Setting Primary Health and Social Care Priorities Using a Deliberative Democratic Participatory Approach

Introduction

Publicly funded regional primary health care investments are usually informed by analysis of locally collected data, surveys, focus groups and consultations. We wanted a deeper understanding of baseline health and social care priorities in culturally diverse Western Sydney. If WentWest could understand the priorities, the operational agenda for commissioning services could be tailored around them. This research describes the organisation, conduct and recommendations of a citizens' jury in 2023.

Methods

Thematic analysis of the transcribed facilitated discussions identified the well-informed priorities of a diverse and representative group of Western Sydney citizens. Listening to internal and external advisory groups delivered communication pathways, expert presenters, handbook preparation and practical support for the jury event. Consistent with the principle that research about the community should include the community, four consumer advisors were colleagues in the research team.

Results

The jury supported a focus on prevention, including early intervention to keep children thriving and connected at school, and better cross-sectoral bonds via coalitions to enable social care to be linked to health care. Team-based care in general practice for proactive data use and building a culture for relationship-based care, developing a patient-centred workforce through incentivising students and expediting registration of overseas trained health workers were recommended. Assets-based community development was seen as an essential approach in linking the community with these recommendations.

Conclusion

The use of citizens' juries in primary health settings is rare. In this culturally diverse community, WentWest now has a foundational understanding of what investments will deliver and has committed to institutionalising this deliberative approach into a permanent citizens assembly.

Patient and Public Contribution

The design of the jury was guided by several advisory groups across the local region. The research team included four consumer advisors to provide overarching feedback and external insights. The jurors were selected to be representative of the regional community. They developed the recommendations reported in this article.

Trial Registration

This research does not involve clinical trials.