Results from a national survey show that people in Scotland are unaware of their right to influence decision-making in health and social care, outlining the need for improved public engagement efforts.

A report published by the Citizens’ Panel for Health Improvement Scotland (HIS) says more work is needed on strategies to engage the public with their right to influence health and care services.

Responses to the survey from across Scotland reveal that only 23% were aware that they had the right to be involved in the delivery and design of new health or social care services, with 62% people reporting that they were completely unaware.

Claire Curtis, Acting Head of Engagement Programmes at HIS, says:

“Our survey shows that there is a strong appetite within the public to have their say in how health and care services are designed and delivered.

“But more needs to be done by NHS boards and local authorities to let the public know how they can engage, and crucially, make it clear the vital impact their voice can have on making health and care services more effective.”

She adds that it is essential that this community engagement is not tokenistic and public feedback is “listened to and improvements are made accordingly”.

Only 507 people completed the survey, reaching a 53% response rate and adjustments were necessary to address under-representation. Despite targeted telephone interviews, “younger respondents and females were still under-represented,” as were people living in social housing and those from the most deprived areas.

In response to if they had been asked to provide feedback or opinion on service design or change in local health and social care, 83% said they had not – rising to almost 9 in 10 for responses of ‘No’ or ‘Not sure’. 

Of the 50 respondents who had been involved in providing feedback or opinions, 34% rated the experience as being neither positive or negative.

Over a third of respondents had a positive experience and 9% rated their experience as ‘Very Positive’. However, over 1 in 10 rated their experience as ‘Very negative’, with just 7% responding that it was negative.

Expanding on the reason for these answers, the report states that when experiences were negative or neutral, this was due to a lack of implementation:

“Where respondents were not as positive about their experience, the most common response was that they haven’t seen any changes as a result or don’t know the impact of their input (20%).”

Close behind the 1 in 5 who were disappointed by the absence of clear changes following their feedback, 16% said they felt the mode of engagement and feedback was difficult. Comments were shared in the report, some remarking that they felt it was a “tick box” exercise – a statement that over 1 in 10 respondents agreed with.

Humza Yousaf, Cabinet Secretary for Health and Social Care, says the government will utilise the findings from this report going forward:

“We welcome this report which provides valuable insight into experiences of public engagement in the design and change of health and social care services.

“The findings will inform our current review of ‘Planning with People – Community Engagement and participation guidance for health and social care’. This guidance supports NHS boards, local authorities, and integrated joint boards to use an equality and human rights-based approach, emphasising what matters most to people and ensures that health and social care providers are supported in involving and listening to their communities.”

According to the report, support across all communities to participate should include raising awareness of the public right in Scotland to get involved in the design and delivery of new health and social care services.

Another area highlighted for development is the role of better informing the public about proposed changes throughout an engagement process and providing feedback on the impact to those who took part.

Ms Curtis says Healthcare Improvement Scotland is committed to working to improvement health and care services across Scotland:

“As we come out of the emergency measures placed on the NHS during the pandemic we will continue working with our colleagues in Scottish Government and across NHS Scotland to improve community engagement and develop our services.”

In terms of what people hope to influence, the survey also asked what matters most to respondents about being involved in the design of new health or social care services and 65% said being able to improve local services. A close second, 56% also saying knowing that their feedback could lead to change and inform decision-making and over 1 in 4 said “knowing that your views and experiences matter”.

A key recommendation by the Citizens Panel to the Scottish government, local authorities, NHS boards and Health and Social Care Partnerships was to incorporate the findings into ‘Planning with People’ guidance.

This guidance is under review and will be reported on over 2022, according the foreword from Jeane Freeman, previous Cabinet Secretary for Health and Sport, and Stuart Currie, Health and Social Care Spokesperson for COSLA.

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