Background: public participation and engagement

Aspirations to increase ‘user involvement’ in the planning, provision and evaluation of public services have been a consistent feature on the political agenda in the UK. The Labour government that left office in 2010 aimed to increase public participation and engagement in a broad range of services, and in the health and social care sector in particular. For example, The NHS plan (Department of Health, 2002) asserted the rights of service users and the public to be involved in the planning and delivery of health care. This overall drive towards greater public engagement included the aim to involve older people in the planning of services (Le Mesurier, 2003). This theme was developed further through the National Health Service operating framework (Department of Health, 2011), placing a legal duty of involvement on strategic health authorities in relation to their plans setting out strategies for health improvement and health service provision. This broad agenda for public participation and engagement (PPE) included a specific focus on involving older people in service planning. For example, the National service framework for older people (Department of Health, 2001) contained a commitment to increase representation of older people within consultative groups across health and social care provision. The governments of both England and Wales have recognised the need to promote this agenda by supporting organisations that enable public input, such as Healthwatch and Involving People. The current Coalition government in England has given less emphasis to specific public engagement measures, possibly due to a commitment to reduce the overall amount of legislation in relation to the public sector. However, high-profile initiatives, such as localism and the Big Society, have public engagement at their core, through their aim to fundamentally shift power and responsibility for the delivery of public services to local communities.

In Wales, the role of older people in policy and decision-making is recognised in the Strategy for older people in Wales 2008–2013, under the heading of ‘Valuing older people: maintaining and developing engagement’ (Welsh Assembly Government, 2003, p 15). This includes a broad aim to embed the participation of older people in society and at all levels of government, including in the planning and development of local services. A wide range of forums have been developed in different areas in Wales to represent the concerns of the over 50s, including forums or networks within all 22 local authorities.