Involvement of lay assessors in the inspection and regulation of public services: a systematic review

Abstract

Background: public services have increasingly sought to use lay assessors (often known as ‘service users’ or ‘Experts by Experience’) to inform inspections across health, social care, and education. This involvement has been credited as giving a voice to users in how services ought to run. Yet, little is known about the process or outcome of engaging with lay assessors.

Objective :we conducted a systematic review to understand how the benefits of involving lay assessors in inspection of public services can be maximised, and the challenges facing their involvement can be addressed.

Method: following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines, we searched the literature using five bibliographic databases, including Medline and PsychINFO, in February 2023, with date of publication limited to 2000 onward.

Results: across 27 eligible studies, results suggest that including diverse views and perspectives is a strength, yet little consideration is given to the power differentials between mixed groups that can shape which perspectives gain dominance. Second, when designing training for lay assessors, services needed to carefully consider the tension between maintaining the assessor’s ‘naive eye’ versus becoming ‘professionalised’. Third, expectations are often not clearly shared over how lay perspectives could be included in final inspection reports, thus risking disengagement.

Discussion: involving lay assessors is still a fairly novel, yet rich and meaningful way to improve services, yet a lack of clear expectations can still act as barriers to meaningful involvement, preventing lay views being heard and acted upon.

Funding: NIHR School for Social Care Research

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Identifiers

ORCID for Andrew Power: orcid.org/0000-0002-3887-1050

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