Different kinds of recognition
There are five main ways in which the contribution of service users and carers is recognised. These are set out below in no particular order:
- Psychological – an occasional ‘thank you’ and other forms of personal recognition, such as an invitation to a party, a place on the welcome team that meets visiting dignitaries, and the chance to chair a conference. For lots of participants, the most important recognition occurs when something changes for the good as a result of their input or feedback. People feel listened to and valued when they can point to something and say, ‘We said…, and you did….’
- Organisational – access to the academic library, use of a workstation, a name badge, pass key for using the staff room, opportunities to receive training, speak at conferences and co-author publications. For example, at Bucks New University, service users and carers involved in nurse education have access to the library, an official name badge and use of the hopper bus to get around the campus.
- Competence – the Higher Education Academy offers four tiers of fellowship, based on the Professional Standards Framework (see the page on Define roles too). This is being taken up by service users and carers, and used as a formal process to recognise different levels of skill and contribution. Is there also a route which supports people who begin as service users to embark on a clinical or academic career in nursing and nurse education? For example, at Herts, the MSc course in Mental Health and Social Inclusion is funded so that one free service user place is available for every 11 funded places.
- Financial – payment of wages or participation payments and expenses puts service and carers on a similar footing as employed staff who are paid for their presence and contribution. Payment also secures commitment as people move beyond casual volunteer status.
- Educational – having an opportunity to attend lectures and courses, and access academic libraries and online learning materials is highly valued by some people. At the University of Greenwich, service users and carers who contribute to the teaching programme have the opportunity to attend modules free of charge. Their presence in the classroom has also been highly valued by students. Elsewhere, young people have valued access to university masterclasses on applying for university and on their specific interests, while others have been given a tour of an operating theatre or morgue.
Historically, service user and carer involvement in nurse education have been positioned at the intersection between permanent and casual employment, volunteering and public involvement in research. This is a complex area where the principles that work well in one field clash with those from another and so procedures are often not well established. Here are some reflections:
- PPI Service users and carers are sometimes employed as permanent, casual or occasional lecturers, such as at the University of Manchester where people are paid through the university casual worker system and so must submit their national insurance and tax details; and the University of Wolverhampton, where people use self-employed consultancy contracts. This achieves equity with other guest lecturers, and sets safeguards in place regarding equal opportunities, terms and conditions of employment and so on. It can also provide access to identity badges, the academic library and staffrooms, an email address, online or offline workspace, printing facilities and e-learning provision.If this route is not taken, it is important to consider whether the mutual obligation of a tightly defined role description, performance requirements, and expectation of payment has, in fact, created a contract of employment that would be subject to National Minimum Wage regulations and other obligations.
- Anyone who has contact with the Benefits Agency or Her Majesty’s Revenue and Customs must declare any payments they receive, whether in cash or kind. Some means-tested benefits rules treat ‘in kind’ gifts to be treated as if they were cash for the purposes of means-testing. Since the means-tested system is meant to be the place of last resort, giving away a payment such as donating it to charity can be viewed as a way of making oneself intentionally dependent on the State, and the claimant treated as if they had received the money themselves.
- Some learning providers contract with a user-led organisation who then manage contract and payment arrangements on their behalf.
- Best practice in volunteering indicates here that people engaged as volunteers should not be out of pocket through offering their time, and so receipted travel and other expenses should be reimbursed; volunteers should not be engaged in ‘for profit’ businesses where their labour is adding to shareholder’s profits; and volunteers should not displace paid staff. Claim forms should be easy to understand and use, and payments made in a timely way, as some volunteers do not have the resources to tolerate a long delay; and some will need paying in cash as they do not have a bank account. Undue delays in making payments will harm the organisation’s reputation, so this should be routinely audited and remedial action taken as necessary.
- There is no standardisation of systems across organisations, as some agencies treat people as volunteers and pay expenses only, while some research bodies pay participation rates and yet others employ people. In this diverse marketplace, the best arrangement is that people should know what the terms are before they engage with the learning provider, and also know about alternative opportunities should they wish to move on.
The Department of Health published guidance on reward and recognition in 2006. INVOLVE have a payments policy that relates to participation in health research. The NHS England policy is here. A local reward and recognition policy has been developed by Sheffield Hallam here.
Example payment rates
At Leeds Beckett University and the University of Manchester, people are offered £20 per hour plus expenses. At University Campus Suffolk it is £11.50. In Southampton University, people were offered £25 per hour but said it was too much and set their own rate at £15 per hour. At De Montfort University the hourly rate is £12.50 to attend a meeting, £25 to co-teach and £30 to lead a session. At Bucks New University, people receive £40 for half a day and £80 for a full day.