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2. Shaping Health Services Through True Collaboration Between Professional Providers and Service Users
Kristin Ådnøy Eriksen, Julia Kittscha, and Greg Fairbrother
Introduction
In this chapter we present two different examples of true collaboration between health service providers and health service users (consumers). The notion of authentic partnership between healthcare users and service‐providing professionals has been promoted by both stakeholder groups for some time now. This partnership goal represents a paradigm shift from prior paternalistic approaches which tended to distance patients and providers under the ‘medical model’, which prized examination and observation at the expense of relationality and wholism (Barbour 1995). Research findings increasingly support the efficacy of such a shift, in clinical outcome, patient satisfaction and cost terms (WHO 2015). Its essential collaborative drive favours closer and more genuine partnership relationships between providers and consumers. Collaboration represents ‘evolving processes whereby two or more social entities actively and reciprocally engage in joint activities aimed at achieving at least one shared goal’ (Bedwell et al. 2012, p. 130). True collaboration between professional providers and service users mean striving for reciprocity and requires active, mutual engagement from the involved parties. One party dictating or controlling another party cannot be considered collaboration. This type of engagement would better be described as delegation or coercion (Bedwell et al. 2012).
The drive towards greater collaboration naturally implicates healthcare and community/advocacy organisations, as well as clinicians and individual consumers themselves. People who have chronic conditions have more contact with providers and systems, often carry a prolonged quality of life burden, and are natural protagonists in the development of forward‐leaning groupings and actions which promote better partnerships.
Key concerns of contemporary patient/provider partnership models relate to: i) practice development (PD) and service improvement (how can this be driven in a more consumer‐centred way?) (Hall et al. 2018); ii) clinician education (how can consumers be productively involved in this?) (Olasij et al. 2019); iii) clinical policy (how can consumer input be fostered?) (Nilsen et al. 2006; Ocloo and Matthews 2016); and iv) research (how can consumers be brought in to the healthcare research community on an equal footing, as investigators?) (Gray‐Burrows et al. 2018). Re‐balancing power relations and promoting empowerment are key action areas proposed today. Barriers to such progress in our health systems have been identified. These include tokenism, stigmatising, inadequate information, professional gatekeeping and financial barriers to involvement.