Embedding Citizen Voice in Governance and Strategic Decision-Making
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Governance in adult social care is no longer viewed solely through the lens of policies, audits and performance metrics. Commissioners and regulators increasingly expect to see how citizen voice and lived experience influence strategic decision-making and oversight. This expectation aligns closely with governance and leadership requirements and wider approaches to CQC quality statements.
Providers that fail to embed lived experience at governance level often struggle to evidence credibility when challenged about culture, responsiveness or service improvement.
What Citizen Voice Means at Governance Level
Citizen voice at governance level goes beyond operational feedback. It involves creating structured, supported opportunities for people with lived experience to influence priorities, policies and oversight processes.
This may include representation on advisory boards, involvement in quality committees, or regular engagement sessions that feed directly into board reporting. Crucially, governance-level involvement must be accessible and supported, recognising differing communication needs and confidence levels.
Commissioner Expectations of Governance-Based Co-Production
Commissioners typically look for evidence that citizen voice is not isolated from decision-making. They may expect to see:
- Clear routes for lived experience feedback to reach senior leadership
- Documented actions taken as a result of citizen input
- Evidence that people influence priorities, not just comment on them
- Alignment between strategic decisions and lived experience themes
Governance minutes, action logs and board reports are often scrutinised for evidence of this influence.
Practical Models for Embedding Citizen Voice
Effective providers use a range of models rather than relying on a single forum. This might include rotating participation, themed workshops, or time-limited involvement around specific strategic decisions such as service redesign or investment priorities.
Support arrangements are essential. Without preparation and facilitation, governance spaces can unintentionally exclude people with lived experience or limit meaningful contribution.
Managing Power, Risk and Accountability
Sharing influence at governance level requires leaders to be comfortable with challenge. Providers must balance transparency with accountability, particularly where safeguarding, financial or regulatory risks are involved.
Clear terms of reference, role clarity and escalation processes help ensure citizen voice strengthens governance rather than creating confusion or tokenism.
Demonstrating Impact
The strongest evidence of citizen voice in governance is impact. Providers should be able to articulate what changed as a result of lived experience involvement and how this improved quality, outcomes or trust.
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