Abstract
BackgroundThe launch in 2017 of the Irish 10-year reform programme Sláintecare represents a key commitment in the future of the health system. An important component of the programme was the development of a health system performance assessment (HSPA) framework. In 2019, the Department of Health of Ireland (DoH) and Health Service Executive (HSE) commissioned the technical support of researchers to develop an outcome-oriented HSPA framework which should reflect the shared priorities of multiple stakeholders, including citizens. This study describes the method applied in the Irish context and reflects on the added value of using a citizen panel in the development of an HSPA framework.MethodsA panel of 15 citizens was convened, recruited by a third-party company using a sampling strategy to achieve a balanced mix representing the Irish society. Panellists received lay-language preparatory materials before the meeting. Panellists used a three-colour scheme to signal the importance of performance measures. An exit questionnaire was administered to understand how participants experienced being part of the panel. The citizen panel was the first in a series of three panels towards the development of the HSPA framework, followed by panels including representatives of the DoH and HSE, and representatives from professional associations and special interest groups.ResultsThe citizen panel generated 249 health performance measures ranging across 13 domains. Top-ranking domains to the citizen panel (people-centredness, coordination of care, and coverage) were less prioritized by the other panels; domains less prioritized by the citizen panel, such as accessibility, responsiveness, efficiency, and effectiveness, were of higher priority in the other panels. Citizen panellists shared a similar understanding of what a citizen panel involves and described their experience at the panel as enjoyable, interesting, and informative.ConclusionsThe priorities of the citizen panel were accounted for during all phases of developing the HSPA framework. This was possible by adopting an inclusive development process and by engaging citizens early on. Citizen engagement in HSPA development is essential for realizing citizen-driven healthcare system performance and generating trust and ownership in performance intelligence. Future research could expand the use of citizen panels to assess, monitor, and report on the performance of healthcare systems.
Highlights
The launch in 2017 of the Irish 10-year reform programme Sláintecare represents a key commitment in the future of the health system
This study aims to describe the method applied in the Irish context to convene a citizen panel for the purpose of developing an health system performance assessment (HSPA) framework, and to reflect on the added value of using a citizen panel in the development of an HSPA framework
We described the methods of using a citizen panel as a key element of the development of an outcome-oriented HSPA framework for Ireland
Summary
The launch in 2017 of the Irish 10-year reform programme Sláintecare represents a key commitment in the future of the health system. Citizen engagement processes can take on varied forms, such as citizen panels, focus groups, citizen juries, consensus conferences, or citizen assemblies [16, 17] These methods are distinct from more passive approaches focused on preference elicitation, such as polling and surveying. Citizen panels put emphasis on empowering citizens to actively deliberate in processes that precede policy-making [18] This contribution is presumed to have important advantages in supporting ownership, legitimacy, and fairness in priority-setting processes, as well as building public trust and greater acceptance in decisions [5, 19]
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