Developing a dialogue on health: user involvement in health and health services

Munro, Catherine A. M. (2008) Developing a dialogue on health: user involvement in health and health services. PhD thesis, University of Glasgow.

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In common with other areas of public services, recent years have seen a shift in the National Health Service (NHS), with increased power and authority transferring from professionals towards the users of services. As a result, user involvement has come to form a central element of government policy on public services, and health in particular, with a series of specific policy commitments to give users a stronger voice and to involve them in the health service having been published by both the Westminster and Scottish parliaments. These seek to increase users’ involvement in making decisions about their own care and treatment, in examining and improving the quality of services and in policy and planning activity. In doing so, this policy aspires to respond to the changing culture of personal and societal expectations of health and the health service; to build democratic participation in the difficult targeting and rationing decisions faced by health agencies and, thus, to help renew public trust and strengthen confidence in the NHS. These are ambitious aims with far-reaching implications as they represent a transformation in the interaction between users, health professionals and health policy makers.

This thesis examined how this policy has been understood and implemented in the NHS by exploring the scope, relevance and quality of the user involvement processes available in three health service settings. In order to develop a better understanding of the issues in user involvement it explored the nature of user participation; the character of user representation and the barriers and facilitators to user involvement in maternity, gynaecological oncology and mental health services. The study examined the response to this policy within these three settings; the functioning of existing user involvement mechanisms and their capacity to involve users in determining their individual health care and in shaping health services and policy to their definition of need. From this examination it defined the key features of a model process for user involvement within the professional service culture and organisational ethos of the NHS. The study then drew conclusions on the capacity of these current user involvement processes to deliver on the policy directive to develop both individual treatment and health services in ways that are responsive and accountable to users.

Finally, the thesis identified those areas that require further research before proposing the lessons for the further development of this significant and potentially influential policy directive.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: user involvement, public involvement, health services, social policy
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > R Medicine (General)
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing
Supervisor's Name: Reid, Prof Margaret
Date of Award: 2008
Depositing User: Dr Catherine A. M. Munro
Unique ID: glathesis:2008-291
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 20 Aug 2008
Last Modified: 10 Dec 2012 13:17

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