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User involvement: beyond the tick-box.

The delivery of person-centred care is central to current healthcare policy. To achieve a person-centred service, patients must be placed at the heart of the NHS and considered ‘co-producers’ of their care and recovery (Department of Health (DH), 2010; Scottish Government, 2010). 
 
User involvement in health care is multifaceted and can occur at many points in the patient journey (Health Foundation, 2014). Ensuring that patients are involved in decision-making about their care is one approach to user involvement (Coulter and Collins, 2011). A further example of patient and family participation involves active partnership with people who use specific services (Forbat et al, 2009). Within this model, choices are made collectively about service organisation and delivery (Angood et al, 2010). 
 
It is now firmly embedded in UK healthcare policy that service users must be involved in decision-making with regard to service design and delivery (Scottish Government, 2010; NHS England, 2012). Undoubtedly, with these political drivers, there has been increasing engagement with service users in healthcare design. However, there is little guidance about what constitutes user involvement. The wider challenge is that it is difficult to evaluate what user involvement really means and, most importantly, how it can be measured to ensure that it is a meaningful interaction. This article critically reflects on some simple and practical techniques that can be used to ensure that user involvement in healthcare delivery and design is meaningful.