Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

We have to set the bar higher: towards consumer leadership, beyond engagement or involvement

Brett Scholz https://orcid.org/0000-0003-2819-994X A *
+ Author Affiliations
- Author Affiliations

A ANU Medical School, The Australian National University, Ngunnawal Country, 54 Mills Road, Canberra, ACT 2601, Australia.

* Correspondence to: brett.scholz@anu.edu.au

Australian Health Review 46(4) 509-512 https://doi.org/10.1071/AH22022
Submitted: 8 February 2022  Accepted: 28 March 2022   Published: 5 May 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Understanding of the benefits of consumer-led health policy, practice, research and education has been developing for decades. However, barriers to genuine, non-tokenistic consumer leadership remain across the health sector. While recent calls to align Australian consumer engagement practices with those in the UK and elsewhere may sound progressive, doing so would be problematic for three reasons. First, Australia has been at the forefront of consumer leadership scholarship and advocacy for decades, and we should not ignore the work consumers and allies have done in improving our health systems. Second, although there have been positive outcomes from consumer engagement and inclusion practices (as often required in other jurisdictions), they are open to tokenism and continue to position consumers’ experiential expertise as ‘lesser’ compared to other health sector stakeholders’ knowledge. Last, compared to consumer leadership, engagement or inclusion are ‘lower bars’ for health professionals to aim for. If we settle for engagement or inclusion in cases where consumer leadership would have been possible, then we lose not only our position at the forefront of consumer leadership, but also the expertise of consumers. Three propositions are provided: (1) we should support consumer-led development policy for consumer leadership in health, (2) we should ensure consumer leadership in oversight over as well as conduct of health and medical research, (3) we should encourage honest claims about the extent to which projects or initiatives are led by or with consumers.

Keywords: consumer engagement, consumer involvement, consumer leadership, lived experience leadership, patient and public involvement, patient engagement, patient involvement, patient leadership, service user involvement, service user leadership.


References

[1]  National Health and Medical Research Council. Statement on consumer and community involvement in health and medical research. Canberra: NHMRC; 2016.

[2]  Scholz B, Bocking J, Platania-Phung C, Banfield M, Happell B. “Not an afterthought”: Power imbalances in systemic partnerships between health service providers and consumers in a hospital setting. Health Policy 2018; 122 922–8.
“Not an afterthought”: Power imbalances in systemic partnerships between health service providers and consumers in a hospital setting.Crossref | GoogleScholarGoogle Scholar | 30017107PubMed |

[3]  Happell B, Roper C. Enhancing consumer participation within psychiatric nursing academia. Melbourne: Centre for Psychiatric Nursing Research and Practice and Melbourne Consumer Consultants’ Group Inc.; 2001. Available at https://www.researchgate.net/publication/285674389_Enhancing_consumer_participation_in_psychiatric_nursing_academia [verified 17 March 2022]

[4]  Gordon S. The role of the consumer in the leadership and management of mental health services. Australas Psychiatry 2005; 13 362–5.
The role of the consumer in the leadership and management of mental health services.Crossref | GoogleScholarGoogle Scholar | 16403131PubMed |

[5]  Epstein M. The consumer movement in Australia: A memoir of an old campaigner. Melbourne: Our Consumer Place; 2013. Available at https://www.ourcommunity.com.au/files/OCP/HistoryOfConsumerMovement.pdf [verified 17 March 2022]

[6]  Liou JMPH, Lee JMPH, Somsanith DMPH, Hirota S, Okahara LBA, Nguyen KD, et al. Developing a community health worker model to incorporate patient leadership and advocacy within the asian immigrant community: a practical perspective. Am J Health Stud 2007; 22 105–13.

[7]  Gilbert D. The rise of the patient leader. Health Service J, 2012. Available at https://www.hsj.co.uk/comment/the-rise-of-the-patient-leader/5040463.article.

[8]  Our Community. The language of consumerism. Melbourne: Our Community Pty Ltd; 2022. Available at https://www.ourcommunity.com.au/control/control_article.jsp?articleId=3563 [verified 17 March 2022]

[9]  Robinson T, Bailey C, Morris H, Burns P, Melder A, Croft C, et al. Bridging the research–practice gap in healthcare: a rapid review of research translation centres in England and Australia. Health Res Policy Syst 2020; 18 117
Bridging the research–practice gap in healthcare: a rapid review of research translation centres in England and Australia.Crossref | GoogleScholarGoogle Scholar | 33036634PubMed |

[10]  Dickinson H, Brown A, Robinson S, Parham J, Wells L. Building collaborative leadership: A qualitative evaluation of the Australian Collaborative Pairs trial. Health Soc Care Community 2020; 30 509–18.
Building collaborative leadership: A qualitative evaluation of the Australian Collaborative Pairs trial.Crossref | GoogleScholarGoogle Scholar | 32876370PubMed |

[11]  Australian Health Research Alliance. Consumer and Community Involvement in Health and Medical Research: An Australia-wide Audit. Australian Health Research Alliance; 2018. Available at https://www.wahtn.org/wp-content/uploads/2019/03/AHRA-CCI_Final-Report_Full_Dec2018.pdf [verified 17 March 2022]

[12]  SciVal. Research Area Trends Report Consumer Leadership and Carer Leadership. 2021. Available at https://www.scival.com/ [accessed 12 December 2021]

[13]  Ocloo J, Garfield S, Franklin BD, Dawson S. Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews. Health Res Policy Syst 2021; 19 8
Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews.Crossref | GoogleScholarGoogle Scholar | 33472647PubMed |

[14]  Forbat L, Hubbard G. Service user involvement in research may lead to contrary rather than collaborative accounts: findings from a qualitative palliative care study. J Adv Nurs 2016; 72 759–69.
Service user involvement in research may lead to contrary rather than collaborative accounts: findings from a qualitative palliative care study.Crossref | GoogleScholarGoogle Scholar | 26689175PubMed |

[15]  Scholz B. THREAD: #CoDesign in #HealthResearch: When reviewing for various research grant schemes. I’m often matched to review applications concerned with co-design. 11 November 2021. Available at https://twitter.com/brett_scholz/status/1457924235884650500 [verified 17 March 2022]

[16]  Daya I. The participation ladder: A consumer/survivor lens. 2021. Available at http://www.indigodaya.com/wpcf7_captcha/2020/10/Participation-ladder_consumer_survivor-lens-2.pdf [verified 17 March 2022]

[17]  Scholz B, Bocking J, Happell B. Breaking through the Glass Ceiling: Consumers in Mental Health Organisations’ Hierarchies. Issues Ment Health Nurs 2017; 38 374–80.
Breaking through the Glass Ceiling: Consumers in Mental Health Organisations’ Hierarchies.Crossref | GoogleScholarGoogle Scholar | 28448229PubMed |

[18]  Scholz B, Happell B. Response to Commentary by von Peter to Happell, Brenda, & Scholz, Brett (2018). Doing what we can, but knowing our place: Being an ally to promote consumer leadership in mental health. International Journal of Mental Health Nursing, 27(1), 440–447. Int J Ment Health Nurs 2019; 28 361–2.
Response to Commentary by von Peter to Happell, Brenda, & Scholz, Brett (2018). Doing what we can, but knowing our place: Being an ally to promote consumer leadership in mental health. International Journal of Mental Health Nursing, 27(1), 440–447.Crossref | GoogleScholarGoogle Scholar | 30390368PubMed |

[19]  Edwards R, Wells L, Parham J. The Australian consumer leadership experience. Canberra: Consumers Health Forum of Australia; 2022. Available at https://chf.org.au/sites/default/files/final-posted_patient_leadership_article_-_the_australian_consumer_leadership_experience_march_2022.pdf [verified 17 March 2022]

[20]  Scholz B, Bocking J, Happell B. Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a ‘sneaky, special degree’. Int J Ment Health Nurs 2018; 27 227–35.
Improving exchange with consumers within mental health organizations: Recognizing mental ill health experience as a ‘sneaky, special degree’.Crossref | GoogleScholarGoogle Scholar | 28145617PubMed |

[21]  Scholz B, Stewart SJ, Bocking J, Happell B. Rhetoric of representation: The disempowerment and empowerment of consumer leaders. Health Promot Int 2019; 34 166–74.
Rhetoric of representation: The disempowerment and empowerment of consumer leaders.Crossref | GoogleScholarGoogle Scholar | 29036568PubMed |

[22]  National Mental Health Commission. Consumer and carer engagement: A practical guide. Canberra: National Mental Health Commission; 2019. Available at https://www.mentalhealthcommission.gov.au/lived-experience/consumer-and-carers/consumer-and-carer-engagement-(1) [verified 17 March 2022]

[23]  Scholz B, Bocking J, Hedt P, Lu VN, Happell B. ‘Not in the room, but the doctors were’: An Australian story-completion study about consumer representation. Health Promot Int 2020; 35 752–61.
‘Not in the room, but the doctors were’: An Australian story-completion study about consumer representation.Crossref | GoogleScholarGoogle Scholar | 31325360PubMed |

[24]  Locock L, Boaz A. Drawing straight lines along blurred boundaries: qualitative research, patient and public involvement in medical research, co-production and co-design. Evidence & Policy 2019; 15 409–22.
Drawing straight lines along blurred boundaries: qualitative research, patient and public involvement in medical research, co-production and co-design.Crossref | GoogleScholarGoogle Scholar |