The participation of children and young people in decisions about UK service development.
BACKGROUND
The involvement of children and young people in decisions regarding service development is well supported in government policy and underpinned by the UN Convention on the Rights of the Child. Information on the extent, nature and outcomes of children and young people's participation can inform further development in this area.


METHODS
Systematic literature searches, plus contact with professional networks, were used to gather and review evidence on children and young people's participation.


RESULTS
There is a rapidly developing body of information describing and analysing innovative practices in this field. However, there is also a smaller, but substantial, amount of evidence demonstrating the limited extent of current involvement. A good deal of guidance is now available about how to promote the involvement of children and young people. However, the basis of this advice is not always clear, and more evidence about children's views and their experience of participation in public decision-making is required. Issues identified as barriers to change included adult attitudes and intransigence, lack of training for key adults, lack of clarity leading to tokenism, the nature of organizations (i.e. their formality, complexity, bureaucracy and internal politics) and the short-term nature of much funding. The evidence suggests that good practice includes a listening culture among staff, clarity, flexibility, adequate resources, skills development and training for staff and participating children and young people, inclusion of marginalized groups, feedback and evaluation. There is only limited evidence that children and young people's involvement in public decision-making leads to more appropriate services, although there is evidence that participating children and young people benefit in terms of personal development and that staff and organizations learn more about their views.


CONCLUSIONS
The value of the participation of children and young people in public decision-making is now well accepted, and is recognized in the standards set in the Children's National Service Framework. However, there is an urgent need for internal and external evaluations of children's involvement.
Cavet
J
J
Social Policy Research Unit, University of York, Heslington, York, UK.
Sloper
P
P
D000293:Adolescent; D002648:Child; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000379:methods; D006296:Health Services / Q000592:standards*; D006801:Humans; D010358:Patient Participation; D006113:United Kingdom