Service user involvement has been spoken and written about for many years in a variety of settings, and is generally considered a good thing. A number of elements of service user involvement have been much debated, including the extent to which service users can realistically be involved in shaping services, who counts as a service user, and how service users can be included when the processes involved in commissioning can be complex and technical. This article considers some of the key issues concerning user involvement in strategic and other commissioning arising from research commissioned by the Joseph Rowntree Foundation. The findings prompt those who are engaged with service user involvement to consider how culture may be as important as, if not more important than, structure when engaging with service users in service design and delivery.
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