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Weak and strong publics: drawing on Nancy Fraser to explore parental participation in neonatal networks

Andrew J Gibson1, Gillian Lewando-Hundt, Loraine Blaxter

  • 1Research Fellow in Patient and Public Involvement, Peninsula Medical School, Exeter, UKProfessor, Institute of Health, University of Warwick, Coventry, UKSenior Research Fellow, Institute of Health, University of Warwick, Coventry, UK.

Health Expectations : an International Journal of Public Participation in Health Care and Health Policy
|November 2, 2011
PubMed

Insights

Parental involvement in neonatal network boards is varied, but often remains a "weak public." Parent representatives have limited influence on decision-making processes in neonatal services.

Area of Science:

  • Healthcare Governance
  • Public Health Policy
  • Neonatal Care Management

Background:

  • Growing emphasis on patient and public involvement in healthcare governance.
  • Limited research on long-term patient involvement and its theoretical underpinnings in corporate decision-making.
  • Need to understand the dynamics of parental engagement in specialized healthcare networks.

Purpose of the Study:

  • To analyze parental involvement in managed neonatal network boards using Nancy Fraser's concepts of weak and strong publics.
  • To examine the nature and extent of parental representation on these boards.
  • To theorize the process of patient and public involvement in healthcare decision-making.

Main Methods:

  • Repeated surveys of neonatal network managers in England (2006-07).
  • Case studies of four neonatal networks, including interviews with managers and parent representatives.
  • Observation of meetings and analysis of board minutes to assess parental representation and influence.

Main Results:

  • A diverse range of parental involvement strategies were identified across neonatal networks.
  • Approaches varied from no parental involvement to structured systems linking parent representatives to neonatal unit parents.
  • Parent representatives were found to have limited participation and influence on decision-making.

Conclusions:

  • Parental participation in neonatal services currently exemplifies a 'weak public'.
  • The limited influence of parent representatives restricts their ability to impact decisions within neonatal network boards.
  • Further development is needed to strengthen parental influence and achieve more robust public involvement.
Abstract

Keywords:
Fraser_managed clinical networkshealth policyneonatal carepatient and public involvement

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