Background

Over the last two decades, there has been a drive to include service users and carers, patients and public in the commissioning, design, delivery and evaluation of health and social care services (Department of Health 1999a, 1999b, 2000, 2005, 2007, 2008).

Studies evaluating patient involvement in planning and developing healthcare services report positive changes in service delivery and staff attitudes (Crawford et al 2002). A small number of projects involving users in the delivery and evaluation of mental health services also found improved patient experiences (Simpson and House 2002), although staff resistance can be an obstacle (Crawford et al 2003). More recent studies identify challenges in involvement leading to changes in practice (Fudge et al 2008),

Alongside initiatives in service provision has been a similar, if more hesitant, impetus in education and training, with increased involvement of service users recommended in all aspects of health and social care education (QAA 2005). A number of National Service Frameworks and strategic plans (DoH, 1999; DoH, 2000; DoH, 2001) propose that service users be involved in planning, providing and evaluating professional training programmes.

In nurse education for example, standards for pre-registration nurse education now require nurse education providers to demonstrate how they are involving users and carers in the planning, delivery, teaching and evaluation of nursing curricula (NMC 2010). Similarly, social work degrees require service users to be involved in the teaching, selection, admission and assessment of students as well as the design and evaluation of programmes (Department of Health 2002).

The research literature on user involvement in health professional education is slowly growing, but a review by Repper & Breeze (2007) found that most papers reported on the processes of involvement with very few studies evaluating the outcome of consumer involvement in training/education and none examining the effect of such education on practice. A more recent review related to nursing only found similar results (Terry 2011).

Overall, consumer involvement was described in the earlier review as a positive process, well received by the service users and carers, students and teachers. Participants chose to become involved in an effort to improve services or through a wish to ‘give something back’. They reported some personal benefits as a result of their involvement (catharsis, increased knowledge, an increase in confidence, self-esteem and confidence), but in some cases reservations about the process were expressed, particularly concerning preparation and remuneration. Students clearly appreciated the opportunity to hear the first hand experiences of service users and carers in the classroom. They felt this gave them further insight into the experience of mental health problems and experiences of receiving mental health services (Repper & Breeze 2007).

Why involve users and carers in education?

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