Introduction

Central government’s emphasis on best value, in conjunction with partnership working and social inclusion, requires that social services departments should work more closely with service users in planning, developing, evaluating and monitoring services and their outcomes. As illustrated in other chapters, this partnership is developing in a broader context than previously, allowing for much closer working relations between social services, health and housing. While acknowledging the broader context, this chapter focuses specifically on the progress in partnership working that has been made between service users and social services departments.

The chapter considers some of the strategies being developed to achieve user involvement, albeit patchily, around the country. These include farreaching initiatives such as funding service users to provide their own services, either as a group or through direct payments, and more limited consultation processes such as needs audits, questionnaires to citizens’ panels, postal surveys and focus groups. It discusses the extent to which professionals are prepared to share responsibility for service delivery, acknowledge users’ expertise, and empower disabled people, older people, users and survivors of mental health services, people with learning difficulties and other service users, by providing the time and necessary support for their fuller involvement in decision making.

In discussing user involvement, a distinction is regularly drawn between the consumerist approach, by which best value is characterised, and userled self-advocacy (Beresford and Croft, 1993). In the former the service users’ role is limited to consultation on service planning and delivery while in the latter, far more radical, approach users seek both to change services and develop new services where the old ones are inappropriate. These approaches lead to very different conceptualisations of partnership, with the balance of power firmly held by professional purchasers and providers in the first but tipped more in favour of service users in the second.

The dichotomy is apparent even within the definition of a service user as someone who uses services. Forbes and Sashidharan (1997) suggest that such a definition is “only possible when services are presented as non-problematic commodities available in the market place, with users as consumers able to purchase and consume these commodities with a free choice”. In reality, the term is problematic and complex.