Involving the public in decision-making about large-scale changes to health services A scoping review

Funded by

The Health Foundation Logo

7 July 2019

Published journal: Journal of Health Policy

Background

Public involvement in large-scale changes (LSC) to health services is strongly promoted – and even mandated – in several health systems. This scoping review aimed to describe the evidence about how public involvement is conceptualised and conducted in LSC, with what impact, and how different stakeholders perceived this process.

Methods

After searching eight databases, 34 publications were included. Data were extracted and charted using a standardised form. Findings from the literature were discussed with frontline stakeholders.

Results

Public involvement remains poorly defined and its aims lack clarity in LSC. Public meetings are most often used to gather public views but raise the issue of representativeness. However, evidence in the literature is scarce about which involvement methods – informative and deliberative – are appropriate for the different stages of the LSC and with what impact. In several cases, the involved public felt they had no influence on decision-making regarding LSC proposals, sometimes leading to an environment of mistrust. In those instances, the public understood the technical arguments for change and actively questioned them, opposed LSC plans and sought alternative routes to voice their views.

Conclusion

More research and consideration are needed regarding who should be involved, with what purpose and how. We argue that in practice two models of involvement, invited and uninvited participation, coexist and therefore interactions between the two should be given further consideration in LSC.

Citation

Nehla Djellouli, Lorelei Jones, Helen Barratt, Angus I.G. Ramsay, Steven Towndrow, Sandy Oliver, 'Involving the public in decision-making about large-scale changes to health services: A scoping review', Health Policy, Volume 123, Issue 7, 2019, Pages 635-645,
ISSN 0168-8510.

 

    You might also like...

    Press release

    Government must go further to level up the health recovery

    Press release

    Health Foundation response to the Queen’s Speech 2022. 

    Press release

    Health and Care Act passes but leaves unfinished business for the NHS and social care 

    Press release

    Health Foundation respond to Health and Care Act receiving Royal Assent 

    Newsletter blog

    How might changing public attitudes influence government policy on health?

    Newsletter blog

    How will falling levels of public satisfaction with the NHS affect debate about NHS reform? Hugh...

    Kjell-bubble-diagramArtboard 101 copy

    Get social

    There is a strong relationship between debt and health. Our analysis highlights that 20% of people in problem deb… https://t.co/rbJuy7LITI

    Follow us on Twitter
    Kjell-bubble-diagramArtboard 101

    Work with us

    We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

    View current vacancies
    Artboard 101 copy 2

    The Q community

    Q is an initiative connecting people with improvement expertise across the UK.

    Find out more