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This is the second of several Reports on our inquiry into Public Services: Putting People First. One of the key themes of this inquiry has been how public services could be improved by involving the people that use them in their design and delivery.
In this Report, we consider various forms of user involvement in public services, from consultation with service users to stronger variants such as user control over service provision (Chapter 2). We examine some of the arguments given for making public services more responsive: that it would be more democratic, that it would improve service levels and that it would be cost-effective (Chapter 3). We also explore some of the potential implications of greater user involvement—for staff working in public services, for service users and for how public services are organised and evaluated (Chapter 4).
Involving public service users by allowing them to control or influence the way in which services are provided can improve service quality, make for more appropriate services and increase people's satisfaction with public services. It is, however, still early days for many of the stronger forms of user involvement, such as individual budgets in social care. Initial evidence about such initiatives seems promising, but there is a need for comprehensive and rigorous monitoring and evaluation, particularly regarding their cost-effectiveness.
In addition, involving service users is not always appropriate. In some circumstances it could create inequalities of service, as well as being risky and expensive. In other situations people may simply be unwilling or unable to engage in this way. A key challenge for the Government and for public service providers will therefore be to establish where user involvement is desirable, and in what form. Service providers also need to ensure that user involvement complements—rather than conflicts with—the contribution made by public service workers.
In this Report, we have not intended to be prescriptive about the level and extent of user involvement, as this will depend upon individual circumstances. Where people do want to be involved in service design and delivery, however, the Government should ensure they get the support they need to do so. This will mean making sure public service workers understand the implications of deeper user involvement, and that they are equipped to deal with its demands. More broadly, the onus is on the Government to set the right conditions in place to help achieve public services that are truly responsive to the people that use them.
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