Introduction and Background

This toolkit is a flexible set of resources for people who work in universities in health, social care and social work departments and faculties who are currently developing the involvement of service users and carers in teaching programmes.  It provides advice and examples which can be used to support the processes of engagement.

It has been written by a collaborative partnership of service users and academics from a number of Universities in the West Midlands, funded by the Staffordshire, Shropshire, Stoke-on-Trent and Telford and Wrekin Life Long Learning Network. A full list of contributors and acknowledgements can be found at the end of this document.

The individual leaflets are designed to be read or printed as required, they include case studies and examples of situations in which service users and carers have made a positive input into educational provision – ideas for you to consider. Above all the leaflets are meant to be practical guides which can be used independently or to support each other.

The leaflets cover the following topics:

Definition of terms used in the toolkit

The term ‘service users’ tends to be used for people who are entitled to use services in health, social care and social work. ‘Carers’ are defined as people ‘looking after family members, partners or friends in need of help because they are ill, frail or have a disability’ (Levin 2004 p.21) .

The other terms that need some form of explanation are ‘partnership’, ‘engagement’ ‘involvement’, and ‘collaboration’. They are used regularly with similar intention. We think that it is the meaning behind the action which is pertinent.

In developing the toolkit we were heartened and encouraged by the innovative approaches to service user and carer involvement that we observed and read about. However, we were also mindful that the progress and quality of involvement can be hindered by the organisational structures within HEIs (Higher Education Institutions), limitations of resources and time and the support available to academics to help them to keep service users’ and carers’ experiences as an essential ingredient of students’ learning. There are no ‘quick fixes’ to full engagement and tokenism is a danger which is best avoided when everyone involved shares the same commitment to the values and principles of service user and carer involvement.( See leaflet 1)

“Tokenism is an ever-present threat in this work, and the day we feel we have cracked this is probably the day that it is at its worst”( Judith Davies OU internal report Sept 2009)

 Power can be an issue for professionals.

“It is important that professionals learn to ‘let go’ some of their power for real service user involvement to happen” (member of Service user panel for OU Faculty of H&SC, SCLD 2009 p19)

Why involvement?

Professional body requirements have made clear the need for service users and carers to be involved in social work and health education. These are supported by valuable research and recommendations from bodies such as the Social Care Institute for Excellence (SCIE).

The General Social Care Council (GSCC) states that in order to gain professional accreditation Universities are required to agree to, “consult with service users and carers to make sure their needs and opinions are reflected in the design and development of courses” (GSCC 2002 p22)

The Royal College of Nursing (RCN) believes that users can bring a rich range of personal skills, knowledge, experiences and abilities that can contribute well to the research arena around health provision, complimenting the expertise of the researcher. (RCN 2007)

Professional nursing standards to support learning and assessment in practice include, “using a range of learning experiences involving patients, clients, carers and the professional team to meet defined learning needs” (Mott MacDonald/NMC 2009 p. 20) and “reviewers will meet with patients and carers who have contributed to each programme” (p33).

The National Service Framework for Mental Health proposes that “service users…should be involved in planning, providing and evaluating education and training” (DH 1999, p109 quoted in Tew, Gell and Foster 2004).

As well as demands from policy makers and professional accreditation bodies in health and social care there is also pressure from user and carer led initiatives based in a social model of disability, citizenship and human and civil rights to be as inclusive as possible. (Council of Europe 2007)

In health and social care education we should recognise that the aim of teaching is not just to enable students to qualify but also to improve the quality of their learning so that the practice of health care, social care and social work is improved for the benefit of service users, carers and the community. This is an important characteristic of these fields of professional study. Partnership between practitioners, service users and carers is seen as invaluable in this process:

‘The participation of users and carers has the power to transform the next generation of social workers’ (SCIE Nov 2009 p1)

For these reasons it is important for service users and carers to contribute to making sure universities get it right and for them to be involved in all aspects of teaching and learning, from curriculum development to direct teaching and assessment.

This toolkit has been written in response to these challenges, and seeks to provide those with a desire to involve service users and carers with a framework to assess their current arrangements through a series of leaflets about different aspects of the process of involvement which include case studies, examples of good practice and self –assessment questionnaires. As you draw on the materials provided, a central theme of the service user and carer toolkit is evaluation; based on the belief that disseminating good practice experiences amongst HEIs, will further contribute to improved outcomes, and enhanced processes for service user and carer involvement, now and in the future.

What are the benefits of involvement?

Students, service users and carers and staff in higher education can all benefit from working together.

“The benefits for involvement for institutions were agreed to be: enhancing learning, challenging assumptions, hearing and valuing people who use services and carers and improving services … Everyone’s learning can benefit from service user and carer engagement”. (SCLD 2009 p.14)

Students can benefit from:

  • The development of transferable skills in participation, inclusiveness, respect for user’s point of view and trust
  • The acquisition of core skills in interpersonal communication
  • The application of theory
  • Encouraging a whole person approach to practice

Service users and carers can benefit from:

  • Developing confidence
  • Validating personal experience
  • Gaining satisfaction from the fact they can make a difference
  • Learning different perspectives

Staff in higher education can benefit from:

  • Reflection and evaluation of teaching content and methods
  • Development of good practice in teaching
  • Confirmation of person centred values

A survey of service users and carers for SCIE (Branfield 2009) found that:

  • All participants believed that service user involvement was a positive step towards giving them more say and control in the services they use
  • Both service users and students developed a deeper understanding of each other’s perspective
  • Service users get an insight into the professional’s world that they considered and made them more tolerant of the difficulties faced by frontline workers
  • Frontline workers are more likely to treat service users like people, not cases
  • It will help challenge stereotypes.

As a member of our team said:

“I realised that my expertise in my condition was of interest to others and could make all the difference to how students related to service users and carers ... The first time I recognised I had acquired skills and information that was valuable to others, was the first time I felt positive about what had happened to me” (Burrell 2010)

What are the Barriers? What gets in the Way?

Reported in a SCIE report (Beresford, Branfield, Levin 2007 p 4) service users agreed that the following were the major barriers to effective involvement in social work education:

  • Academics do not attach high enough value to service users’ knowledge
  • The culture in some universities needs to change – e.g. the tendency to prioritise academic knowledge over that gained through experience
  • Access requirements are not always fully met
  • Many service user organisations lack capacity and infrastructure
  • Training for service users and their organisations is lacking
  • Payment policies and practices need improvement
  • The benefit system discourages involvement.

Local research by Scottish Consortium for Learning Disability (SCLD 2009) adds

  • Lack of allocated funding
  • Insufficient staff time
  • Use of jargon by academic staff
  • Power imbalances between academic staff and service users and carers
  • Lack of experience.

Tew, Gell and Foster (2004) found various barriers for individual teaching staff and service users and carers:

Teaching staff

Service users and carers

  • Isolation
  • Lack of information
  • Inertia
  • The existing culture of the course or institution may feel hard to change
  • Lack of time to reflect, discuss and plan
  • Lack of resources
  • Lack of experience of service user and carer involvement.


  • Isolation
  • Lack of confidence and self belief
  • Feeling ‘blitzed’ by jargon
  • Lack of understanding of learning and teaching strategies.



Strategies to overcome the barriers.

Am I “an expert”?
Are my experiences of real interest to you?
Will I bring about change?
Will I contribute to improvements?
Am I here to make up the numbers?
Can you now tick the consultation box?
Do I make your organisation look good?
Do I make you look good?
That’s my experience.
(Burrell 2010)

Social Care Institute for Excellence (SCIE) developed  a strategy to support service user and carer involvement in social work education in February 2007 followed recently by two useful documents - ‘At a glance’ Paper 19 Building user and carer involvement in social work education (November 2009) and a Workforce Development Report ‘Developing involvement in social work education’ (December2009).  Although aimed at social work the key messages from these documents can be applied right across the health and social care field:

  • The mandatory involvement of users and carers in social work education is a very exciting and powerful policy development
  • Valuing the knowledge of users and carers and recognising that this is different from, but equal to, professional and academic knowledge is of critical importance to the success of programmes
  • Users’ and carers’ experiences are relevant and should be incorporated across all areas of the curriculum
  • User and carer involvement in programme management, student assessment and recruitment activities should be implemented
  • It is important that HEIs recognise the differences between users and carers and make careful preparation in order to manage these differences appropriately
  • It is vital that HEIs engage with local user and carer groups as these can provide help with assembling a wider pool of users and carers and can ensure that the activity is truly user and carer led
  • Users and carers need resources, training and support in order to effectively perform all the tasks required by HEIs
  • Regulations around payments for participation and the welfare benefit systems remain a barrier

The project team was brought together to respond to these issues in a creative and accessible way. We wish you well in applying these resources to your area of practice.

Vida Douglas - Project Chair


Toolkit Team

Helen Burrell - Service user and carer Staffordshire University
Sheila Dixon - Head of Mental Health University of Wolverhampton
Vida Douglas (Project Manager and Toolkit Lead) - Head of Social Work (Qualifying) University of Wolverhampton
Anne Fletcher - Senior lecturer, Faculty of Health and Social Care, The Open University in the West Midlands
Marie Gildea - Team Leader HEFCE Health and Social Care, University of Wolverhampton
Dr Sue Read - Reader in Learning Disability, Keele University
Penny Vincent - Senior lecturer, Civic Engagement and Regeneration, Staffordshire University

With acknowledgements to:

Dr Elizabeth Boath - Reader in Health, Staffordshire University who began the project
Anne Longbottom - Staffordshire, Shropshire, Stoke-on-Trent and Telford and Wrekin Lifelong Learning Network
Koki Patel - Service User Representative, University of Wolverhampton
David Walker - Director Creatist Designs Ltd
Gemma Witton - Multimedia Learning and Development Officer, University of Wolverhampton


Beresford P., Branfield. F. and Levin E., (2007) Position Paper 07 Common Aims: A strategy to support service user involvement in social work education.  Social Care Institute for Excellence.

Branfield.F.,(2009) Workforce Development report Dec 2009 Developing Involvement in Social Work Education. Social Care Institute for Excellence.

Burrell. H., (2010) My Experience. (Unpublished)

Council of Europe (2007). Report on user involvement in personal social services [Accessed 5/5/10] Available at: Http:// 

General Social Care Council (GSCC).(2002) Accreditation of Universities to Grant Degrees in Social work. [Accessed 25 /06/10] Available at:

Leeds Health Action Zone (2001).Service user and carer involvement toolkit. [Accessed 5/5/10] Available at:

Levin, E (2004) Involving service users and carers in social work education. Social Care Institute for Excellence.

McPhail. M., (Ed.) (2008) Service User and Carer Involvement: Beyond good intentions. Dunedin Academic Press. Edinburgh

Mott MacDonald /NMC partnership(2009).  QA handbook Case studies Nottingham, Bradford, Edge Hill, Brighton, Southampton, Leeds, de Montfort. [Accessed 5/5/10] Available at:

The Open University in Scotland (2009)Opportunities for involvement for service users and carers at the Open University in Scotland. The Open University in Scotland.

Professional Education Public Involvement UK network. (Forum for discussion  + references, case studies etc). [Accessed 15/11/10] Available at:

Royal College of Nursing (RCN) (2007). User involvement in research by nurses. London; Royal College of Nursing

Scottish Consortium for Learning Disability (SCLD) (2009) Effective engagement in social Work education – a good practice guide on involving people who use services and carers. [Accessed 25/03/10] Available at:

Social Care Institute for Excellence. (2009)   Building user and carer involvement in social work education. ‘At a glance 19’.. [Accessed 25/03/10] Available at:
Tew J., Gell C. and Foster S. (2004). Learning from Experience; involving service users and carers in mental health education and training. Mental Health in Higher Education [ Accessed 5/5/10] Available at: