I bet even academics secretly have little sayings up their sleeves that have no evidence base but help them make sense of campus and the wider world.
One of mine is: politicians like targets, academics like frameworks, professionals like guidelines and patients…well, we just like to get things done.
Still, given the choice, we would probably plump for standards- something that was easy-to-understand to measure how good things are with the services we use. I stress ‘how good’ because I accept that these things can be used as a form of punishment.
It is probably a collective failure of the public involvement movement that we didn’t plump for 3 or 4 measures of success and development all those years ago. We likely tipped our hat just a little too much to our academic colleagues in those days; good and wonderful colleagues but also a powerful lobby within a lobby. In my opinion, gut instinct is an undervalued tool in decision-making.
Rudimentary those measures might have been but they would have given us a compass. Many years on, their absence shows. We lack overall direction. The successes we point too are often soft, fluffy and occasionally a bit podgy. This, in a hard climate.
And now this desire to diagnose, prescribe, analyse, test, is so built into our psyche it can stultify that part of us which is saying ‘just do it, for goodness sake, someone make a decision.’
That’s if we aren’t swimming in data and models and tools of course. There are more tools in public involvement than exist in my local Homebase. We have been far too reticent about endorsing or favouring a few of these and sending the others packing. So in the meantime we expect people to continue to swim if they can and shrug our shoulders if they drown – ‘perhaps they just used the wrong tool, silly things. Never mind.’ It’s not good enough.
For instance the Public Involvement Impact Assessment Framework (PiiAF) is one of the best I’ve seen. It has provenance in that it originated out of recommendations made by INVOLVE and others many years ago. It was funded properly and acquitted well. So why don’t we just say it should be on everyone’s desk. Same with the really excellent RAPPORT study.
This sense of struggle seeps – perhaps weeps – through the evidence being submitted to the NIHR review of public involvement.
And it was to try and machete through the long, obscuring grass that I asked NIHR to establish the Breaking Boundaries review.
I hope that we will inject some urgency into this debate. I would love us, as the review panel has charged itself to do, identify 3 or 4 ways in which we might define success in 5 and ten years time. You might not like them but we would all have something to aim for – the emphasis is on ‘we’ in that statement.
So c’mon what measure would you plump for? Go on, trust your instincts.