Involving citizens in the design and delivery of services has become a key lever in the drive for public service improvement. The reform of health and social care through the development of personalised budgets where disabled and older people receive direct payments to allow them to arrange and buy their own support services instead of getting them from their local council, is putting the theory of citizen involvement into practice.

Currently most public services are based on the principle of consumerism. In the context of social care this means that users are viewed as patients in need of timely and effective services from the local council or the NHS. This view requires that the professionals deploy their knowledge and skills to solve a problem for the user.

Citizen involvement requires a shift away from a ‘consumerist’ to a ‘co-production’ perspective where the users are co-producers of the services. Co-production means that users are active participants in the process. They decide to manage their lives in a different way, rather than being dependent users.

The effect of this shift is that the job of the professions changes from finding the solution to building up the knowledge and confidence of the users to take action themselves. Users self-manage their health without turning to the professionals. The professionals deploy their knowledge to help the users devise their own solutions which might involve smoking cessation programmes to exercise regimes.

The 2007 Varney report on public service transformation described the next stage in public service reform as critically involving the greater engagement of citizens and businesses in service design and delivery. Developing this co-production approach across all local government functions means that councils will need to conceive of themselves as primarily commissioning organisations so that they can deliver the kinds of changes required.