Evaluation and Consultation

Abstract

The article suggests that in evaluations of health and social care in the UK, especially those that are officially sponsored, users have occupied a minimal role. It is argued that this is largely because such studies are conducted in the context of a dominant positivistic paradigm, particularly in medicine, that emphasizes 'scientific' as opposed to lay knowledge and the merits of experimental designs. The article focuses mainly on mental health where de institutionalization policies, and a growing emphasis on social treatments, together create a greater need for evaluations to incorporate users in more empowering ways. At the same time, a current interest in 'consultation' has generated many innovative and exciting new inputs for service users—for example, citizens' juries—that offer important lessons for user participation in evaluation. The paper argues that although much consultation has not been assessed itself, lessons may still be learned about the value of lay involvement, and which participation models exist that can be used to inform the future development of evaluations in health and social care.