Public and Service Users Involvement in Health Care Planning Decisions - Essay Example

Public and Service Users Involvement in Health Care Planning Decisions Public and Service Users Involvement in Health Care Planning Decisions The literature about public and patients’ involvement in the health care sector decisions does not provide a single definition for the role in which these crucial stakeholders should play. In line with this, various terms, such as patient collaboration, involvement, partnership, empowerment, and provision of patient-centred care are often used in an interchangeable manner to define public and patient involvement in different aspects of the health care sector (Longtin et al., 2009; Wait & Nolte, 2006). However, the NHS (2013) noted patient and public involvement in health care as relating to various aspects such as the element of decision-making, goal setting, self-monitoring, self-medicating, taking part in physical care, and many other elements in the health care sector. For this reason, health care involvement of the public and other users, such as the patients, entails all other possible ways in which the public and patients could have an impact on the decisions made in the health care sector regarding a variety of components that include their treatment and care, provision of health care services, planning services, and other important elements in the health care sector (Contandriopoulos, 2004). According to the General Medical Council (2006), a good care giver is the one who involves their patients in the process of providing them with their care so that they could make informed decisions regarding the direction in which their treatment is going to take. Hence, the primary purpose of involving patients is to make them an important component of the decision-making process for their treatment, with an objective of ensuring that treatment was patient-centred. On the other hand, the purpose of public involvement in the health care sector is to ensure that there is a high level of accountability (Florin & Dixon, 2004). For these and other reasons, involving the public in the health care sector is desirable since they involve themselves in the decision-making process on what is ostensibly their health care system since they pay taxes that fund the health care sectors in their countries (Ham & Smith, 2010). According to various research studies, there is evidence that patients could influence their caregivers’ decisions (Kravitz, 2005; Bettes et al., 2007). In this regard, this is essential since it is an indicator that the patient can play an integral role of being involved in the process of their care. A factor that Thompson (2007) identifies as essential in emphasising the freedom of patients while at the same time underlining the ‘voice’ of the patient in exerting change in their health and care. On the other hand, involvement of the public in health care is essential as it promotes high accountability with the public aware of the available choices they could make for their care and treatment. Besides, public involvement is important since it contributes to the implementation of policy decisions from a user participation, which promotes the acceptance and easy adoption of public policies as they have the input of the public through their involvement (Hughes et al., 2008). Based on these reasons, rationale, and importance of public involvement in the health care sector, this expose addresses various issues related to the involvement of the public and other users with a focus on the health care planning decisions. It is important to point out that these health care decisions vary from the involvement of patients in their care to the involvement of the public in the development of policies focusing on the health care sector. Hence, the potential advantages of involving the public and any potential obstacles or problems will be addressed in the essay. Potential Advantages In the contemporary society, health care users are increasingly being involved in their own care than they have been involved in the past (Tait, 2005). In line with this, it is essential to point out that the involvement of the users in their care has become a widely accepted practice as it promotes their satisfaction with the care they received and involvement in care also benefits the users, in this case the patients (McEvoy, Keenaghan, & Murray, 2008). Other than the improved satisfaction, involving users in their care empowers them to be responsible for their process of care, which is essential as it improves the general outcome of the care that caregivers gave them while under their care. Rutter et al. (2004) noted that user involvement in health care provides them with an equal footing with professional caregivers, which makes them become partners in the process of care. The generation of a semblance of a level of partnership is crucial in the planning of their care as there is an exchange of ideas between the caregiver and the user, which leads to an approach of caregiving known as person centred planning. Consequently, the person centred planning aspect improves the outcome of care since the user is actively involved in the decision-making process. Involving the public and users has an effect on the quality of services that the health caregivers and the entire sector offered. One of the important roles of user and public involvement in the health care sector is to improve communication between the various stakeholders involved in the process of caregiving. One aspect of communication between stakeholders is the communication between the caregivers and their patients. Various studies indicate that there is a relationship between the quality of care that patients received and the level of communication between their caregivers (Nowak, 2011; Brédart, Bouleuc, & Dolbeault, 2005; Ha & Longnecker, 2010; Zolnierek & DiMatteo, 2009). This is due to the fact that there is shared decision-making between healthcare users and their caregivers. In this case, the first step towards approaching quality care is the involvement of the patients in order to provide patient-centred treatment. Hence, their involvement ensures that they received the highest quality of care in their treatment and the outcome of their care. On the other hand, the involvement of the public in the health care sector ensures that the public – as users – took an active role in setting the priorities in the health care system and aspects of planning (McEvoy et al., 2008). In effect, there is an establishment of a decision-making process on highlighting the important services that the public requires, which also sets a mechanism that promotes the quality of services provided in the health care sector. Public and user involvement in health care planning and policies promote a high level of accountability in the health care system. Through their involvement, there is the generation of particular principles, values and methods that guide the working partnership between users and professionals working in the health care sector. The establishment of these principles, values, and methods is the first step towards the creation of a level of accountability since each stakeholder has a role to play towards achieving success in the health care sector. Moriarty et al. (2007) identify the participation of the public in health care planning as best achieved through consultation committees established between the professions in the health care sector and the public. This is further supported by McEvoy et al. (2008) who noted that the health services users’ representatives in such consultation committees ensure that there is accountability within the health care sector with regard to the management of services within the health care sector. For example, Foster and Gabe (2008) noted that elected officials in England were given an authoritative voice during the 2003 election of representatives to the Local Government. In this case, it is common knowledge that Local Government representatives are elected by the public who in turn are the health care users. Therefore, the authoritative voice in the health sector provided to the representatives, following their election, was a way of ensuring that there was public involvement in the health care sector through elected official of the Local Government. The roles of these officials included an evaluation of the approaches in which health care services met the needs of the public and also to scrutinise on-going projects and collaborate with the NHS in services delivery, which ensures that there is accountability as the elected representatives assess whether each stakeholder played their roles (Foster & Gabe, 2008). As earlier indicated, there is evidence to suggest that the involvement of patients in their care does not only improve the quality of care, but it has an immense potential of improving the appropriateness and the outcomes of care they received since there is the generation of satisfaction from the health care users (Coulter & Ellins, 2006). Based on this aspect, it is essential to point out that patients are involved by providing them with information on their care and treatment since information is the foundation of patient-centred approach that promotes satisfaction in the health care sector. In contrast, the failures brought about by the lack of a proper communication mechanism promote dissatisfaction among patients regarding the treatment and care they received. Coulter (n.d.) notes, “If clinicians are ignorant of patients’ values and preferences, patients may receive treatment which is inappropriate to their needs” (p. 27). In this case, the level at which the needs of patients are met promotes satisfaction among patients. Nonetheless, patients are not in a position to provide and express their preferences to caregivers if they were not provided with sufficient and appropriate information that include detailed information about their conditions and the possible outcomes of their conditions without or with alternative choices for their treatment. Provision of this information is the basis of their involvement in the process of care as it contributes to better decision-making and positive outcomes of care. The involvement of users in the health care sector improves satisfaction since they participate in giving directions to the services offered. For example, the involvements of health care users in projects, services, and programmes in the health sector ensures that there is confidence in the services that people were offered. To underline this point, Fisher (n.d.), notes that one way of involvement of users is through commissioning, which underpins the approaches in which the NHS takes in order to develop health care services among users. Through commissioning, users could be involved in several activities such as identifying the local health care needs, identifying the interventions required to address the present deficiencies, identification of the required resources, monitoring and evaluation in order to ensure that set decisions are acted upon (Fisher, n.d.). In effect, users’ participation in various commissioning activities ensures that they were aware of the health care services in place since they are part of the implementation process, which improves the level of satisfaction in the health care sector. In order to improve the outcomes of care and treatment, public involvement is essential. Fisher (n.d.), noted the importance of public involvement in the health care sector through the processed of commissioning provides an opportunity to “create better health outcomes” (p. 104). This is a fact that has been identified by the NHS, which has consequently created a new model known as foundation trusts that “are independent organisations operating within the NHS to improve health outcomes for patients and local communities” (Slipman, n.d., p. 115). These trusts conduct seminars and conferences that ensure various health care facilities learnt about the emerging good practices while other trusts from other care facilities and communities learned about the good practices implemented by others with an objective of implementing similar projects within their facilities (Slipman, n.d.). Through these forums and the eventual implementation of the programs adopted from other facilities following public involvement, individual caregiving facilities implement a procedure that ensures that there are good practices that promote the level of outcomes since health care practitioners practice using evidence from successful practice. Potential Problems Gregory (2007) highlighted the importance of sufficient resources in the promotion of engagement programmes in order to ensure that service users have the opportunity to contribute to the health care sector. In particular, resources are an essential component in ensuring that there was effective promotion of the need for public user engagement, which requires adequate promotions. In this case, a legitimate public user involvement requires being an open exercise in order for it to be legitimate. In this case, there is the need for the promotion of the programme in order to provide the public users with adequate notice to prepare for their involvement and engagement. Besides, involving the public requires effective logistics due to the consultative process that has to be efficient. Without proper logistics, the public user involvement programme will not achieve effective outcomes. These logistics require resources with limited resources contributing to inefficient achievement of the overall user involvement process. Other than barriers represented by the issues related to the availability of resources, it is crucial to point out that other challenges abound. Ridley and Jones (n.d.) identified the potential problem presented by the possibility of professionals in the health care sector having a notion of feeling threatened by the involvement of the users in the process of care. This is accentuated by the fact that accountability is moving from the traditional aspect whereby doctors were only accountable to professional bodies towards a model in which the public was involved in determining their accountability (McCormack, 2006). In line with this, the NHS (1998) identified the likely understanding of the concept of user involvement in the health care sector from professionals in the sector and noted that the lack of understanding of the role of users and the public by medical practitioners acts as a barrier to their involvement (as cited in Ridley & Jones, n.d.). With regard to staff training, there is evidence to suggest that staff members are not well-equipped through effective training in order to work well in partnership with patients, users, and communities in order to achieve the best of outcomes of care and treatment. This consequently acts as a barrier towards achieving effective involvement of the public and users in the process of care. For other health services professionals who are equipped with essential training to involve users, patients, and communities in health care, the process of involvement could feel like an extra burden to them on a workload that could be already overwhelming (Ridley & Jones, n.d.). In effect, this could contribute to the failure of involving patients and users in their treatment and care, and even in the entire planning of services in the health care system. Other than the burden on health professions, there is a possibility that healthcare facilities could incur costs burden when they involve the public, users, and the community in planning the services in the health care sector with a focus on their organisation (Ridley & Jones, n.d.). Hence, managerial decisions could focus on investment in direct services instead of focusing on public involvement, which consequently acts as a barrier to involvement. Challenges with ensuring representation are often at the foundation of concerns in involving people. Ridley and Jones (n.d.) identify the domination of special interest groups in the public and user involvement in the health care sector, which consequently inhibits the involvement of people. In line with this, the issue of representativeness of the people in the health care sector comes under scrutiny based on the interest of these special groups. In this case, the groups fail to articulate for services, plans, policies, and programmes that failed to consider the views of the ‘typical’ health care user with their attention focusing only on their interests. In effect, this acts as an effective barrier to the involvement of the public in the health care sector. On the other hand, Baggott, Allsop, and Jones (2005), consumer groups noted that the agenda of public involvement is determined by the Department of Health, which identifies the agenda, the timescale, and various rules of engagement, which consequently hinders the extent to which the public is involved in the health care sector. More importantly, it is essential to note that important decision makers, such as the Department of Health, and other services providers fundamentally react to the special interest groups that are more articulate than others, which in turn forgets other crucial groups that are less well-organized and not as articulate (Foster & Gabe, 2008). Service users could also be unfamiliar with the issues that require their involvement. For example, they could be unfamiliar with the subjects under discussion due to technicalities such as the language being used, the processes of meetings, the policy development procedures (Horey & Hill, 2005). All these factors act as barriers to the involvement of the public in the health care sector forums and seminars called to ensure their participation in service planning and other crucial policy developments agenda. Besides, unfamiliarity with the people that the members of the public should work with during the process of their involvement could be a significant challenge that could prevent their involvement. On the other hand, Anderson, Shepherd, and Salisbury (2006) identify the processes through which meetings take place could be characteristically tedious and intimidating in a manner that prevented services uses to make their contributions in a manner that was effective as they are required to survive issues related to jargon in order to become familiar with the proceedings in order become effectively involved and contribute to the proceedings. Conclusion The importance of the public and service users in their involvement in health care planning decisions cannot be overemphasised. From the literature provide, there are various ways in which different stakeholders could be involved in the process of care planning decisions. These range from their involvement in their care while undergoing treatment and care to taking part in management decisions related to policy implementation. In the modern society, health care practice requires the involvement of the public and users in planning services. This is due to the benefits that the health care sector could withdraw from the involvement of the public and patients. For example, the involvement of the public through elected Local Government representatives has enhanced the satisfaction of the service users and the public in the services that the health care sector provided. In addition, the high level of scrutiny provided by the representatives ensures that there is a high level of accountability by each stakeholder involved in the process. Despite these and other benefits of public and service users’ involvement, barriers abound regarding the involvement of services users in planning decisions. They include barriers related to lack of proper training of the professionals in the health care sector to involve the service users in planning decisions. 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