www.publicinvolvement.org.uk

The Cabinet Office consultation exercise Effective Consultation (links to Adobe PDF) is open until 28/09/2007.

I always enjoyed the old joke when the young thrusting impatient new civil servant asks his boss - a silver headed veteran of the old mandarin class - "Why does Government have to be so secret!?" to which the wise elder replies soothingly 'Not secret, dear boy - just ... private".

However we must now consign this joke to the dustbin of history because as Hilary Armstrong, the then Minister for the Cabinet Office and Social Exclusion tells us in her foreword "Consultation helps. It helps public bodies make better-informed decisions on matters of policy.." The policy makers of nowadays would have us know that the business of government is now open to our inputs - "most credible when it listens and shows it is listening."

The consultation code has been in place since 2001 and we have used it as a useful point of reference when we have helped others with their consultations. So over the summer we will be thinking up our full response to the 12 questions posed in the doc.

Looking beyond this particular exercise, we are very interested in developing a consultative model suitable for use in local contexts - we have worked on ones in North East London and there is a particularly fraught consultation exercise happening in our patch in SW London where both Andrew and Val are involved but not with their M-A-C hats on.

What we would find really useful would be a consultation-lite pack where not so much the principles of consultation - they remain much the same whatever the context - as the processes are adapted to the environment of the local smaller scene - less people, less money but still very important issues that loom large in people's lives. Caroline's involvement in her local park falls into this category as well as her work with her local school. This level of advice is particularly important when the legal process i.e. judicial review can be invoked with all the PCTs wondering where they stood after the 'Derbyshire' judgement on consultation around choice of suppliers for a general practice.

Look at the list of organisations to whom the Cabinet Office consultation has been sent - all national organisations and established players in the consultation game. Some are much bigger and richer than others but whatever their size and status, they are at least on the list and have set up processes to push the issues through committees or whatever. They may even have or the consulting department has access to large budgets which will fund for example exercises like those undertaken by the Department of Health with its "Your health, Your Care, Your say" consultation. One estimate of the cost of that exercise was £1.39m with £1.05m going to Opinion Leader Research. Let's come back to costs in a minute.

Local bodies such as councils and PCTs can and do access users in many ways but there are issues of proportionality and frequency that have to be carefully managed and dealt with. One feature that local and national bodies share is that feature whereby in becoming more grand, more senior you get further away from the user. (This is not a feature just of the public sector - it is true of most organisations). The grandees lose the knack - if they ever had it - of communicating clearly to people outside their magic circle and the junior more lowly staff sent to 'meet the public' come across as powerless and uninformed, there to take the flak and soak up the anger.

Questions of timing are also important - just when to consult is one of the trickiest issues. Too late and the room for manoeuvre is limited. Too early and the questions are too broad and the options too vaguely formulated. Our feeling here is that this issue becomes easier to resolve and may indeed go away if consultation is seen as a continuing conversation. If people are in touch already and are used to communicating with each other, the process of getting views on a particular set of issues becomes more productive and cost-effective.

The biggest elephant in the room is one very rarely acknowledged is the one of power - does the local body doing the consultation really have the power of decision over the issue consulted about? Too often we have seen local managers who are consulting conscientiously being accused of being the powerless lackeys propagating central government policies which are going to be implemented whether local opinion likes it or not. The accuser are not always wrong either.

It would be a very good idea if local government and health bodies could act together to see what best practice in consultation looks like from the front line. If nothing else, as service commissioners they need to learn how to do cost-effective local consultation fast.

One other point we wanted to make at this stage - the document is called "Effective Consultation". What is that? I know performance targets are rather out of fashion with this government but they are nonetheless useful. The only target measured at the moment on consultation is whether or not they have been out there for 12 weeks or more. The connoisseur of uselessly collected, tabulated and reported on information will enjoy the report in the Annual Report on Consultations showing the proportion of consultations out there for 12 weeks or more as varying over the years between 80% to 71%. Meaning?

An effective consultation - a suggested M-A-C list:

• reaches the right people = a database of interested organisations and individuals kept up to date and checked at least annually; capable of segmentation by demographic criteria and user characteristics i.e. if it is a swimming pool, does the list give you regular users of current facilities. Easiest to do on a continuous basis and providing a basis for dialogue.
• in the right way = through the channel that the organisations and individuals mentioned above have asked for and
• over the right time = the period necessary for debates to be organised and held within the organisations consulted and considered feedback given as defined by those consulted
• feedback given = all those who sent in responses who identified themselves should be given feedback on subsequent actions and decisions by being remailed/ contacted in the same way as the original notification eg mailing or email.
• propositions and options clearly defined with all supporting information either given in the material as circulated or signposted as being available elsewhere - if possible tested with small groups before distribution including local elected representatives
• measured afterwards - e.g. proportion of responses received against total print/ total number on list/ local population affected; numbers attending at meetings; evaluations of meetings - at least 60% satisfied overall;
• issues understood = exploration/ explanation workshops/ seminars held early in consultation period after which people can go away and formyulate their own responses

Follow the Money

The consultative paper does not do anything as ill-mannered as mention money so let us take a longer look at this topic. What would be the budget for a consultation assuming you have not set up the sort of continuing dialogue with your stakeholders that we advocate?

Going back to the Your Health, Your Say consultation, we found the estimate of £1.39m for the cost of that consultation with £1.09m going to the OLR agency. As consultants ourselves, we are not in a position to huff and puff about the fee levels as such but it is interesting to try and relate the costs to the outcomes in terms of opinions delivered or people touched. OLR claim 16,000 responses to an online questionnaire and a one day Citizens Summit with 1,000 people attending. (Very impressive technically with everything webcast online). The Department of Health supplied the following information in response to a question and gave a lower figure for costs:-

4 regional events with a representative and random sample of the regional population demography:

• 1 x 100 participants
• 3 x 50 participants

1 national event with a random sample of 1,000 participants representative of the national demography. Also included are:

• Citizens' advisory panel; 
• Development of a core questionnaire to made available to the public and to be used as part of the devolved Listening Exercise; 
• Production of Imagine Video.

Total cost: £900,799.00
Costs include:

• Development and printing of all deliberative research instruments, including facilitators pack and participants pack;
• Analysis and reporting of events, questionnaire responses, and listening exercise returns;
• Hire of all required technology for the national event;
• Venue hire, catering and refreshments;
• Research team and participant travel and accommodation expenses;
• America Speaks involvement in project design and execution.

Final costs may vary slightly depending on number of questionnaires returned, questionnaire length, content of video and other variable factors.
Big bucks whatever the accurate figure is. The link www.dh.gov.uk/en/News/Yourhealthyourcareyoursay/DH_4136405 tells us that 42,000 people took part in that particular exercise. In coming up with the White Paper, they added in another 100,000 responses to the Green Paper on adult social care. We can't include the latter group in our costings and if we take the 42,000 figure and the £1.39m budget figure we get a cost per head of £33. If we are less generous and just take the 16,000 who replied to the questionnaire and the 2,000 at the regional and national events as above, and divide that into the £901,000 fee we get £50 per head. We can confidently say that most of the money went on the meetings - online questionnaires are cheap to do once the questionnaire has been agreed.

Actually that represents good value for money. However this remains an area where it is not sensible or possible to set 'one size fits all' guidelines. The way forward is to ask all who do a consultation to give the costs of the exercise - both above the line costs - printing, outside editors/writers, facilitators, research agency - and below the line i.e. their own staff time and we will start getting some decent data on what all this is costing.

The lesson to learn is when and where is it worth spending money? It is always worth spending money to avoid senior or for that matter junior staff sitting in empty halls eager for someone/anyone to come in and speak to them about the issues under consultation. If you can get an individual response from 'ordinary people' attending by themselves or as part of an informal group such as mothers on an estate or community groups for under £50 per response we reckon you are doing well. Our earlier post talked about Patient Involvement - Pockets filled with Gold or the Empty Hall? Where fees of £40 for a two hour group discussion were being offered. If you do not pay, then the people who do turn up are the known and deeply committed - activists you do need to speak to but you need other points of view as well.

What has your experience been? What is the mix of channels and opportunities that have given you the best results? Give us your views... and we hope this might help with your own response to the consultation.

M-A-C supports organisations and individuals organising consultations and any exercise where user views are being sought and collected. We can write the document, set up websites and user surveys and facilitate small groups. We have access to printers and designers and help design and implement communication plans. We can advise and assist in the implementation of 'influencing' programmes for opinion leaders and other stakeholders. Visit www.mooreadamsoncraig.co.uk for more information.