Abstract

The role of older people in commissioning services: levels and outcomes [Abstract (Maximum 500 words)]

Objective: to report on a study of older people's involvement in commissioning in two contrasting English municipalities with reputations for successful activities in this field. The study was designed to identify the structures, processes and outcomes associated with successful involvement.

Data and methods: data were collected through a literature review of involvement of older people in commissioning at three levels of decision making : individual; community; and strategic. This information was used to contextualise the two local studies and to structure focus groups with older people, commissioners and providers. Two national focus groups from leading organisations in each of those fields were also convened.

Results: data from the review and national groups showed that attempts to involve older people were numerous but generally had little impact on commissioning decisions. By contrast, the two local sites were shown to be outliers in both older people's assessments of the value of being involved in decision making and in their impact on decision making. They provided evidence of different approaches to involvement, the factors associated with their relative success and the limits of involvement.

Policy implications: the study generated policy and practice recommendations for securing the engagement of older people in a wide range of commissioning activities and levels in ways that could have some impact on decisions. However, it also demonstrated the limits of such involvement and raised questions about how far older people should focus on scrutiny of and challenge to service quality rather than risk incorporation into agendas set by commissioners.

Slides