The role of community representatives on health service committees: staff expectations vs. reality

Objective: This paper examines staff views about legitimacy of different roles for community representatives sitting on health service committees as part of a formal Community Participation Program (CPP) in an Area Health Service (AHS) in Australia.

Design: A cross-sectional survey using a self-completed questionnaire by staff on committees with community representation in the AHS in 2008.

Setting: The study site has a population of approximately 1.4 million and covers 6000 km2. The population is ethnically and socio-economically diverse.

Results: There are generally positive staff attitudes at this AHS for community participation as part of the CPP with positive impacts identified, including on service delivery and the conduct of health service meetings. Most saw community representatives having legitimate roles in representing the community, improving communication between the health service and the community and providing constructive feedback. However, staff expectations about the community’s role on committees do not match the reality they say they observe and less than half the staff thought the community and health service agree on the role of community representatives.

Conclusions: As well as reviewing and enhancing training and support for representatives and staff as part of the CPP, there is a need to question staff expectations about community members who sit on health service committees and whether these expectations are shared by other key stakeholders, most notably the community representatives themselves. These expectations have implications for the CPP and for similar programs designed to engage community members on committees and working groups with health professionals.