Weak and Strong Publics: Drawing on Nancy Fraser to ... · Drawing on Nancy Fraser’s Work •...
Transcript of Weak and Strong Publics: Drawing on Nancy Fraser to ... · Drawing on Nancy Fraser’s Work •...
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Andrew GibsonDr Loraine Blaxter
Professor Gillian Lewando Hundt
Institute of HealthUniversity of Warwick
Weak and Strong Publics: Drawing on Nancy Fraser to
Explore Parental Participation in Neonatal Networks
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Introduction
• How do we theorise the process of patient and public involvement?
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Drawing on Nancy Fraser’s Work
• Weak and Strong Publics• Publics and the State • Participatory Parity
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Practice and Policy Context
• The Department of Health in 2003 recommended the development of managed clinical newborn networks
• 2006-7 newborn network boards are at different stages with different strategies for parental involvement
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Aims of the Study
• Explore the development of user involvement and roles within neonatal networks locally and nationally
• Identify strategies for recruiting, supporting and training parents to be effective participants
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Methods National Survey of:Parental involvement in all 23 network boards in England
5 Area Case Studies : • Interviews with key professionals • Observation of meetings and review of
minutes• Interviews with involved service users
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Preliminary Findings
• Wide variation nationally in level and type of parental involvement
• Lack of diversity in parental board members
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Recruitment of Parents
• Accessing people already involved in some way (e.g. via PPI groups or Maternity Services Liaison Committees)
• Contacting parents through the units in the network
• Parent selection of representatives
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The Ideal-Type Parent Board Member
• Experience of neonatal services• Enthusiastic about making a difference• Be able to represent the views of other
service users• Sufficient time and interest to participate• Able to work as part of a team• ‘Ordinary’ people
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Being a Parent Board Member
“Between this (setting up a parents’ group) and the network it is taking up a lot of time and effort. It is hard fitting it round home life, and I don’t want to spread myself too thinly.”
(Parent Board Member)
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Culture and Organisation of Board Meetings
• Average number of parents on a board is 2 (6 boards), but 8 boards had no representation at this level
• Average neonatal board has 20-29 members
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Culture and Organisation of Board Meetings
“I have to admit that I was terrified walking in that room today. I don’t know why, it wasn’t as if they were all going to quiz me or anything.”
(Parent Board Member on her first meeting)
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Culture and Organisation of Board Meetings
• Some board members feel that having parents at board meetings might be tokenistic
• Others feel that only parents who are “network minded” should be involved
• Concern that parents will represent themselves rather than the broader view of parents: “wanting a level 3 neonatal unit on their doorstep”.
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Modes of Parental Involvement
Parents as:• consultants
(experiential representation)• a source of information
(statistical representation)• representing the views of other parents
(democratic representation)
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Parents as Representatives
Network Board
Network Parent Group
Unit Parent Group
Unit Parent Group
Unit Parent Group
Unit Parent Group
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Discussion• Participatory Parity:
‘social arrangements that permit members of society to interact with one another as peers.’
• Barriers to achieving participatory parity• Parental participation within neonatal
services: an example of a weak public.