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Sunday, 17 January 2010

CQC "Experts by Experience" - again.

This is to update my blog of 6th September 2009: “I'd like to offer you my time, skills, experience and goodwill free of charge.“ and to record some corrections the Care Quality Commission (CQC) have offered.

I said in the Sept 6th entry: The first problem is that this is an indirect process: you have to do it through one of their selected charitable agencies...through seven pages of their website, and downloading a list of their selections.“

I am revisiting this because I recently had a telephone conversation with the CQC’s lead on their ”Experts by Experience“ project, Mandy Moore. Mandy told me my experience of being presented with a lengthy application form inappropriate for volunteering, was misleading as ”most Experts by Experience are employed and paid by the “...national and local organisations who recruit, train and support our expert by experience on our behalf to take part in our inspection work.” and the application form is appropriate to paid work for one of those organisations. She couldn’t explain why the first of those “...national and local organisations who recruit, train and support our expert by experience on our behalf to take part in our inspection work.” expressed ignorance of the whole thing.

Obviously, from my original title, I was given to think the CQC ”Experts by Experience“ role is a voluntary one - why. Firstly because the CQC website doesn’t say otherwise on it’s introductory ”Get Involved“ page. What the current website version does say is:

  1. ”Find out how people who use health and social care services are involved in our work.

  2. Find out how we involve people in the regulation and inspection of social care services and visit people whose rights are restricted under the Mental Health Act.

  3. We believe involving people who use health and adult social care services in everything we do is central to to improving services for everyone.“

The above is text accompanying three separate links to further pages. Clicking these gets us to the third page. On none of the three does it tell us the involvement is anything other than voluntary. However, on the second third page we come across the first mention of ”Experts by Experience“ which has a link to yet another page. It has probably taken about twenty minutes for an ordinary literate person to get here if we include reading and absorbing. I did say seven pages in my original entry but I’m reasonably sure the CQC website has been changed since then. Anyway, people who are unable to read or write wouldn’t stand a chance with the current four let alone those browsing who had lost patience well before the fourth page.

Clicking the ”Experts by Experience“ link we find a full page of text, the first paragraphs say: ”We involve people who use services and family carers to help us improve the way we inspect and write our inspection reports. Because of their unique knowledge and experience of using social care services, we have called them Experts by experience... Our experts by experience are people of all ages, with different impairments, from diverse cultural backgrounds who have used a range of social care services... An expert by experience will take part in an inspection and talk to the people who use the care service. Sometimes, they will do telephone interviews for people who use home care agencies, one to one meetings with people in supported living and groups sessions over lunch for people in care homes. If they are visiting a service, they will also look at what happens around the place; see how everyone gets on together and what the home feels like.“

Right at the bottom of the page the text now tells us: ”As we do not employ or pay experts by experience in our inspection work directly, talk to one of the organisations who are inspecting the care services which you feel you have experience of.“

There is another reason I assumed it was voluntary work (apart from the absence of any mention otherwise for several pages). That is the term ”Experts by Experience,“ in my experience, was first associated with the now extinct National Institute for Mental Health in England (NIMHE) in the early part of the 2000s. NIMHE had a distinct group of mental health service users called ”Experts by Experience“ and if we look that well known survey report by the Sainsbury Centre: ”On Our Own Terms“ (http://www.scmh.org.uk/publications/on_our_own_terms.aspx?ID=376) we will see the NIMHE Experts by Experience Group heavily featured for action in the report’s recommendations. Further to this, the term is now widely used by service user groups right across the UK.

So my mindset is firmly with the term meaning service users and volunteers and it seems to have been hijacked by CQC - to CQC’s detriment as it will undoubtedly create some confusion for many others. In fairness, I did briefly discuss this issue with the Chair of the National Survivor User Network, Tina Coldham. Tina’s response was a shrug of the shoulders and a comment that the term hasn’t a copyright. She suggested it had also been used by CQC ”for years.“ I pointed out CQC is not yet a year old.

What on earth is this guy chunnering on about? You might ask. Well - it’s about the importance of language again. The term ”Experts by Experience“ belongs to the service user movement. To us, it means that we have a hugely important particular kind of expertise to offer - expertise outside of the reach of health and social care professionals.

When CQC uses the term it carries a whole new range of different expectation labels. In addition, when we service users choose to offer our involvement and that particular expertise we do so ”On Our Own Terms.“ CQC does it on its own organisational terms, or those of third party organisation who carefully choose (usually) middle class yes people for involvement.

CQC now has a Voices into Action leaflet about how they will involve people. This leaflet, merely a promise at the time of writing on Sept 6th, reads well and has glowing intentions. However, as someone reasonably closely involved with the service user movement, I see very little of the fine words comprising this leaflet engendering action - as yet.

Whatever its promise, and I held much admiration for the concept of CQC at its inauguration and still have great hopes for the CQC registration process, we should all remember that CQC is another government QUANGO and there is plenty of evidence of the cries for help from government slithery words as they disappear down the political drain.

Here’s four items of essential reading for CQC:


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