Involvement of Lay Assessors in the Inspection and Regulation of Public Services: A Systematic Review

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Deborah Chinn, Katy Brickley, Andrew Power
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Abstract

Public services have increasingly sought to use lay assessors (often known as “experts by experience”) as members of inspection teams in health, social care, and education settings. This involvement has been credited as giving more influence to users over how services ought to run. Yet, little is known about the process or outcome of engaging with lay assessors. We conducted a systematic review to understand the benefits and challenges of involving lay assessors in the inspection of public services. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the literature in English using five bibliographic databases with the date of publication limited to 2000 onward. Across 27 eligible studies, results suggest that including diverse views and perspectives is a strength, yet little consideration is given to issues of “representativeness” of lay assessors or the power differentials within mixed groups that can shape which perspectives gain dominance. Despite a frequent rehearsal of the many benefits of involving lay assessors in inspections as a potential force to drive up the quality of inspections and inspected services, the impact of including lay assessors in inspections in terms of improving services was hard to determine. When designing training for lay assessors, services needed to carefully consider the tension between maintaining the assessor’s “naive eye” versus becoming “professionalised.” It was also apparent that expectations are often not clearly shared over how lay perspectives could be included in final inspection reports, thus risking disengagement. Involving lay assessors is still a fairly novel, yet rich and meaningful way to improve services, yet a lack of clear expectations, and typical exclusion of lay assessors in setting standards for regulation, can still act as barriers to meaningful involvement, preventing lay views from being heard and acted upon.

Abstract Image

非专业评审员参与公共服务的检查和监管:系统回顾
公共服务部门越来越多地使用非专业评估员(通常被称为 "经验专家")作为卫生、社会保健和教育机构检查小组的成员。这种参与被认为能让用户对服务的运行方式产生更大的影响。然而,人们对非专业评审员的参与过程或结果知之甚少。我们进行了一项系统性综述,以了解让非专业评审员参与公共服务检查的益处和挑战。根据系统综述和元分析首选报告项目(PRISMA)指南,我们使用五个文献数据库检索了英文文献,文献发表日期仅限于 2000 年以后。在 27 项符合条件的研究中,结果表明,纳入不同的观点和视角是一个优势,但却很少考虑到非专业评估者的 "代表性 "问题或混合群体中的权力差异问题,而这些问题可能会影响哪些观点占据主导地位。尽管经常反复强调让非专业评审员参与检查有很多好处,是提高检查和被检查服务质量的潜在力量,但很难确定让非专业评审员参与检查对改善服务的影响。在为非专业评审员设计培训时,服务部门需要仔细考虑保持评审员 "天真的眼光 "与变得 "专业化 "之间的矛盾。同样明显的是,对于如何将非专业人员的观点纳入最终检查报告,往往没有明确的共同期望,因此存在脱离的风险。让非专业评审员参与进来仍然是一种相当新颖、丰富和有意义的改善服务的方式,但缺乏明确的期望,以及在制定监管标准时通常将非专业评审员排除在外,仍然会成为有意义参与的障碍,阻碍非专业评审员的意见被听取和采纳。
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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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