An effective process for community led, collaborative needs assessment, service planning, service delivery and performance review. Despite years of re-organisation and promises health services for island and other remote and rural locations are planned, delivered and reviewed from the top down using data and assumptions which are often not applicable to these communities. Local conditions and circumstances are not taken fully into account and there is rarely any effective collaboration and partnership with local communities and local third sector organisations. The result is that services, organisation and protocols of delivery are imposed on these communities which are neither efficient, effective or cost effective for them because they do not take account of the local conditions or the needs and wishes of the local community. Significant amounts of money and effort are put into “community consultation” exercises which usually take the form of a list of centrally pre-determined priorities which residents are asked to rank. They are mostly unengaging and ineffective in addressing local needs and circumstances. The underlying reason for carrying them out is to “prove” that community consultation is taking place. An effective process of bottom up, community led, collaborative needs assessment, service planning, delivery and performance review which takes account of local circumstances and resources needs to be established, genuinely supported and actually used. This will require all service providers to operate collaboratively with community and third sector representatives and will require them to develop and use the detailed and locally specific processes of needs assessment, service organisation and service delivery which are currently missing. This requires a massive change in the assumptions and practice of health service planners and providers. This change needs to be promoted, encouraged, supported and ultimately insisted upon. Until such a system is in place islands and other remote and rural locations will not get the health, social and care services that they need.
Including people with lived experience of disability and of age on decision-making committees where what they have to say will actually be heard, listened to, heeded, and acted upon and where they will have equal making amongst non-disabled people in decision-making.
This content is created by the open source Your Priorities citizen engagement platform designed by the non profit Citizens Foundation