Open Government Partnership

Involving people in developing, designing, and improving health and care services in Scotland: an introduction 

September 12, 2025 by Open Government Team No Comments | Category Uncategorized

Rachel Dowle from the Office of the Chief Designer tells us what it is like being part of the team driving forwards the very first Open Government commitment for Health and Social Care in Scotland.  

This piece is the first of a number of posts that Rachel and the team will publish, exploring different aspects of our commitment to Health and Social Care. 

Our commitment within the 2021-2025 National Action Plan 

“We will improve and increase both service user / participant, and service delivery staff, in the development, design and improvement of health and care services in Scotland.”

This commitment focuses on the quality of public participation, which is one of the core principles for the Open Government Partnership. We want to ensure that people can understand and be involved in the decisions that affect them. 

Involving people in decision-making 

My own personal reflection is that there is a lot of engagement that takes place across government, and we need to ensure that all of it meets the standards set out in Scottish Government’s participation guidance. However, we are often told by communities and organisations we work with that they don’t feel that this is always the case. 

In particular, we often hear that people feel they are asked to share their experiences a lot but don’t see what change that brings about. We also hear that they would like to be more involved in making decisions. If we are committing to working in partnership with people, how do we avoid falling short by listening to the voice of, but not sharing back? How do we create opportunities for the people behind those voices to be more involved in the creative thinking and decisions that follow on from listening? How are we keeping people safe when asking them to contribute their life stories and experiences? And how do we make sure those perspectives contribute meaningfully to public services that meet people’s needs? 

All of this requires real thought about the right engagement approach, planning how to reach a diverse range of people, and providing inclusive and accessible ways to take part in activities which are not only listening exercises. That might be taking part in research, contributing to focus groups, working together to produce insights, creatively coming up with ideas, testing concepts to see if they work, taking part in decision-making… this list goes on. And of course, once all that work is done, it should be clear to everyone what has happened with the outputs and that their time and efforts have been worthwhile, even if changes to policy and legislation take time. 

Ultimately, good quality participation builds trust. Trust is vital for a functioning democracy that can deliver meaningful change. We need people who are willing to be part of the process to develop, design, and improve policy because they trust that their input will have impact.  

Peer support and collaboration 

As a vehicle, Open Government is a great way to access peer support and to learn about the innovative work happening across Scottish Government. As part of our commitment, we’ve been lucky to have Susan Paxton from the Scottish Community Development Centre as co-chair, as well as the involvement of our civil society group the Health and Social Care Third Sector Collaborative.  

These relationships help shape our work and outputs. Having time and space to reflect on how we can strengthen participation, regardless of any specific policy, allows for a different kind of conversation. 

This is about creating opportunities for more people to be more involved in all stages of the design of policy and services. Trusting relationships are rooted in accountability and openness, but they need to be nurtured and strengthened by  working together on our shared challenges. 

Creating safe and inclusive spaces 

While we are still on a journey, in Health and Social Care we’ve focused delivery in key areas with the aim of creating safe and inclusive spaces for partnership working. This is in recognition that if we expect people to work differently, we need to provide support for everyone involved – those commissioning the work, those delivering the work, and of course those who have experience of accessing or delivering services and members of the general public. Everyone brings a different perspective. 

During the delivery of the commitment we’ve enabled co-design sessions all over the country. These have been focussed on learning from, thinking with, and making recommendations with people with lived experience – reaching communities that may otherwise have been left out. Where we do capacity building through training and coaching, we aim to support the development of findings and insights that are robust, as well as accessible to others, so that they can be used in other policy or service design projects.

Going forward 

Of course we have a lot still to do. I’m looking forward to wrapping up the current commitment, which includes reflecting on and sharing what we’ve achieved and what we can do better, before working with the Open Government group, and those who have been involved in the delivery of the commitment so far, on where next National Action Plan might take us. 

Stay informed

Subscribe to the Trust and Transparency in Scotland Community Bulletin for regular updates on Open Government commitments as well as opportunities to get involved and contribute to the growing community around trust and transparency in Scotland.  

Find out more about the co-design work with seldom heard voices.

Watch a series of introductory videos to our GIRFE approach.

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