What is a consumer representative?

A consumer representative is a member of a government, professional body, industry or non-governmental organisation committee who voices consumer perspectives and takes part in the decision-making process on behalf of consumers. This person is nominated by, and is accountable to, an organisation of consumers. In the case of maternity consumer representation on behalf of MCN, you would be accountable to our organisation, whilst representation the views of our members and broader maternity consumers.

Consumer representatives often hear other committee members say that they are also a consumer and can act as a consumer representative. Everyone is a consumer, but not every committee member can represent consumers. Other committee members such as midwives, researchers or Obstetricians are usually placed on the committee to represent those perspectives. They cannot possibly do this and represent maternity consumers at the same time. Only those people whose primary experience is as a consumer can represent a consumer perspective because their judgment is not clouded by another perspective.

What is the role of a consumer representative?

The role of a maternity consumer representative is to provide a consumer perspective. This often differs from a bureaucratic, service provider, industry, academic or professional perspective. The role of the consumer representative involves:

Protecting the interests of consumers, service users and potential service users
Presenting how consumers may think and feel about certain issues
Contributing consumer experiences
Ensuring the committee recognises consumer concerns
Reporting the activities of the committee to consumers
Ensuring accountability to consumers
Acting as a watchdog on issues affecting consumers
Providing information about any relevant issues affecting consumers
Voices consumer perspectives.
Takes part in decision making process on behalf of consumers.
Nominated by and accountable to an organisation of consumers.
More information here (Consumer Health Forum):
http://elearning.ourhealth.org.au/guidelines/index.htm

Limits to the role of a consumer representative

A committee should not expect the consumer representative to:

Have a technical background in the subject under discussion. The consumer representative provides consumer perspectives on an issue. Most consumers are not technical experts in medicine or research but have legitimate interests in it.
Undertake consumer consultations beyond what is required to inform their own input at the meeting or to ensure their own accountability to their constituency. If wider consumer consultation is required, the consumer representative can advise the committee on how this might be achieved but should not undertake the work themselves.
You can find more on the CHF (Consumers Health Forum) website: https://chf.org.au/guidelines-consumer-representatives
Watch: https://www.youtube.com/watch?v=ikAfQYacRZA&list=PL0hT8LUg95rTKXy-f2aWrhe-A2fvcmdh

NSQHS Standards mean hospital and health services NEED consumer representatives

The NSQHS Standards were developed by the Australian Safety and Quality Commission in collaboration with the Australian Government, states and territories, private sector providers, clinical experts, patients and carers. The primary aims of the NSQHS Standards are to protect the public from harm and to improve the quality of health service provision. The eight NSQHS Standards provide a nationally consistent statement about the level of care consumers can expect from health services. As part of a hospital accreditation process, they need to demonstrate evidence of meeting these standards. The one that is most applicable to us as consumer representatives is the "Partnering with Consumers Standard".

Intention of this standard

The Partnering with Consumers Standard aims to create health service organisations in which there are mutually beneficial outcomes by having:

consumers as partners in planning, design, delivery, measurement and evaluation of systems and services
patients as partners in their own care, to the extent that they choose.

The Partnering with Consumers Standard recognises the importance of involving patients in their own care and providing clear communication to patients. This standard, together with the Clinical Governance Standard, underpins all the other standards.

Consumer partnerships add value

Consumer partnerships add value to healthcare decision-making. Consumer involvement in the development, implementation and evaluation of health care contributes to2, 3:

Appropriately targeted initiatives
Efficient use of resources
Improvement in the quality of care provided by a health service.

There is growing acceptance that practices supporting partnerships at the level of the individual – from communication and structured listening, through to shared decision making, self-management support and care planning – can improve the safety and quality of health care, improve patient outcomes and experience, and improve the performance of health service organisations.6

As consumer partnership becomes more embedded in the healthcare system, there is an increasing need to monitor and evaluate its impact. Monitoring, measuring and evaluating consumer partnerships – through mechanisms such as recording patient experience and patient-reported outcome measures – are vital to ensure that the partnerships are meeting the needs of the community and consumers. More here: https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard

Watch:https://www.youtube.com/watch?v=8_NizT6izvM&list=PL0hT8LUg95rTKXy-f2aWrhe-A2fvcmdhZ&index=9

Questions to contemplate:

What are the clinical benefits of partnering with consumers?

What are some of the various ways consumers can be involved in the health system?

Other tips:

Most consumer representatives gain consumer representative positions on various committees or advisory group. Some tips on what to expect (whilst some committees and employees of the health system are great and are well viced on how to engage with consumers, most are not). You should:

Be provided with the:

- Terms of Reference

- agenda

- accompanying documents that need reading/reviewing before the meeting

Also be aware there is an expectation you are reimbursed for your time (after all, everyone else is being paid for their time). Here are the recommended pay rates (though many health services don’t reimburse, it’s something we are continually advocating for). Here is recommended consumer reimbursement rates: https://drive.google.com/open?id=0B-gOcYGYQT7RMVZBV0M1aXV2dzNwTnlKeWZaZllmNUFZR1ln

What do I need to be “on the lookout for?” when contributing to the health system as a maternity consumer representative?

- Woman centred care- directed by the woman, for the woman. Sometimes you may hear patient centred care, or woman-centred care as encompassing the woman and her family (but not every woman will want her family involved in her care). Women should also be contributing at all levels of policy development, including decisions such as where maternity services are based, hospital policies, MGP criteria,

- Informed consent/ informed decision making- benefits and risks explained, then the woman is the ultimate decision maker. Free of coercion/bullying. Be aware of the language in meetings, forms you provide feedback on etc.to ensure they do align with providing informed consent.

- evidence based care- where is the evidence from? Is it high quality evidence? Cochrane Reviews are highest quality of evidence. You’ll find every scientific report should be assigned a number- 1 is highest quality, 5 is lowest. These assignments of numbers or grading take into account the population, the significant different, controlling variables etc. Randomised control trials (RCTs) are usually also useful (but not always). It’s not your job to understand the evidence/research, but just be aware of how “evidence” can be used to support opinion, even though the quality of evidence may be poor. Here is an article which is quite detailed in explaining evidence;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124652/

Being an advocate is equally as important:

Alongside consumer representation, advocacy is just as important for change. As an organisation, most of our advocacy is at Federal Level, because we see funding reform and accountability as a huge step (imperative!) to achieving woman-centered care and moving towards continuity of midwifery carer. Individually, we lobby in our local area too.

We regularly use the media, meet with Members of Parliament (state and Federal), hospital executives, send letters and rally to help highlight the importance of our issues and evoke change. Here in an infographic to provide an overview of what we have been lobbying for federally: