Transcript: Real Lives, Real Difference: service user and carer involvement in professional education


Focused on the subject of service user and carer involvement in professional education.

Podcast Episode: Real Lives, Real Difference: service user and carer involvement in professional education

Category: Social work (general) 

Host(s):


What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.

MD - Michelle Drumm
PB - Peter Beresford
JM - James McKillop
TF - Tom Friel
SS - Surinder Kaur Saroya
MM - Mo McPhail

MD The Real Lives, Real Difference conference was held at the University of Stirling on the 4th of June 2013. It focused on service user and care involvement in professional education. The keynote speaker, Peter Beresford from Brunel University and Chair of Shaping our Lives, argues that user and care involvement in professional education is of unprecedented importance and makes possible a transformed approach to occupational roles, education and practice. Here is his presentation:

PB I am pleased to be here, it's always nice to be in Scotland, I have to say it's increasingly nice to be anywhere that is a long way away from Westminster, which is not very far ... I cannot tell you how awful it feels to be so close, I live in Battersea, just a few miles away, and there is a kind of strangeness affecting our society which of course affects the South with special intensity, and I am not ... I have to say these things because I have conversations with different people every day and we come back to the same things, all sorts of people, and we always end up saying things like, 'what are the young people going to do?', 'what's it going to be in the future?', 'where are people going to live?', and it may not be quite the same here because you have your own parliament, but we cannot escape it living where I do, and it's a grim feeling. But I don't want to talk about just the grim things, I think what's exciting and what I am guessing about today here, is that so many of you are here with a real commitment to take forward the kinds of things we are talking about, about service user and carer involvement in professional education, and that's exciting its time has come and it's important, and I share that enthusiasm and commitment, I hope, and I am committed to taking forward discussion and action to make this more real in every way for everybody's life in all kinds of professional education, starting with Social Work. Because I think we are exploring something with the biggest, most transformative implications that there can be in a world like ours for how people see each other, how people treat each other, how people try formally to support and look after each other in a modern society. At the same time, here in Scotland, and I believe in the rest of the UK, and indeed in other European countries I am seeing it, these ground breaking developments may be at risk, it's not just in England I don't think, it is more generally when I speak to friends and colleagues from other places. And maybe it's at risk because of its fundamental implications for real and positive change. So I think we're not just here, we can't just be here as we want to be here, as supporters and advocates for these positive things for taking forward the voices of people of service users and carers in professional education, but I think we also are going to have a role, a bigger and bigger role as guardians and defenders of this big change. Does that make sense to people?

So I don't think it's going to be an easy or a simple road that we are going to be going on, but it is one that's the right road of enormous importance and of central value for everybody's future. Now, just to say about me, as you heard I work at Brunel University were I am involved in teaching students to become professional Social Workers, as well as undertaking research, I have got my own experience of long term use of mental health services, I could really identify with what Glen said, and as our Chair said, I am also proud to be involved in a national user controlled organisation and network Shaping our Lives. Please Google and check out the websites of Shaping our Lives, I hope there may be things of use and interest to you.

So I am saying that these are complicated and very contradictory times of change. Just to say, 2 weeks ago in my day job as an academic, an educator at Brunel University, I was involved, all the time of course in student recruitment for our Social Work BA and MA courses, and I always enjoy that, although, and I am not being facetious it does make me a bit nervous, not as nervous obviously as candidates, because it is such a responsibility, and I was involved in carrying out the group discussions because I am not a Social Worker, as well as being an observer for the individual interviews that we also carry out, and I think we have got a good and fair system of selection that we have developed. So 3 of us carried out our group discussion, there was a colleague of mine who's a registered Social Worker, me, a Social Policy academic, of course someone also with lived experience as a service user who works at the University, and alongside us on equal terms, a service user who was a member of our service user group, and what's great is that people who are service users like her, and I say this from a service user perspective, are routinely involved on truly equal terms in student selection, as well as in a whole range of other activities around the Social Work courses and programmes. And we all 3, and I really think this is true to say, played an equal role and there's nothing special about us, this is what can be going on now in the process, and it's a great feeling I think of effectiveness and equality that you experience in situations like that, and we saw some good people that day, even though, I don't know how it is in Scotland, but on the day that we saw people, people would not even know if they had a chance of getting a bursary, so insecure are things around Social Work and bursaries in education in England currently. I am always impressed by the skills and experience that people coming to be Social Work students bring with them, but what I also think is evident, from my experience over the years, is that more and more over that time, candidates seem able to feel that they can talk about their own experience as service users or involved in heavy issues which are the province of Social Work, and these will be respected, valued and recognised as strengths that they can bring to the course and to the role of Social Worker. And so it was again this day, and it's a great feeling that we are going to be building a new generation of committed, skilled Social Workers, a number of whom will also as part of what they are bringing in a value for, will being that experiential, what I call experiential direct knowledge of the kinds of difficulties that the people that they will be working with may face, to inform their work, to increase their understanding, to shape their role and to make them the best practitioners that they can be. And it's only a few years ago, if truth is told, that all this became very real in Social Work, and I personally am proud of Social Work as a pioneer in this area. Social Work is an easy target, we see it all the time, through the right wing press and through politicians who are after a cheap bit of populist policy or a sound bit, but it was Social Work that first, as a profession, addressed issues of equality, diversity and anti oppressive practice, and it was Social Work that first has made user and carer involvement a requirement of its professional education, and there is no government now, however much they might mock or ridicule people or service users, or Social Workers who will dare to get up on a platform and attack people for their difference for diversity. And I was lucky enough to be in at the beginning of the official developments for user and care involvement in Social Work in England. An external committee was set up by the then government lead, Dame Denise Platt, and she listened to people like me, I was fortunate to be on that, from Shaping Our Lives, when we were saying that user and carer involvement was crucial for the new Social Work degree that they were planning to establish, and so it was that when that was introduced in 2003, first it was a requirement that there was user and carer involvement in all aspects and stages of qualifying, and then later post qualifying Social Worker, and second, that money was identified and ring fenced from the centre from central Government, towards the costs, we know there are costs, of enabling such involvement. Just to say that I am going to make sure that everyone who wants to can have a copy of this afterwards, I ought probably also to apologise for not using Power Point but I hope it's okay that I don't.

I remember seeing feedback at the end of a year once from one of our groups of students, and they put 'Peter does not use Power Point, there is nothing to look at.' And I think that person did have a point, but I am hoping there's also different ways of hearing and learning from each other. Now this changed, of course it wasn't magical in effect, all the consultations and research that Shaping Our Lives and other ones that I have come across that have been undertaken have highlighted some similar issues. Some higher education institutions, universities, colleges, have been at the vanguard of trying to take forward really good effective and worthwhile involvement. Other have kind of made solid progress and of course there are some that have been slow or less interested, and even in the same college or university, sometimes there are really good things going on in one area, maybe like recruitment, but not in another, for example assessment or teaching. User and Care involvement have tended, that's the word I would use, they have tended to be patchy so far, but they have been moving on and we know that students value them. A diverse range of students of service users also hasn't always been adequately involved, and also sometimes not so often those with experience of the controlling aspects of social work policy and practice, for example, in relation to child protection work, so we mustn't over claim about what we have achieved here. But at the same time I don't think we must underestimate the importance of what has been happening in our countries. These were moves were unprecedented, they were a real, real profound breakthrough, and most of all, as well as there being this principle there should be involvement, the money was there, maybe not enough, but some money was there so it was possible for social work departments to get on with the reality of involvement without being dependent on their college to cough up with the funding, which we know is not something you can take for granted. And when I have told people from other countries, when we have had conversations and other professions about these 2 crucial elements that have been in there for social work, they've always thought they were ground breaking and of critical importance, and they have been envious, they have been envious that there were these levers that we could pull to make sure this could keep going and happening. But, I have to say, increasingly I have the sense that the powers that be now, may not necessarily take the same view, and I will come back to that.

So no wonder that service users repeatedly have talked about, have seen user and care involvement as a means of what's been called 'changing the culture', changing the culture of education and of a profession and of its professional practice. And here we can see there can be a truly different approach to education based on what I have called the 'first hand' or experiential knowledge, what people know from living it, the lived experience of service users, evaluing and acknowledging and giving credit to that experience and those people and not just of re-running old professional assumptions or theories of having so called experts decide what's important, what needs to be taught and how it should be taught and by who it should be taught. Is this making sense so far?

So, with this different way I am saying we create workers with a wider range, a less bias range of knowledge to bring to their role, which includes engagement with service users on equal terms in their learning. Not only coming across service users in crisis or in difficulty, but as equals in a learning situation, and by being involved, service users and carers themselves can gain new confidence and transferrable skills, which then can lead them to all sorts of possibilities, including the one that the government never stops talking about, but not as an opportunity, always as an obligation, having a job, and other opportunities, including even, and we know it happens, the opportunity if they so wish of becoming professionals themselves. Yes, as I am saying, even as these positive developments have been taking place, other negatives have been building up. In England, the social work regulator, the what was called the 'General Social Care Council', which had supported and encouraged such involvement was closed down by the government and in its place, social work regulation was taken over by what's now called the 'Health and Care Professions Council', HCPC. That's a body, and I am not one to be negative about it, but just to state the facts, a body without a background of experience in user and carer involvement, with a much narrower brief, a narrower understanding based on medicalised professions and what it would itself call a 'tick box approach', a much more minimalist approach to regulation. Only when things have gone really wrong, is it that they should intervene. It's already undertaken a consultation on user and carer involvement which feels a bit ominous, we have yet to see how much value it's going to attach to it. Similarly since the coalition government came to power with its commitment to cuts in public spending, there have been rising fears that the funding that's gone with involvement will be terminated, and I understand this dedicated funding has already been lost in Scotland, which it seems to me it's so important, and it's difficult to see at times when universities, especially in England, but I guess there are problems here too, are strapped for cash, that this wouldn't have potentially profound and negative effects on taking forward in a good way, user and carer involvement in professional education.

But other worrying developments are also taking place, these are taking place, the ones I am familiar with in England, but I think that's a ... kind of, it's a worrying feeling that what happens in the South is what they then export everywhere else. So I can't speak for Scotland, but there's been in England, certainly, a move, increasing move away to graduate qualifying social work courses, is that happening here ... away from under graduate courses? No? It's definitely happening in England, where under graduate courses are closing. And that's a worry, because of course it narrows the range of people who can become social workers, and I think it's related to a notion that the best social workers are those with the strongest looking, conventional academic qualifications, which of course has to be open to serious question. But it also calls into question the value and importance of lived experience and experiential knowledge that the policy makers attach. This same problem is also reflected in an increasing pre-occupation, even under graduate level, and it's coming to my university with higher academic qualifications. I have never seen any evidence that shows a meaningful link, correlation between a good value based practitioner and crude academic qualifications. No-one is saying of course that people don't need academic skills, but service users certainly say over and over again that they value people with empathy, understanding, shared experience and a capacity to listen and be non judgemental. I have never come across anyone who has said, I insist on an A and 2 B's at A Level, which is the way the road is going. Now the new government in Westminster is interested in what it calls 'Elite Routes', it calls them Elite Routes to social work, like the so called front line approach, and the idea is that people it describes as 'high fliers', because they have what's seen as high quality conventional academic expertise, will make especially good social workers, although there is no evidence to support this. The built in logic of this initiative, which our government is putting a lot of force behind, for me, is that it will undermine the skills, independence and role of social workers and I think that's a very serious worry that we need to have. And where of course within a scheme with its assumptions will people with the much valued experience as service users be likely to be, where will they be in that band? I don't think they are going to be anywhere, they will not be seen as 'high fliers'. And so much we might say for addressing diversity and inclusion. And what seems to be happening, I think amongst policymakers, the received wisdom of the current policymakers is that book learning is being seen as increasingly more important that experiential learning. Not, I would argue, the lesson to be learned from service users or indeed from the evidence.

2 new reviews have been set up in England into social work education, with children families and with adults. So having just had the Social Work Reform Board, the Munro enquiry into child protection, you may wonder what the need is now, yet again, for a rerun of 2 reviews like these. And the terms of reference for the latest, which is the one working with adults, by it's Chair, David Croysdale Appleby, who is the Chair of Skills for Care in England, gives you some idea. And this highlights the kind of thinking that's taking place, I think. The minister for social care says he wants to be "reassured about the present investment of £100 million in social work education". I think it's interesting there don't seem to be the same constant ministerial preoccupations about value for money when it comes to medical or psychiatric education, and yet we know there are some large and long standing problems there. But also some rather more powerful professions. Then there's the suggestion that adult social work should pay, as I have already said, more attention to what are called elite entry routes, like Frontline and Step Up To Social Work, which we have got developing in England. This, despite the fact that the last meeting of the social work reform board, which was a follow on from the tragic death and the scandal that surrounded the death of Baby Peter, and I was there, the track record of such schemes which were first started in education, was described by people present, key people, not social workers, is disappointing to say the least. The Minister also wants to look at the case for a generic qualifying course which is what we now have, and the scope for what they see as increasing specialisation within the qualifying degree, even though the evidence against this has only recently been run through yet again. Unfortunately the evidence, the repeatedly highlighted benefits of user and carer involvement in social work education don't seem yet to have entered their radar. I have to hope it does. I have been fortunate enough to be involved in a project, the EU Leonardo, 2 year funded project called Power Us, and that's been a partnership, and we are still going, between service users carer and educators in England, in Sweden and in Norway. And our partners have thought that UK requirements and funding for such involvement were a wonderful development. The policymakers here, strangely, don't seem to take the same view. Our European colleagues feel that we have achieved great things here which we should be proud of, and so do new colleagues that I meet from other European countries as a result, but this does not seem to be the UK political view here. For all the rhetoric that we know goes the rounds routinely about involving service users, partnership and co-production, there seem to be heavy pressures in a different direction. Everywhere, from my experience, and yours may be different, I feel there is uncertainty. If you take a key strategic initiative, which I have been fortunate to be involved in, in taking forward service user and carer involvement led by service users and carers in social education, that's SWEP, something that the Social Work Education Partnership, which is now an independent charity, which grew out of a project funded by the English Department of Health, which has been going for a long period, housed initially in the social care institute for excellence. Please check out SWEP's website, SWEP is a truly user and carer led initiative, to advance user and carer involvement in social work and other professional education. So as well as its information sharing website, it's undertaken consultations and research sought to develop capacity and improve standards, all in a democratic partnership which can work between service users and carers, but lately its efforts, our efforts to secure funding have been unsuccessful, we are now at real risk, what other national body is there for us, in England, that can push in that same way for user and carer involvement, crucial though we know it may we? Furthermore, I think a really valuable effort by SWEP, SCIE, Social Care Institute for Excellent, and the partnership for universities, including university here, to evaluate and develop user and carer involvement in social work education, to explore its impact on practice, how it can help, has so far been unsuccessful. I ask what more useful, necessary or important work at this time could there be?

Now in England at least, there are widespread concerns, not just about social work education in user and carer and involvement, but for the future of social work with adult's altogether, amongst both practitioners and service users. Social Workers have a vital and unique contribution to make, in relation to disabled people, older people, people with long term and life limiting conditions and illnesses, mental health service users and people with learning difficulties. And that's not only what Social Workers themselves and their professional organisations say, that is a repeated message from service users in consultations and research that I and others have been involved in. It's service users themselves who repeatedly make this point. But the truth in England is, that fewer and fewer adult service users are now getting the vital advocacy and support that social workers can offer, and instead posts are being slashed. Social Work with children and families is also increasingly at risk, although you have a sense that governments a little bit more nervous about having a childcare scandal on its watch. So there's a sense that in their search for cuts and economies, policymakers will see many of the tasks, and it's already been happening, which qualified social workers deal with service users, which require a whole range of expertise as tasks that can be left to unqualified and more malleable staff, if they are addressed at all.

I think we can see all professions at risk from a politics and ideology that devalues public service, the people who need such service, and devalues the professions associated with those services and those people, and that's what we are seeing now, we are seeing politics which seem frequently to be dedicated to attacking and undermining all those groups. Those professions from teachers to nurses, from midwives to social workers. It's significant that while social work was the first profession, as I have said, that sought systematically to involve service users and carers in its education, other health related professions, more and more, are now interested in following in the same direction, even without the requirement in place that they have to do so. This is a way in which helping professions, I argue, can be brought closer to their users in helpful and meaningful ways instead of being something that's imposed on them, here are ways in which professionals and services can reflect more closely, be better informed by and directed by the interest, the rights and the needs of service users, rather than those of state policymakers and people from a particular ideology and value set. But as I have tried to say today, just as this is an enormous opportunity, so there are these major threats and barriers, and I think whatever our role and identity as individuals, we will need to strengthen our alliances, to fight off these obstacles, to work for the continuing and extended development of truly participative learning and education. Where there is a real sense of equality fostered, where crude walls between practitioners and service users, between learners and educators, between professionals and service users which don't reflect the value of our identities and our complex diversity, we are all much more than one thing, are challenged and bridges built. There also need to be new and reinforced alliances between different professions and educators in different fields, between practitioners, professional organisations, trade unions, carer's organisations, disabled peoples and user led organisations. And I feel that organisations like the Social Work Action Network already reflect these value, or it reflects these values and commitments and ways of working, there are examples to build on. We have a chance in what people here are doing, for something truly different, doors have opened which I believe it will actually be difficult for politicians to shut, that doesn't make the task though an easier one, but it's a crucial one, and it's one which I feel though I am not a natural optimist, someone once said of me when we had that conversation when we had that conversation about, do you see the glass half full or half empty? Peter doesn't even see the glass, but I do feel optimistic about this, and I feel we will win ultimately, but it's the degree of pain and struggle in the meantime, because quite clearly we are heading forward to achieve the values that societies like ours like to pay lip service to, but which us communities are committed to, rather than going back to increasing inequality, want, control, discrimination, exploitation and exclusion. Thank you.

MD James McKillop of the University of Strathclyde, Service Users and Carers Network, tells us why the conference was set up and the importance of service user and carer involvement.

JM I think it came about because there's 8 universities in Scotland and they all got £5,000 from the government to set up service users and carers input into social work education, so it came from the government, and then they cut the funding last year, so obviously we all got together to protest against it and so far we have got nowhere, and it's very important, because our input is so vital to the education. University lecturers, believe it or not, they want to get the best for their students, and they feel that by bringing in people with real life stories, it helps people qualify better and do better once they are out in the field.

I personally do, I go in and talk to social work students, I do an hours presentation about how I led an ordinary life, dementia developed, my life fell apart, and a social worker came, got me support and with that support I got back on my feet, that I no longer need services. I will need them again in the future when the illness worsens, but I don't need services just now and I have saved the public purse thousands of pounds.

MD Tom Friel, Director of Inclusion Scotland, speaks about some of his concerns around current care and supports, what needs to change and how change can happen.

TF My name's Tom Friel, I am a Director with an organisation, a disabled organisation called Inclusion Scotland. I am involved in various other groups as well, on the Chair of Access Panel, I am on the Community Health Partnership and a whole load of other organisations, locally, you know which, years gone by I would never have got involved in that, you know, then I became disabled, but the natural course of event, because when you become disabled you are completely in blissfully ignorant to every aspect of your life that's ... everything in your life has changed, you know ... and it's a long hard road to learn how to readapt and change your life, and unfortunately the people that make all the decisions in our life, they're still living in 1968 Social Care Act, you know that's the foundation stone of their perception of thinking, and they have never changed, you know, because you always do what you have always done, you will always be what you have always been, and nothing changes, and it's, you know we collectively have to be the change we want to see in the world and it's not going to happen otherwise, because it's long gone are the days where they can get away with people at the top making decisions, by the time that decision comes down all through the different pathways of service delivery and it reaches us, it's crap, you know it really is crap, and they are throwing huge amounts of public money, year in year in, at care, you know, if you think logically, nobody wants to be cared for, everybody wants to lead an independent life, so they need to get smarter at that, they need to start thinking differently, because only when they think differently will they talk differently, and when they talk differently they will act different, and they will act differently by changing their perception way of thinking. Right at the start of the process they are trying to fix everything when it's broken at the broken end of the process and delivery end of the process, they need to go right back to the start of the process and change the way we think, because we are only going to think differently, talk differently, act differently or we deliver directly, and we can only do that by changing the perception of thinking. Because everything we do in life, no matter what we do and without exception, starts with a thought, how we perceive that thought is relevant, how we deliver that thought.

Everything we do is a biological mechanical and automatic process, if you do an assessment of need in that process, which is a revolving process, every day of every minute in every day, that process must revolve and it must move forward. If you come in and do an aid an adaption or an assessment of need and it doesn't fit in with that process, that process grinds to a halt, and we don't go anywhere, and that's happen with care. You come in and you assess them, you need that and everything, the whole mechanism that you have got to go through, I mean if people have got, like me have got multiple conditions, I need multiple service providers, and everyone has got a different criteria or a different set of rules and a different set of process and a different budget and, I mean it's absolute nonsense, absolute nonsense, and it's millions of pounds of money, millions and millions and millions of pounds, and by the time it gets to us, it's peanuts, it's absolutely shocking and that's got to change.

I have designed a thing called 'DOVE', it's a design of a versatile environment, which is an all encompassing and holistic approach to a persons disability or impairment, so they need to look at that and then set out what the person, you need to achieve with that person and it must be a co-production, set out what they are trying to achieve and then put in, in place what you need to do to achieve that, and it's got to fit into that process, biological, mechanical, hydraulic, electro process, if it doesn't sit into that process, it's a waste of time, it's a waste of money, and it leads to huge deterioration and isolation in peoples lives, and if they don't get that simple process, now it's not rocket science and it's not even the appliance of science, it's what people and professionals and doctors in the medical profession, have worked on for years, you know, I mean we spend huge amounts of money with the NHS, fixing people when they get broken, right, and then they put them into care if they can't fix them, they get a long term condition, we have got 2 million people in Scotland, living and diagnosed with 1 or more long term condition, by 2033, half the population will be living and diagnosed with 1 or more long term condition, and a third of the population will be disabled, we can't possibly care for that amount of people, we need to look at doing things smarter and we need to do things to include people and co-production with people. You know, we are the experts in our lives, not that I chose to be, I mean I don't know what your profession is, but social workers, they chose that profession, we don't choose that profession, that's imposed on us, so we need to make the best of what we can out of a very difficult situation, because all the people that make very decision and every aspect of our life, who are predominantly middle aged, middle class, able bodied and neurotypical self claimed professionals, but the reality of the situation is, they have no physical work life experience in the services that they are trying to deliver, so they need to get smarter and they need to take our knowledge and they need to get smarter ways of delivering that knowledge.

MD Surinder Kaur Saroya, a service user from (unclear...) and the Open University and the Faculty of Social Care, gives her views on the importance of the conference and tells us about her main concern.

SS I think it's very important, I mean I have met Peter Beresford before and I was very impressed with what he was saying. One of my key issues and concerns are the fact that there's not enough participation from the BME community, and this is what I am sort of visualising constantly. I always feel that it's me, I am at the event, I am from an ethnic background, and therefore it's important for me to feel included, I am included but I feel isolated, I feel that I want to be a part of a diverse group, something that is collective, a collective representation, rather than just one prospective.

He was talking about that the government doesn't understand, and I can relate to what he's saying, the government has no idea of what's going on for, you know, the live life experience that real human beings have, and this is a real concern for me because there's so much poverty going on out there, I mean in terms of disability, you know in Scotland we have got 1 million disabled people in Scotland, and 2 million with long term chronic conditions, and the problem, the concern is, there's such a great divide between Westminster and Scotland, and you know up here, my concern is do the cabinet ministers and Mr Cameron have any understanding or any iota of understanding of actually what's going on for us in Scotland?

MD The conference closed with a presentation by Mo McPhail, Head of Social Work at the Open University in Scotland, who spoke about the findings from a research project, which explored the views of service users and social work lecturers about recruitment of service users in social work education across Scotland.

MM Good afternoon colleagues and friends, as Gillian said, I head up the Social Work programme at the Open University and I am also an Op-en University research student, so I am talking to you today in that capacity as a student, so I hope you will be very, very kind to me and forgive me for any stumbles I make. I want to start off with a cartoon, and some of you will know that I love cartoons and the way that they can convey meanings that the written word can't often convey, and this is about a student talking to a service user or carer, saying "I have helped train you to empower me", and it's maybe not, it's not the easiest cartoon to get, but it conveys to me the complex relationship between service users, carers and students, and in fact social work lecturers. It's actually drawn by a guy, Richard Norris, to acknowledge him, whose a very senior health, person in health in Scotland, and I just wanted to be very clear what I am trying to do here today, is to share my findings from the research, about the how and why of service users involvement in social work education, specifically in Scotland. There has been quite a bit of research and books and articles, but they tend to be mostly in England and there's very few research studies in Scotland. So this is what ... and the other distinct aspect is that it's about comparing the views of service users and social work academics, social work lecturers. And I just thought I would do a little bit of background, a little bit of history of where the idea came from for evolvement of service users in social work education. There's lots of common policies and laws across England, Wales and Scotland and Northern Ireland, for example the NHS Community Care Act, the United Nations convention on the Rights of a Child, Human Rights policy and legislation, they go across the whole of the UK and elsewhere, but in terms of Scotland, specific Scottish policy, there are a couple of bits of policy and legislation I wanted to pick out about Scotland. There was a paper, a white paper, produced in 1999 called Aiming for Excellence, and it was about reviewing social work and social work education in Scotland, and you are probably ... a familiar character, Donald Dewar, may have heard of Donald Dewar, he was saying we want a strong focus on people, we want to tailor services to meet the needs of people, as opposed to fitting people into a limited range of services. Fine sentiments, and you have probably heard things like that over and over again, what matters is what actually happens in practice. That white paper led to a law, which was called the Regulation of Care Scotland Act, and that set up 2 bodies you may have heard of, one was the Social Services Council, the SSSC, lovingly known as, and also the Scottish Commission for Regulation of Care, (cheering) and that's important because ... that bit of law was very important because it set up the SSSC, who set up the New Honours Degree in Social Work, and part of the rules, regulations of that was that service users and carers, people who use services and carers, should be involved in the design, delivery and the evaluation of the social work degree, so it's actually law, it has to be done. It didn't say how it should be done, just that it should be done. And that message was reinforced by the Changing Lives report, which was a report of the 21st Century social work review, there was a user and carer group and it did, the report actually really did have a sense that service user and carer panel had had an influence on the report as it was written. So that was policy and legislation, but there was also other really important drivers for service user and carer involvement, and I think just a few of them are, for example, consumer movements, that said the consumer should have a say in what services or products they received, and another kind of political movement, Civil Rights, the Black Civil Rights Movement, Gay Rights, Women's Rights, these kind of rights based movements also influenced the involvement of service users. The new ways of managing social services and social work education, I think sometimes referred to as 'New Managerialism', meant that developed a new type of regulation of social work, social work education, and another sort of strange bed fellow, if you like, is the radical movements in social work, which tried to bring about more empowering practices in social work.

I have read quite a lot over the past, however many years I have been studying, I just picked out some of the books and articles that have influenced me most ... and top of the pile there, are my colleagues, Wendy Ajor, John Dow and Maggie G, who wrote in a journal, I think it was a Social Work Education journal, about the importance of networks, having a network approach to involving service users, rather than just bringing in individuals, it's about finding out where there are service user or carer groups and building those kind of relationships in local areas, and nationally, there are some national groups who have a lot of experience of service user involvement. Peter Beresford, who you heard this morning, has been a great influence, particularly when he has written about what is social work knowledge, is it about the research that social work researchers and lecturers do, or is it about the wisdom, the lived experience of service users and carers, and as you heard this morning, he's arguing for equal status of both of those different kinds of knowledge. I won't go through them all because of the ... I will just say, Mark Smith, he's another colleague from Edinburgh University, and he's written with his colleagues at Edinburgh, about involving people, because from involuntary service users, people who perhaps didn't want to be involved in social work services, but are required to because of court orders or other legislation. The final person, Steven Webb, he writes very much about the dynamics of service user involvement, that actually, that the people involved in the groups are very well connected to lots of other organisations, so those people bring with them a lot of experience in political, service user movements and other rights based groups, so people are not just there as individuals, they bring all that experience with them and I have tried to explore that a bit in Scotland across the various groups. How I went about the study, and who was involved, I had interviews with 20 service users and I noted there that the focus was on service users rather than carers, and that's not for any other reason that I had to have a narrow, a very clear focus for the research study, because I don't have any money or resources to do anything bigger. So 20 service users and 10 social work lecturers were interviewed between January 2011 and January 2012, and I really do thank people who gave up their time and their thoughts and their energy, people seem to want to talk a lot about their experience of, involvement with the universities, but also about how they got to be involved with the university groups and their understanding of why they were there, and the social worker lecturers ideas about why people were being involved.

I also had the privilege of travelling down to the South West of England to do a pilot study, to practice my questions, if you like, with a group of service users and lecturers down there.

Right, what are the main findings? Well there's lots of findings and I can only share a small amount at the moment, but I just wanted to highlight that as a comparison of the views of the social work lecturers and the service users, and maybe not surprisingly there wasn't a great difference in views, about how service users were recruited and why service users were recruited, but there were some differences and I will try and highlight those as I go along. I hope that will be of some interest to you. There were basically 4 question areas, and I will go through each one, but the first one was about how people were recruited and on what basis. Secondly was what are the reasons people are involved. Thirdly, what kind of support really did work, did make a difference to involving service users? And fourthly, looked at the roles and relationships between service users and others involved in social work education. So I will go through each question briefly to say what the key findings are.

How were service users recruited? Three main approaches, and that was true virtually across all the Universities, service users were either contacted via local social care or social work agencies, or people went direct to service user forums, which were service user led, or some people were involved as a result of personal or prior contact in previous jobs, that sort of thing. And I also did an analysis of who was recruited via each of those methods, and a very strong, I'm recognising it's a small group of people, but a strong message came across that a combination of those 3 approaches is very important in order to achieve a broad mix of service users across different backgrounds, both in terms of education, in terms of income, in terms of ... I will move on quickly, but it's very important, if for example you just went, contact was just though personal or professional contact, you would get a narrower group of people than if you went to local agencies to bring people in. So I think that's quite an important message to take on if we want to get that broader mix of people. And I suppose people may recognise the different types of experiences, people who are involved in the Universities across Scotland, people who had experience of services of mental health services, learning disability services, just let you have a look at the list there, and I think the question to be asked is who's not there, what type of experiences, what type of social work experiences are not represented, not involved. Another point which I think is of interest that each university had developed particular areas of expertise involving particular experiences of social work services, which maybe reflected the social work lecturers research interest or prior work interests, and that actually could be seen as a strength, because people have very good contacts, they have good knowledge and understanding, which is enhanced by people who have experienced those services. People talked a lot about, in the university groups, about wanting to have a more diverse group of service users and carers in their group, but actually if you look across Scotland, there is quite a wide range of people and experiences and maybe if we shared some of those experiences, we don't all have to have a token person from different services, so that's an argument for great collaboration across the universities. Service users I interviewed were, by and large, very strong about using networking, network, network, network, to reach out to what Peter referred to as people who are not often heard, and using those sensitive and thoughtful ways of making contact with people who aren't represented anywhere across the universities. Many people spoke of very positive experiences they'd had of assertiveness training, either at the university, with the university groups, or in fact with the agencies prior to involvement with the university. Social Work lecturers also said similar things, but there was a stronger sense of, we need to include more service users but the very real recognition that the limited time and resources meant that people's choice of involving people was limited, and I think that's quite a hard question for us to think about, we have limited resources, how can we use them to make sure that the most marginalised people are involved in the business? Are service users involved to represent themselves or are they involved to represent other groups, other networks of the service users or carers? And most people, both service users and social work lecturers, said that people were there to tell their own stories, but there were people who said that it was very important, it was part of their policy to speak for people who were unable to speak for themselves. The other, I think we mentioned it earlier, the really important experience, people had experience of working with other local service user groups or national service user groups and brought that wealth of experience, people were very well connected, so actually they're not just telling their story, they have got lots of different experience, and been involved, many people involved for 25 years in rights based political service user organisation and I think it's really good to acknowledge that, that there is that wealth of experience to work with. Many people have been involved with agencies who have very long tradition of involving service users in the management of the agency and that's incredibly valuable experience to make use of. Reality, that's people said, that was why they were involved with social work students, is to help people have an understanding of what the world was really like and the lives, the lived experiences of service users, and a real sense of wanting to make things better for other service users in the future, it came across very strongly. I thought it was quite interesting that quite a few people would see themselves as service user activists in other parts of their lives as service users, but didn't see that as relevant to the role within the university. So we all know that service users have multiple identities, they are mothers, daughters, fathers, sons, grandparents, but also people have different identities as service users, they're activists in one sense, but maybe consultants in another sense, I though that was interesting. Whereas social work lecturers tended to talk about the importance of modelling good relationships between service users and social workers. And also people, you know say yes, and it is a requirement, I didn't get any sense from anybody it was just a tick box exercise that the people I spoke with were passionate and committed to involving service users. People did say, oh and it helps enhance the universities reputation, well fair enough, that's fine. One of the other sort of, not a huge difference, but a difference of emphasis was service users placed a very high value on practical issues like transport, taxis, and people talked of the huge effort it takes simply to get to the university location, and people can sometimes feel exhausted by the time they get there, and maybe need some time to rest and be refreshed. I think everybody said how much they like the lunches, that was really, really important, oh yes, it voices recognition. Another thing that was shared by both service users and the staff was that staff attitudes and the way that staff treat the service users and carers is actually really, really important, it doesn't cost a penny, but how people are treated, it's noted and very much valued. The other agreement between service users and lecturers was that clarity of the task that people are being asked to do and training and support, really, really important. And as Peter mentioned this morning, funding and payment is a huge big issue and it's, I think, I suspect England is going to go the same way as Scotland and I know that in Wales, the Care Council is phasing out the grant to support service user involvement there. So we can see the direction of travel I think, across the UK. I think I have already made the point that people have multiple identities as service users. Another point that people made a lot of emphasis with, was the relation to the term 'professional service user', people heard that term, professional service user, and there was a very, very strong dislike of that term, that people thought that it was a disrespectful term and nobody could relate to it at all. People didn't like the term, but there was some behaviours that they didn't like, if people were speaking on behalf of others and they weren't really, I think that was seen as problematic. Another interesting finding, this is just 20 people, that of those 20 people, the majority of people were not currently receiving social work services, quite a lot of people had not received social work services and for many social work lecturers, that was not problematic at all, because people come with lots of other life experiences. But for some service users, they said that people should currently be involved in social work services in order to be involved in a social work degree, so there were some differences of opinions there. And most lecturers said they prefer to use whatever term that service users preferred. And people generally felt the term 'service user' wasn't ideal, but nobody had come up with a better term to describe collectively service users. Throughout the interviews, there were references to power in the relationship between service users and social work academics and I think a colleague of mine who used to work here, said it's the big elephant in the middle of the room, power, that we need to acknowledge that and work with it that people use their power wisely and sensitively. Comments from service users, where does the power lie, is it with the university or is it with networks of service users? And I thought that was useful to think about, what is this about ... who is selling their experience and why, and some people felt that it should include any group of people who are marginalised in society and that social workers might come into contact with. The other suggestions, if service users have support workers with them in order to participate, then they need to be very careful of the power dynamics in whose voice is being heard, and that there is another power dynamic if people are involved as a result of personal contact with lecturers, so it's being aware of those experiences. Another point made by several people was that whilst it's important to hear individual stories, it's also important to hear collective voices, and to see, I think again as Peter Beresford did this morning, to see things in a much wider context of what's happening to people in terms of welfare cuts and erosion of services. And yes, just to finish off really, saying, 'where do we go from here particularly', I don't like the term in economic austerity, because I don't necessarily agree that we do need austerity measures, but the reality is that there's not a lot of money around, so how can we move forward? I will send the bill for the strepsils later. Messages that come across, face to face contact between students and service users and carers is considered very, very important and of great benefit. But there may be other ways, additional ways that we can share across the university groups and we can share both individual and collective voices and experiences. One university, maybe more, has shifted the focus that the social work students actually go out to service users and it's the students who do all the travelling and not expecting service users to come into the universities. And I think to re-emphasise the importance of recognition, the very rich contacts and experience and networks and connections service users have in the bigger, bigger picture in society.

Well I have got some more other thoughts, so I will only be a minute, Gillian, very, a lot of interest in mentoring, experienced service users mentoring new service users coming into the groups, as I said we should try and reduce the inconvenience to service users having to come to the university and consider other ways of having contact. To recognise the different areas of expertise across the universities and perhaps be more strategic in how we work together. Networking, networking, networking, that's a very strong message coming from the research.


Transcript Copyright:
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License