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Conflict of Interests in Service User Involvement

Gateshead Access Panel

Contents

Why this discussion document is needed?

This document is needed because of discussions currently taking place with regard to Service User Involvement Strategies. These discussions have raised issues concerning conflicts of interest, payment of service users and volunteering. In the circumstances, Gateshead Access Panel (GAP) have seen the need to review and reiterate our policies on these issues for the sake of clarity both internally and externally. We have divided this document into two main areas:

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Conflicts of Interest - Policy and Procedure Monitoring and Development

As an organisation for and of disabled people Gateshead Access Panel have always had to be aware of the varying roles disabled people may choose to hold within the organisation. For each of these roles the people involved have to 'change hats' to fit their different roles. Voluntary organisations will not be surprised at this situation but statutory workers may need to understand these inherent issues within our organisation and the issues this raises for Trustees, Paid and Unpaid Workers, Service Users and Members. Invariably this "changing hats" has the potential to cause conflicts of interest and has to be closely monitored but it has become more of an issue with regard to suggestions that "service users" are to be paid for their opinions.

There is now a need for GAP to review our "Conflict of Interest Policy" and define these roles for the sake of clarity of our work both internally and when working with external organisations. By doing this we are taking the opportunity to review GAP's policies with regard to Service User Involvement, Trustee and Volunteer Agreements and Worker Contracts with regard to Conflict of Interest.

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Different 'Hats'

The different roles disabled people may have in the organisation include:

Trustees

Our Trustees are all disabled people. They are the governing body ensuring that the organisation keeps to its constitutional direction and is financially viable. Trustees are expected to uphold the organisations policies and not bring the organisation and its other trustees into disrepute. As with all Trustee bodies they receive training on the various aspects of their roles and receive advice and guidance from any workers they contract to service them. Charitable Law is such that Trustees are not expected to receive any financial benefits from the organisation (beyond out of pocket expenses) and should not be seeking any indirect benefit. In other words they are expected to be there because they believe in the objects of the Charity and not for self advancement nor benefit. Trustees are elected from the organisations membership and - though not specifically - usually from people who attend the organisations Focus Group (or Consultation) Meetings. Trustees can be service users of our Projects (for example through advocacy), they can be Volunteers on a daily basis and take part in our focus group meetings. They may also be Trustees of other organisations.

Paid Workers and Unpaid Workers / Volunteers -

  1. Approximately, 90% of our work force are disabled.
  1. Volunteers may be working for the organisation in a variety of areas for example, as auditors, trainers, advocates whilst receiving training and support from the paid workers.
  1. Trustees can work as volunteers on a daily basis.
  1. These voluntary roles involve agreements about upholding the organisations policies and not bringing the organisation, its trustees, other volunteers or employees into disrepute - like any paid or unpaid worker anywhere and in keeping with Good Practice in working with Volunteers.
  1. Paid workers have contracts which say that they are expected to uphold the organisations policies and not bring the organisation, its trustees, volunteers or other employees into disrepute.
  1. The position of disabled workers in any organisation can be made particularly difficult if they are continually 'seen' as a service user / disabled person first. For a disabled worker their first premise is that they are doing a job of work like anyone else and can become jaded if they are continually asked for information and viewed as a consultee by other workers - both externally and internally. We have evidence of a disabled person leaving their employment as a social worker (not Gateshead) because colleagues continually 'used' the person as a service user.
  1. Paid employees who are facilitating Service User Group Meetings are expected not to influence users discussions even if they are service users themselves. This is in keeping with 'good facilitation practice' where the facilitator must remain impartial.
  1. GAP's Constitution sets out that paid workers of the organisation cannot be voting members so that they cannot unfairly influence the direction of the organisation for their own gain.

Focus Group

Members - disabled people as service users are consulted about their personal opinions with regard to a vast array of issues and by a variety of external agencies about their services. These Focus Groups can include trustees and volunteers who are also service users and therefore interested in the subject of a particular Focus Group Session. However trustees, volunteers and paid workers of Gateshead Access Panel attending or taking part in discussions as a service user, must declare this and have this recorded in the minutes of meetings.

Service Users

GAP employees, trustees and volunteers are invariably service users of the service we are being consulted about and also of our own services. It is important therefore that they can voice their opinions but it is equally important for the situation to be monitored for conflicts of interest and with regard to influencing outcomes for their own gain.

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Implications for GAP's Policy on 'Conflict of Interest'

From our various internal and external discussion so far we have determined that our policy includes or will include:

  1. It is the role of the Chair and the General Manager to ensure that opinions of Paid workers are taken into account but do not overpower or unduly influence - for the workers own gain - the views of the general membership and those attending focus group meetings.
  1. It is the role of the General Manager to ensure that disabled employees are not 'used' as service users simply because they are disabled or consulted inappropriately and to the extent that this affects the work and position of the employee.
  1. Management and non disabled workers must be sensitive to the fact that disabled paid workers often use the Services of the various projects of GAP, for example the Advocacy Project. In this case it is appropriate that the worker has the opportunity to offer opinions on that service.
  1. Paid employees who are facilitating Service User Group Meetings are expected not to influence service users discussions even if they are service users of the service being discussed. This is in keeping with 'good facilitation practice' where the facilitator must remain impartial. This does not mean that the facilitator should not challenge and explain equal opportunity, diversity and rights issues when working with GAP's own focus group.
  1. It is the role of the volunteer organiser to ensure that volunteers are consulted appropriately with regard to their opinions on GAP's own services.
  1. Trustees, volunteers and paid workers of Gateshead Access Panel attending or taking part in discussions as a service user, must declare this and have this recorded in the minutes of meetings.
  1. Where Trustees are also trustees of other organisations they must make it very clear which organisation they are representing at meetings.
  1. If any Trustee, volunteer or paid worker find that they have a conflict of interest in any of their representations for or with the organisation they should stand down from discussions.

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Service User Involvement Strategies

Statutory Organisations are now being encouraged to form strategies around service user involvement. For a statutory organisation to form a policy around Service User Involvement it is very important for their workers to understand the potential conflicts within organisations. Any strategy will of course have implications for voluntary agencies and their service users. From GAP's recent discussions with Gateshead Council's Involvement Worker there is an obvious need to explain not only conflicts of interest but also to discuss four main issues:

What constitutes 'Volunteering'? - this question is raised because a Council worker recently told us (we think wrongly) that 'a volunteer is someone who works in our office'. This has made us realise that although Gateshead Access Panel may be aware of good practice in volunteering we have a duty to be very clear about this issue in our policies and procedures and to inform others.

Whether service users should be paid - for their involvement and what the consequences of such payment are. This is especially important for organisations such as GAP where service users are also Trustees, Paid Workers and Volunteers of the organisation.

What support service users and Volunteers - need to 'carry out' such involvement.

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What is Service User Involvement compared to Volunteering?

Service User Involvement

We consider this to be where service users are acknowledged as 'specialists' with regard to their own needs concerning their own impairments and are consulted about how services are provided for them. GAP has arranged for service users to attend meetings, for example, the Health Improvement Group to explain their experiences of related services in an effort to inform service delivery. Other arenas for such consultation include:

  1. Focus groups for internal purposes and for external agencies.
  2. Public meetings.
  3. Providing case studies/personal experiences during training sessions .
  4. Questionnaires.
  5. Meetings set up for specific discussions.
  6. Seminars and conferences.
  7. Exhibitions.
  8. Reference groups who prefer to be involved at a distance (such as responding to GAP Newsletter items).

In GAP's experience the most effective areas towards improving service delivery is the use of service users' case studies/experiences in training sessions, highlighting case studies in general, focus group activity and through advocacy. The Service User is -

  1. not working strategically,
  2. only representing their own views,
  3. receiving essential but limited support from workers.

 

Volunteering

Volunteers who are service users working strategically - We consider a service user to a be a volunteer if they become involved in every aspect of the processes of service delivery and decision making on an ongoing basis. The intention is that disabled people will be in a stronger position to influence decision making processes and can use their own, other service users experiences (case studies) and GAP's organisational mechanisms to influence change. No payment is paid beyond out of pocket expenses otherwise the volunteer will become classed as an employee of the organisation with full employment rights. This has caused problems for some Charities, Businesses and the Volunteers they have working for them (see Chaudri v Migrant Advisory Service 1997).

The volunteer is -

  1. acting in a voluntary position with an agreement to represent their own organisation for example, presenting their own and others experiences of using services but in line with the organisations policies.
  2. working in a strategic way.
  3. learning new skills, receiving management support and training to carry out the work.
  4. a service user of the services of Gateshead organisations including Gateshead Council, Gateshead Health and so on.

Some officers of the Council have commented to our volunteers 'you should be getting paid for this'. This is perhaps a misunderstanding by the officers concerning volunteer practices (see below) as opposed to service user involvement.

 

Volunteers in other Work Situations

GAP volunteers can work in office based situations such as finance, library, administrative work and/or away from the office in the whole range of our services, auditing, training, advocacy. No payment is paid beyond out of pocket expenses (as noted above).

 

Volunteers working strategically but independent of an organisation

Sometimes officers from the statutory sector recruit service users directly onto their groups and committees. It is of course possible for a disabled person to be involved and not require the above support because they have these skills already and feel they want to act alone without membership of an organisation. GAP's position on this is that the statutory organisation should acknowledge that the person is representing their own opinions and not a constituted body where policies inform their working practices and opinions.

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Input and Support required for Service User Involvement as compared to Volunteering

GAP has always identified that there are different levels of Involvement that disabled people want to take part in. Each level requires a different level of input and commitment from disabled people as either consultees or volunteers. On this basis they also require different levels of support from the organisation. For example, some of GAP's members only want to attend our focus group meetings as service user consultees whilst others want to carry out regular and organised volunteering including unpaid work associated with statutory strategic group meetings.

 

Service Users / disabled people as consultees:

Input: Focus groups, public meetings, questionnaires, meetings set up for specific discussions, one off attendance at 'Community Care' meetings (for example, Welfare to Work, Health Improvement Group, Access Consultation Groups) seminars and conferences, exhibitions, reference groups who prefer to be involved at a distance (such as responding to GAP Newsletter items).

Support required: limited support in the form of accompaniment to single meetings, facilitation of focus groups, briefings for conferences and seminars and post meeting support depending on identified need by service user and training in confidence building.

Pros and Cons of paying service users as consultees:

  1. Jeopardy to benefits.
  1. During a recent GAP focus group meeting it was clear that if service users were paid for their specialist knowledge:
  1. some may only turn up to meetings because of the payment.
  2. some may be swayed from being truly independent and their impartiality may be unclear.
  3. service users who attend such regular meetings may come to depend on the income received.
  1. Trustees of voluntary organisations such as GAP are made up of some of the same service users attending such meetings. Trustees are not allowed to receive any benefit from connection with the organisation they govern under the 'Shared Purse' clause of the Charities Commission Regulations.
  1. There could be a division created between service users - an elite of service users who can receive payments (such as those already in paid employment) and the 'underdogs' (those on benefits or who are Trustees of the organisation) who cannot. In GAP's experience there is no real choice for service users in that they are either able to accept payment or they are not.

 

Service Users / disabled people as Volunteers:

Input: on-going involvement in all processes of GAP's work for example, planning organising, training, audits, consultancy processes, governance, advocacy, on going meetings with Statutory organisations such as Welfare to Work, Health Improvement Group, Access Consultation Groups.

Support Required: full management support as per good practice volunteer organising with for example, regular support and training, goal setting, supervision sessions and reviews. Confidence building, strategic thinking, equal opportunities, diversity and where appropriate training the trainer. A volunteer agreement established to ensure that good working relationships are established and that GAP's policies are upheld by the volunteer.

Pros and Cons of paying service users / disabled people as Volunteers : This would be difficult to justify for the following reasons:

  1. Would be against good practice guidelines for volunteer involvement with the organisations they have agreements with / are committed to.
  1. Could mean that they are seen as being employed by the voluntary or statutory agency paying them anything above out of pocket expenses meaning the volunteer would receive the benefits of employment laws.
  1. Implications for the Charities Commission Shared Purse rules where volunteers are trustees of an organisation.
  1. Volunteers who are already 'at risk' of being called to medical because of their voluntary work would have a double jeopardy situation of having to declare income.

 

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Main differences for involvement of Services Users and Volunteers

Service Users -

 

Volunteers -

 

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Implications of Paying volunteers and service users more than out of pocket expenses.

a. Anyone who agrees to carry out voluntary work and who is receiving benefits (for example, income support, incapacity benefit) must tell the Benefits Agency. Despite volunteering being allowed by the Benefits Agency, in GAP's and many other organisations experience notification of volunteering often leads to a review of the disabled persons ability to work and their benefits. Disabled people including our own members have lost benefits as a result of this.

"I rang the Jobcentre and told them that I had been asked to chair a service user involvement group for £20 once a week. The Jobcentre told me that if I did this they would send me for a review of my incapacity benefits" (community care September 2003).

b. It is possible for disabled people to receive payment for some 'permitted work' whilst claiming incapacity benefit - the amount varies but the intention of payment for permitted work is to encourage disabled people to 'go back to work'. Going back to work is not always the goal of people undertaking Voluntary Work.

Many agencies encourage disabled people to take up employment by stating 'benefits can be guaranteed' whilst the disabled person is carrying out 'permitted' work. This includes voluntary work, permitted work at the lower limit / higher limit and supported permitted work. It should be noted that the following extract indicates that there is no such thing as a guarantee:

Extract from Disability Rights Handbook 28th Edition -

Although work that falls into the permitted work categories is allowed, "it may not be completed ignored. The sort of activities or tasks you are able to do, whether they are connected with the work or not, could be taken into account when deciding whether you pass the incapacity test under the personal capability assessment or the own occupation test. When you start work, the decision maker may in some cases, decide to refer your case to a Department of Work and Pensions doctor for an opinion and you may find yourself subject to another medical examination".

The 'guarantee' is only that the person will receive the same level of benefits but only if they are still entitled to such benefits and they may be called for an immediate medical. Any medical examination that may be due during a period of permitted work will also go ahead.

c. If someone receiving benefits does not declare money paid to them then they may be acting fraudulently and could be charged with a criminal offence - for example if they are in receipt of income support . As far as the Benefits Agency and Employment Services are concerned there is no distinction between being a disabled service user and a volunteer.

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Implications for GAP's Policies on Volunteering and Service User Involvement

a. GAP is committed to assisting disabled people as service users and / or volunteers in overcoming the barriers that exist to them from being involved in our own service delivery planning and those of the statutory sector.

b. GAP is committed to working with private and statutory sectors to encourage and support service user involvement and to assist in explaining a better understanding of service user involvement.

c. GAP adheres to the good practice principles for volunteer organising where guidelines insist that no payment should be received by the volunteer other than out of pocket expenses for the work they are undertaking on behalf of the organisation. GAP trustees will not put the organisation or a disabled person in jeopardy by forming a contract of employment with a service user / volunteer by paying them money above out of pocket expenses that could be construed as wages.

d. GAP would discourage the payment of service users even given that some may be able to receive payment without fear of losing benefits. This is because of :

e. GAP acknowledges that some service users as members of some voluntary groups feel more valued if they are receiving payments for their opinions and involvement. This in principle is up to the groups policy and decision making processes to determine. GAP does not feel it should impose it's views onto these groups and their service users. However we would encourage the need for benefits advice and risk assessment for each service user involved so that they can make informed choices of such risks. Unless there is agreement from Department of Work and Pensions / Benefit Agency that payments and voluntary work can be made / carried out without jeopardising disabled peoples positions (both current and future that is, they won't be asked for interview because they are volunteering or receiving payment) then we feel that there is a risk to consider.

f. GAP believes that if it or any organisation decides to pay volunteers / service users it is the duty of the organisation (whether statutory or voluntary) to inform the service user / volunteer that -

 

g. GAP believes that if payment is made then this should be at least the current minimum wage otherwise rights are being denied to the person being consulted for example, as an "expert". The minimum wage is a minimum standard set to value work supplied and paying less than the minimum wage can be seen as devaluing people.

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Appendix A - GAP Conflict of Interest Policy

 

Introduction

Trustees have a legal obligation to act in the best interests of Gateshead Access Panel and in accordance with Gateshead Access Panels Constitution (Charity's Governing Document)

A Conflict of interest is, where an individual's personal or family interests and loyalties conflict with those of Gateshead Access Panel.

Such conflicts can create problems; for example they can

•  Inhibit free discussion resulting in decisions or actions taken, that are not in the interest of Gateshead Access Panel

•  Risk financial loss to Gateshead Access Panel

•  Risk the impression that Gateshead Access Panel has acted improperly

•  Risk the reputation of Gateshead Access Panel and its trustees, volunteers and employees

•  Risk personal liability suits against trustees

The aim of this policy is to protect the organisation and the individual(s) involved from any appearance of impropriety.

Declaration of Interests

In order to protect Gateshead Access Panel, all staff must declare and record any conflicts of interest including any gifts or hospitality received or offered whilst carrying out their duties.

A Declaration of Interests Form, reference GAPDOI2, is provided for this purpose.

It is necessary that the information supplied is, accurate and correct at all times. Staff should always ensure that any changes are recorded as and when they occur. In addition the Board of Trustees will review all declarations on an annual basis.

Should any member of staff be unsure of what to declare, or whether or when a previous declaration needs to be amended, please err on the side of caution.

Should you wish to discuss this issue further or any aspect concerning Conflict of Interest, please contact XXXXXXXXXXXXX, for confidential guidance.

The Declaration of Interests Form, GAPCOI2, will only be accessible by XXXXXXXXXXXXXXX, (level of access required in accordance with Data Protection Act).

Data Protection

The information supplied will be processed in accordance within the principles of the Data Protection Act 1998. Data will only be processed for the purpose of providing protection to Gateshead Access Panel and will not be used for any other purpose.

Trustee's Annual Report

Should a trustee receive any authorised benefit in accordance with the Charity Commissions Regulations, this information must be recorded in the Trustee's Annual Report. (SORP 2000 Regulations)

Declarations Made

Once a declaration of interest has been made, you, your carer/personal assistant or service user, may not take part in any decisions from which you may personally benefit. You must declare your interest at the earliest opportunity and withdraw from any subsequent discussions.

However, you may participate if

•  The benefits outweigh the risks, enabling Gateshead Access Panel to achieve the desired outcome

•  The benefits are universal to service users of Gateshead Access Panel irrelevant of their connection to you, as the risks are minimal;

•  Where it has been agreed that your input is necessary

Where a trustee, volunteer or employee of Gateshead Access Panel attends or takes part in discussions as a service user, they must declare this immediately. This must also be recorded in the minutes of the meeting.

If an individual fails to declare an interest that is known by any trustee, the trustee must declare this interest on behalf of the individual in order to prevent a breach of trust and or breach of duty to all concerned.

In any event where the Board of trustees must decide if an individual has a conflict of interest, the decision will be made by vote, with a majority vote prevailing. Trustees may not vote if this affects their own interests.

Any discussions that have taken place concerning a conflict of interest will be recorded and reported in the minutes. The report will include

•  The nature and extent of conflict

•  An outline of the discussion

•  Action taken to manage the conflict

Where a conflict cannot be resolved, external mediation will sort.

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