and social care. Their experiences and feedback can inform staff training, resource allocation, and the development of new services that truly meet the community’s needs. This is the rhetoric that drives both health and social care. However, when you talk to people who use services, sometimes you find that the rhetoric does not match the practice. All too often, there is a tendency (particularly in the NHS) to focus on the needs of the staff and the organisation, rather than putting people and outcomes at the centre of the agenda.
To turn rhetoric into practice, organisations need clear processes to engage people who use services and their families, and to ensure that, once engaged, their views, opinions and suggestions are actioned. To effectively place service users at the heart of care services, organisations can adopt several strategies. Firstly, care services must have user engagement at the centre of everything they do, and they must not see it as an add-on. It is important to create structured channels for service users to provide feedback on their experiences. This can include surveys, focus groups, and one-on-one interviews. Ensuring that feedback is regularly reviewed and acted upon is vital to demonstrate to service users that their voices have a real impact. There is nothing more demoralising for people when they have spent time giving you their opinions than to see them ignored.
Involving service users in the design of care plans and services leads to much more efficient use of both financial and human resources. Co-designing services encourages collaboration between providers and users, ensuring they are user-friendly, accessible, and relevant. Workshops and brainstorming sessions can facilitate this collaborative process, but collating feedback that frontline staff receive daily is a really important way to understand and develop the service.
One of the most effective things any service can do is empower service users by informing them about their rights and the care options available to them. Providing information in a clear and accessible manner enables people to make informed choices about their care and encourages active participation in planning. The more people are involved, the better their experience and the greater their satisfaction with the service, because they will see a service that responds to their needs rather than shoehorning them into established ways of delivering care.
Technology is playing an increasing role in the care sector, and it’s important that it is used in ways that improve outcomes for users and give them more choice, autonomy, and control. The deployment of technology should also improve the experience of the people who deliver care, and it should enable them to spend more time in direct relationship-based care and remove administrative burdens. Technology can also be used to create platforms where service users can share their feedback and experiences. Online forums, mobile applications, and social media can enhance communication and foster a sense of community among service users.
Co-produced services do require some significant changes to the culture and approach of care staff. People who work in care will need the skills to engage with service users effectively. Training should focus on communication, empathy, and understanding the importance of user involvement in care planning. A workforce that values user perspectives is essential for creating a culture of inclusivity. This is a challenge, particularly because we are used to working in a paternalistic system that often thinks it knows better than the people who use the services. While the benefits of involving service users are clear, challenges may arise, including resistance from staff and logistical difficulties in gathering feedback. To address these, leadership must foster a culture of openness and adaptability. Regular training and workshops can help staff understand the value of user engagement, while innovative approaches, such as community events, can facilitate feedback in a less formal setting.
Placing service users at the heart of care service planning and delivery is essential for creating a responsive, effective, and compassionate social care system. By actively involving people in the decision-making process, care providers can enhance service quality, improve health outcomes, and ultimately foster a more satisfied and empowered community. Embracing user engagement is not just a best practice; it is a fundamental shift towards a more human-centred approach in care. By prioritising the voices of those we serve, we can build a brighter future for health and social care that truly meets the needs of our communities.
