PURPOSE: The UK Department of Health has made clear statements about the need to involve the users of health services, and their carers, in the development and evaluation of NHS services. However the methodology to support such involvement is in its infancy. This paper draws on published literature and the experience of the authors in this area. It provides a critique of the current position and offers a model for the constructive and positive involvement of service users and carers in health services. RELEVANCE: Physiotherapists, along with other members of rehabilitation teams, have been described in the disability literature as 'part of the problem, not part of the solution' to the issues faced by disabled people in accessing and using appropriate services. One of the longstanding criticisms of health services is that they are designed for the benefit of the people who work in them, not for the people who use them. In order to move on from this perspective a true partnership approach needs to be developed. DESCRIPTION: Three projects which had service users involved will be described, along with a critique of the approaches used. Wheelchair services in North Derbyshire, UK, were set up in accordance with a model produced jointly by therapists and wheelchair users; a project to reduce the incidence of pressure sores within a defined geographical area (North Derbyshire, UK) was designed, run and evaluated jointly with service users; and a research project examining the overlap of occupational therapy and physiotherapy had service user involvement (West Yorkshire, UK). OBSERVATIONS: The degree to which service users were successfully involved in these projects varied and reasons for this are suggested in this paper; barriers to service user and carer involvement are identified and related to the literature; the theoretical frameworks from which therapists and service users approach the development of services is discussed and a model identified to allow a common approach to be developed. CONCLUSION: It is essential that physiotherapy services, along with other health care services, are able to involve service users meaningfully in the development and evaluation of the services they provide. As more and more services set up arrangements to allow for service users and carers to be involved it is essential that a knowledge base is built up to support this work. This paper contributes to this knowledge base. Future work will be needed to evaluate the impact involving service users and carers has on service delivery. It is recommended in this paper that such evaluation of outcome is an integral part of service delivery.
ORCID: 
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)