The programme is consistent with the values expressed in the following:
- Reports of General Practitioners at the Deep End
- Gaun Yersel
- Commission on the Future Delivery of Public Services (Christie Commission)
- Community Empowerment and Renewal Bill
- Equally Well – The Report on Ministerial Task Force on Health Inequalities
- People Powered Health and Wellbeing Programme
The programme is also consistent with the values expressed in Self-Determination Theory. Self-determination theory is a theory of motivation and suggests that experience of autonomy, competence, and relatedness generates the highest quality forms of motivation and engagement.
As the Alliance identified at their ‘How are we doing? Getting to Grips with Evaluation and Co-production’ event is August 2013; these components are strongly linked to co-production.
Blurring distinctions between partners, and facilitating not delivering.
Recognising people as assets, and building capabilities.
Building peer support networks, and enabling mutuality and reciprocity
The National Links Worker Programme adopts language that reflects its values. There has been discussion for some years on the appropriate use of language as services attempt to be seen to move away from a ‘medical model’ of care.
The term ‘patient’ is seen by some as the most medical term and one where the balance of power lies with the clinician and the patient is seen as a passive, subservient partner.
‘Client’ and ‘customer’ are other alternatives that are seen by some to equalise the power differential. However they are seen by others as disingenuous, the power of being a client is that you can take your business elsewhere but as an NHS patient the ‘customer choice’ is limited.
The term ‘service user’ is also seen as neutral. Service user is often shortened to ‘user’ and this has potentially negative associations.
The National Links Worker Programme aims to embed a links approach in primary care; with this in mind the term ‘patient’ is sometimes used. This is a clearly understood relationship and one that is often based on trust between a primary care team and an individual.
In the context of interactions with the Community Links Practitioners, another term is needed, with client, customer and service user all being problematic, the terms ‘people’, ‘person’, and ‘individual are preferred.