Why involve users and carers in education?
The reasons for involving users and carers include:
- Quality improvement: a belief that the involvement of users and carers leads to deeper clinical understanding and improvement in relations between healthcare professionals, patients and their families and a consequent increase in the quality of care and treatment provided (Wykurz and Kelly 2002). Meeting users and carers outside clinical environments helps students gain a clearer understanding of how conditions can affect people’s daily lives (Terry 2011).
- Political impetus: aimed at making health and social care services more responsive to the needs of the public, while challenging professional workers’ supposed resistance to change.
- Consumer choice and influence: has also been fuelled by a less deferential populace, progressively more informed through access to the internet and other sources of information.
- Expert patients and self-management: people with long-term conditions often exhibit extensive knowledge and understanding of their ailments, care and treatments, leading to recognition of these ‘experts through experience’ as valuable partners in the healthcare journey with a move towards greater self-management (Expert Patients programme 2012; Griffiths et al 2007).
- Community engagement: engaging with local communities and often minority and marginalised populations captures specialist expertise and knowledge within our local community and healthcare economy.
- Moral recognition: as citizens and ‘owners’ of the NHS, the public is entitled to have a voice in all aspects of their health service (Telford et al 2002).
- Emergence of the service user movement with demands for a greater say in the services that they use, often including the voices of disenfranchised communities such as those experiencing mental health issues or disability, black and minority ethnic groups and women (Ocloo and Fulop 2010). “The demands of these groups vary and include citizenship issues, welfare rights, challenging societal attitudes and barriers and the entitlement to be involved in decisions impacting upon them” (Chambers & Hickey 2012: p4).
- Public distrust of professionals in the light of ‘high profile’ cases and concerns about the safety and quality of healthcare (Higgins et al 2011, Ocloo and Folup 2010).
- Shift away from a medical model of care with service users as passive recipients of services towards a more empowered approached where service users are involved in decision making, personalised care and self-management (Chambers & Hickey 2012). If user and carer involvement in healthcare is to become a reality, healthcare professionals need to be educated in a way that reflects this philosophy.
By ensuring that user and carer perspectives are threaded throughout the educational process, it is anticipated that our students and future staff will be more attuned to work within and help develop a patient-focused service where partnership working, personalisation and self-management are at the forefront of contemporary healthcare practice.
Regulatory bodies and service user involvement in health professional education
The widespread involvement of service users involved in the education and evaluation of a range of health and social care professionals has led to increased monitoring and regulation of service user involvement in the education and training of health and social care professionals. See Chambers & Hickey (2012) for an overview.
• The UK White Paper ‘Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century’ (DH 2007) advocates greater patient and public involvement.
• The Alliance of Health Care Regulators on Europe has argued that patient and public involvement in health care regulation should be regarded as good practice (Joint Health and Social Care Regulators’ Patient and Public Involvement Group 2010).
• The Council for Healthcare Regulatory Excellence (CHRE), which oversees and scrutinises the work of 9 regulatory bodies including the HPC, regards user involvement in regulation as a necessity, not an option. CHRE (2010) consider it “important that patient involvement is reflected in the design and delivery of education programmes and that any course evaluation, has taken the views of patients into account” (CHRE 2010, p27).
• Various regulatory and educational bodies of health and social care professions have advocated, and sought to ensure, a greater level of service user involvement in the provision of education and training (e.g. GMC 1993, ENB 1996, UKCC 1999, GSCC 2005, NMC 2010).
• The Health Professions Council (HPC) is a regulator of 15 health professions and its role includes approving and upholding high standards of education and training. The HPC recently reviewed service user involvement across education and training programmes leading to registration with the Health Professions Council (Chambers & Hickey 2012).