1.6 All together now? Discussion
Views – whether from citizens or consumers – are diverse, although there are similarities within and between groups: for instance, on the need for respect. Diversity of opinion as well as diversity of need must be addressed by frontline managers. A few of the individuals and groups noted by our testers include: users of services for mental health, physical disability, older people, children and families; carers; workers; union representatives; managers; the general public; local and national government; and children and parents.
On a single issue such as the development of a user-run project for people experiencing mental health difficulties, there are likely to be many views that a manager will need to balance. Workers may consider that they should run the project with users/survivors as committee members or volunteers. Users/survivors may consider that only workers who themselves have had experience of mental health problems should be employed on the project. The local community may be concerned that a project for people with mental health difficulties is proposed for their area and national government has produced a service framework which requires and supports user involvement. So, managers may find themselves chairing, for example, a public meeting about a proposed project, taking part in negotiations with staff and unions, as well as hearing from service users about whether they think the project will meet their needs.
One way to integrate direct experience of using services with service provision is to recognise that experience as a desirable quality when employing managers and practitioners. Service users become valued as ‘experts through experience’. A policy initiative is to promote a wide range of care providers through social enterprise in the health and care sector.