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Geoff Hinkins

Don’t be surprised if ‘service users’ expect to use services

We often run workshops with staff in adult social care on the use of strengths-based language and behavioural science, to explore the factors that increase demand for adult social care services.

‘Labelling’ is one of those factors. There is plenty of evidence which shows that people act up (or down) to the labels applied to them by others. If we are told that we appear to be someone that takes care of our health and is motivated by staying independent, we’ll take that on board. Unfortunately the opposite is also true, and the language used across the sector can reinforce someone’s perception that they are someone who needs help and support.

In short, if we label someone as a ‘service user’, we shouldn’t be surprised when they expect to use services.

I had a conversation with IMPOWER colleagues this week about the different terms that organisations use to refer to people they work with in adult social care. The breadth is staggering, but each has its own problems:

Service user – defining someone by their relationship to your services doesn’t set the scene for a holistic conversation about their goals. It narrow-frames the discussion to the menu of services that the council can offer – restricting the focus of both the person and the worker.

Customer or client – linked either to a focus on personalisation or the management trend to see people as ‘consumers’ of public services. This assumes people are equipped to make informed choices about their care in the same way as they choose their broadband or groceries – is that really the case?

Patient – particularly common in a hospital setting. This implies people are a collection of symptoms to be managed – not an individual with their own goals, extending beyond their current need for support.

Citizen – people who use this label often do so because is suggests that the individual is more active and central to the work. This works in an academic context, but in day-to-day use a lot of people really dislike this term. For many it seems to conjure images of either distant bureaucracy or a science-fiction dystopia.

This leads us to people / person which are increasingly used in community-led approaches. As a term it can be messy, particularly in reports and forms – you can tie yourself in knots distinguishing between people accessing services, people being provided more preventative support, people contacting you for information or people who have no contact with you at all. But people’s lives are also messy. At least talking about people resists the urge to use narrow definitions based on someone’s interaction with your teams (which ignores a broader view of their life). For me, this is the term that has fewest negative connotations and keeps us focused as widely as possible.

Giving staff the tools to understand and change behaviour (including their own behaviour in terms of labelling) is part of our EDGEWORK approach, and has been a key factor in the success of our work with clients. I’d love to hear the terms that you’ve come across in your own organisations or others, and the effects that you’ve seen from labelling – positive or negative. Do get in touch with your examples!

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